Health beliefs and compliance with mammography-screening recommendations in asymptomatic women

The utility of the health belief model (HBM) for predicting compliance with the American Cancer Society recommendations for mammography screening over and above demographics, knowledge, physician input, and objective risk for breast cancer was assessed. In all, 615 predominantly middle-class White women, age 35-92, were surveyed in 1987-1989. A multiple indicator measurement model of the HBM constructs of perceived susceptibility, severity, benefits, and barriers was verified with confirmatory factor analysis. Physician input alone accounted for 25% of the variance in compliance; HBM constructs alone, 16%. HBM constructs accounted for 7% additional variance in compliance beyond all other predictors and thus may be a fruitful focus for interventions to increase screening rates.