Stages of Change for Mammography Among Mexican Women and a Decisional Balance Comparison Across Countries

• Published in: Journal of cancer education Vol. 33; no. 6; pp. 1230 - 1238
• Main Authors: Salinas-Martínez, Ana María, Castañeda-Vásquez, David Emmanuel, García-Morales, Norma Guadalupe, Oliva-Sosa, Norma Edith, de-la-Garza-Salinas, Laura Hermila, Núñez-Rocha, Georgina Mayela, Ramírez-Aranda, José Manuel
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-12-2018; Springer Nature B.V
• Subjects: Biomedical and Life Sciences; Biomedicine; Breast cancer; Cancer Research; Females; Mammography; Pharmacology/Toxicology; Reference Groups; Self Efficacy; Statistical Significance; Mammography; Breast cancer; Transtheoretical model; Stages of change
• ISSN: 0885-8195; 1543-0154
• DOI: 10.1007/s13187-017-1236-1

An analysis of the adoption of secondary preventive behaviors is significant in regions with disparities in mammography use and breast cancer survival. Therefore, we determined the cognitive factors and the degree to which they differentiate stages of change in mammography among Mexican women. We also compared the decisional balance performance at Mexico, Switzerland, South Korea, and the USA. A cross-sectional study was designed for women in the stages of precontemplation (
n
 = 240), contemplation (
n
 = 243), action (
n
 = 205), maintenance (
n
 = 311), and relapse (
n
 = 348). We only considered those ≥40 years with no cancer history. We measured the
pros
,
cons
, and self-efficacy, among other components. The decisional balance was estimated, and the result was transformed into T-scores. Odds ratios (OR) and 95% confidence intervals (CI) were estimated with multinomial logistic regression using precontemplation as the reference group. The decisional balance distinguished stages partially: in contemplation, the OR was 1.26 (95%CI 1.08, 1.47) and in maintenance, 1.34 (95%CI 1.13, 1.59); in action and relapse, the statistical significance was marginal (
p
 < 0.10). The decisional balance T-score performance registered variations among countries. Additionally, the effect of self-efficacy progressively ascended from contemplation to action and maintenance (OR = 1.29 [95%CI 1.05, 1.58], 1.53 [95%CI 1.20, 1.96], and 2.48 [95%CI 1.82, 3.39], respectively). Furthermore, risk perception and severity did not have an effect on stages of change among Mexican women. Recognition of what provokes action in a population is a key factor in the efficacy of screening programs. Variations among countries highlight the necessity for importance of investigating cognitive determinants for mammography in specific areas.