Lechner L, de Vries H, Offermans N
Department of Health Education & Promotion, University of Maastricht, The Netherlands.
Prev Med. 1997 Jul-Aug;26(4):473-82. doi: 10.1006/pmed.1997.0161.
This study analyzed the relationship between past screening behavior, determinants, intention, and future screening participation in the Dutch national breast cancer screening program.
Participation at the first and second screening rounds was monitored. Furthermore, between the first and the second screening rounds, women received a questionnaire (response 58%, n = 395). The questionnaire was based on the ASE model, including attitude (consequences, anticipated regret, and moral obligation), social influence (support and modeling), and self-efficacy. Other distal variables assessed were previous screening behavior, evaluation of screening characteristics, and demographics.
Participants at the second screening differed from nonparticipants on all ASE determinants. Stepwise multiple regression analyses showed that for previous participants and nonparticipants different ASE determinants and distal variables explained the variance in intention to participate in the next screening (30 to 45%). Logistic regression analyses showed that past behavior and intention (which mediated the effects of the ASE variables) were significant predictors of participation in the second screening.
Differences between previous participants and nonparticipants in determinants of intention and future screening behavior can be used to improve participation and adherence to breast cancer screening.
本研究分析了荷兰国家乳腺癌筛查项目中既往筛查行为、决定因素、意愿与未来筛查参与情况之间的关系。
监测首轮和第二轮筛查的参与情况。此外，在首轮和第二轮筛查之间，女性接受了问卷调查（回复率58%，n = 395）。该问卷基于ASE模型，包括态度（后果、预期遗憾和道德义务）、社会影响（支持和榜样作用）以及自我效能感。评估的其他远端变量包括既往筛查行为、对筛查特征的评价以及人口统计学特征。
第二轮筛查的参与者在所有ASE决定因素方面与未参与者存在差异。逐步多元回归分析表明，对于既往参与者和未参与者，不同的ASE决定因素和远端变量解释了参与下一轮筛查意愿的差异（30%至45%）。逻辑回归分析表明，既往行为和意愿（介导了ASE变量的影响）是第二轮筛查参与情况的显著预测因素。
既往参与者和未参与者在意愿决定因素及未来筛查行为方面的差异可用于提高乳腺癌筛查的参与率和依从性。
