Optimism may moderate screening mammogram frequency in Medicare: A longitudinal study.

Area of Science:

• Psychological science
• Gerontology
• Public health

Background:

• Optimism and cynical hostility are linked to health behaviors and outcomes.
• Their association with healthcare utilization, specifically breast cancer screening, is understudied.
• Understanding these links can inform targeted screening interventions.

Purpose of the Study:

• To examine the association between optimism, cynical hostility, and mammography screening frequency in older women.
• To investigate if sociodemographic factors mediate these relationships.
• To analyze psychological attitudes' impact on breast cancer screening behavior.

Main Methods:

• Utilized Women's Health Initiative (WHI) observational cohort data linked to Medicare claims.
• Included 48,291 women without prior breast cancer history, enrolled in Medicare.
• Employed survival modeling to analyze screening frequency based on baseline optimism and cynical hostility, adjusting for covariates.

Main Results:

• Lower optimism (higher pessimism) was associated with 5% more frequent screening mammograms (p < .01).
• No significant association was found between cynical hostility and screening mammography frequency.
• Higher education and income levels were independently associated with more frequent screenings (p < .01).

Conclusions:

• Lower trait optimism, higher education, and higher income are associated with increased screening mammography frequency in older women.
• Sociodemographic factors did not mediate the optimism-screening relationship.
• Findings highlight psychological and socioeconomic influences on adherence to breast cancer screening guidelines.