Facilitator Psychological Constructs for Mammography Screening among Iranian Women

Background: While many researchers often use a theoretical framework for mammogram repeat interventions, it seems they do not apply an identified mediation analysis method. The aim of this study was to determine the mediators of mammogram replication behavior in two tailored interventions for non-adherent Iranian women. Materials and Methods: A sample population of 184 women over 50 years old in Sanandaj, Iran, was selected for an experiment. Participants were randomly allocated into one of the three conditions: 1) an intervention based on the Health Belief Model (HBM) 2) an intervention based on an integration of the HBM and selected constructs from the Theory of Planned Behavior (TPB), and 3) a control group. Constructs were measured before the intervention, and after a 6-month follow-up. Results: Perceived self-efficacy, behavioral control, and subjective norms were recognized as mediators in the HBM and selected constructs from the TPB intervention. Perceived susceptibility, severity, barriers, self-efficacy and behavioral control met the criteria for mediation in the HBM intervention. Conclusions: This study was successful in establishing mediation in a sample of women. Our findings enrich the literature on mammography repeat, indicating key intervention factors, and relegating redundant ones in the Iranian populations. The use of strategies to increase mammography repeat, such HBM and TPB constructs is suggested to be important for maintaining a screening behavior, once the behavior has been adopted.