This dissertation study tested the Fear and Mammography Adherence Model (FMAM), a theoretical framework proposed by the researcher, to predict mammography adherence. Grounded in the Health Belief Model and the Extended Parallel Process Model, the FMAM theorizes that perceived susceptibility to breast cancer, self-efficacy, perceived benefits of mammography, and breast cancer fatalism explain breast cancer fear. In turn, both an emotional and a cognitive component of fear, breast cancer fear and mammography fear, explain mammography adherence. The research participants were African American women, 42 years of age and older, who never had breast cancer and resided in the greater Bridgeport, Connecticut area. A self-administered questionnaire was completed by women attending Sunday services at five churches. There were 144 questionnaires included in the analysis. Results of regression analyses provided partial support for the FMAM in that perceived susceptibility to breast cancer, self-efficacy, perceived benefits of mammography, and breast cancer fatalism predicted breast cancer fear [F(4,129) = 7.96, p < .001], with self-efficacy (beta = -.213, p = .022), and breast cancer fatalism (beta = .317, p < .0005) making a significant unique contribution. Both components of fear, breast cancer fear and mammography fear, predicted mammography adherence [X2 (3, N = 138) = 9.31, p = .025]. Mammography fear made a unique contribution to explaining mammography adherence (OR = 0.933, p = .027). Yet, the hypothesized curvilinear relationship in the shape of an inverted U between breast cancer fear and mammography adherence was not supported. The results of logistic regression should be interpreted with caution because mammography adherence was exceptionally high (91%) for this group of well-educated African American women with excellent access to health care and to mammography. Results of this study provide support for defining and measuring two components of fear, as both the Breast Cancer Fear Scale and the Mammography Fear Scale demonstrated validity and reliability for this group of respondents. Future research could explore the sources of breast cancer fear for African American women. The study findings on mammography fear could be used to improve the physical and interpersonal environment within which a woman has her mammogram.
|Advisor:||Taub, Alyson Z.|
|Commitee:||Guttmacher, Sally G.|
|School:||New York University|
|Department:||Nutrition, Food Studies, and Public Health|
|School Location:||United States -- New York|
|Source:||DAI-B 73/01, Dissertation Abstracts International|
|Subjects:||African American Studies, Womens studies, Public health|
|Keywords:||African American women, Breast cancer, Fear, Mammography|
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