Motivating mammography adherence in elderly Latinas: a test of three mathematical models of decision making

Many elderly Latinas do not have mammography every one to two years as recommended by cancer organizations. To elucidate the causal factors underlying this behavior, 52 Latinas, aged 65 and over, were asked to judge the likelihood of having yearly mammography in 79 different scenarios constructed from factor levels of cost, perceived risk, and the source of a recommendation (none, a recognized cancer organization, a doctor), assuming a convenient mammography facility. A configural-weight-averaging model, with different parameter values for the 30 adherers (women who reported having had mammography at least twice in the preceding four years) and the 22 non-adherers, gave a good fit to the data and did well in predicting reported mammography adherence (r = 0.85). According to this model, offering free mammography would not induce non-adherers to adhere; they would require a recommendation, and value a doctor's as highly as that of a recognized cancer organization, but reported never having received one from either source. All 52 women reported never receiving risk information from any source. These results have direct educational and dissemination implications for cancer organizations.