Structural equation modeling for implementation intentions, cancer worry, and stages of mammography adoption

• DOI: 10.1002/pon.3293
• Publication Date: 2013-05-10T07:50:46Z
• Authors: Kei Hirai; Kazuhiro Harada; Aiko Seki; Miwa Nagatsuka; Hirokazu Arai; Ayako Hazama; Yoshiki Ishikawa; Chisato Hamashima; Hiroshi Saito; Daisuke Shibuya
• Keywords: Adult; Breast Neoplasms; Intention; Anxiety; Middle Aged; Models, Psychological; Patient Acceptance of Health Care; 3. Good health; 03 medical and health sciences; Logistic Models; Japan; Humans; Female; Psychological Theory; 0305 other medical science; Attitude to Health; Early Detection of Cancer; Mammography

AbstractObjectivesThis study aimed to develop a structural model for mammography adoption in Japanese middle‐aged women by using constructs from the transtheoretical model (TTM), the theory of planned behavior (TPB), implementation intentions, and cancer worry.MethodsQuestionnaires based on items including TTM, TPB, implementation intentions, cancer worry‐related variables, and demographic variables were distributed to 1000 adult women aged 40 to 59 years, with 641 subjects being used in the final analysis (response rate = 64.1%).ResultsRegarding the stage of adoption, 79 participants (12.3%) were at the precontemplation stage, 30 (4.7%) were at the relapse stage, 142 (22.2%) were at the contemplation stage, 88 (13.7%) were at the action stage, and 302 (47.1%) were at the maintenance stage. Our model, derived from structural equation modeling, revealed that the stage of mammography adoption was significantly affected by goal intentions, implementation intentions, perceived barriers, history of breast cancer screening, and relative risk. A logistic regression analysis revealed that goal intentions and implementation intentions significantly predicted mammography uptake within 1 year.ConclusionThis study developed an integrated model constructed from TTM, TPB, implementation intentions, and cancer worry to account for mammography adoption in Japan, and also confirmed the predictive validity of the model. Copyright © 2013 John Wiley & Sons, Ltd.