ABSTRACT
PURPOSE: This study explored the role of the Health Belief Model in predicting breast cancer screening among women in rural Appalachia. Health beliefs (perceived susceptibility to breast cancer, severity of breast cancer, and benefits and barriers to screening) were used to predict health behavior (mammogram frequency). METHOD: A total of 170 women aged 18-78 were recruited at a free health clinic in central Appalachia. Women completed surveys that assessed demographic characteristics, mammogram frequency, and perceived susceptibility, severity, and benefits and barriers to mammography. FINDINGS: Consistent with expectations, women with objectively elevated risks for breast cancer (history of abnormal mammograms or family history of breast cancer) perceived themselves to be at higher risk for breast cancer, and those with a history of abnormal mammograms were more likely to receive mammograms regularly. In addition, older women expected their prognosis to be marginally poorer following a diagnosis, perceived greater benefits and fewer barriers to mammography, and were significantly more likely to receive mammograms regularly. Consistent with the Health Belief Model, fewer perceived barriers to mammography predicted greater mammogram frequency. However, the model was not fully supported because perceived susceptibility, severity, and benefits to mammography did not predict mammogram frequency. CONCLUSIONS: Results highlight the importance of reducing real and perceived barriers to screening in order to improve mammography rates among rural populations.
Subject(s)
Breast Neoplasms/diagnosis , Health Knowledge, Attitudes, Practice , Mass Screening/psychology , Adolescent , Adult , Aged , Appalachian Region , Early Detection of Cancer/psychology , Female , Health Behavior , Humans , Insurance, Health/statistics & numerical data , Mass Screening/methods , Middle Aged , Prognosis , Risk Assessment/methods , Risk Assessment/standards , Rural Population , Surveys and QuestionnairesABSTRACT
Consistent with a Diathesis × Stress model, it was hypothesized that anxious solitude (individual vulnerability) and the middle school transition (environmental stress) would jointly predict peer exclusion and victimization trajectories. Youth (N = 688) were followed from 3rd through 7th grade, with the middle school transition in 6th grade. Peer-reported peer exclusion and physical victimization trajectories across the middle school transition were modeled with piecewise growth curves. As expected, anxious solitude predicted elevated exclusion and victimization in both elementary and middle school. Nonetheless, exclusion and victimization declined after the transition on average, and anxious solitary youth versus average youth experienced greater relative declines. The pattern of results suggests that the collective renegotiation of peer relations after the transition, rather than posttransition decline in classroom emotional support, contributed to the posttransition decline in peer mistreatment.
