Use of a theoretical framework to understand factors that influence participation in mammography screening among Korean women
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he purpose of this study was to explore whether the method combining of the Health Belief Model (HBM) and the Theory of Reasoned Action (TRA) explains adequately women's mammography utilization behavior for early detection of breast cancer in Korea. A total of 310 women aged 30 years and older participated in the study. Of the participants, 155 women who obtained a mammogram during the data collection period were classified as the study group and the other 155 who had never had a mammogram were classified as the control group. The researcher developed instrument used in the study included demographic variables and questions measuring the concepts of the HBM components and subjective norms from the TRA. Trained data collectors administered the questionnaire employing a face-to-face survey method in the waiting areas of hospitals and health promotion centers. Logistic regression was used to identify odds-ratios of statistically significant variables affecting actual utilization of mammogram. Multiple regression was employed to examine the influence of demographic variables, components of the HBM, and subjective norms on the intention to have a mammogram within a year. The study showed that factors influencing women's actual participation in mammogram differ substantially from those affecting women's intention to have a mammogram within a year. Age, self-efficacy, and subjective norms of husband and daughter(s) were significantly associated with actual participation in mammography screening. On the other hand, income, knowledge, perceived susceptibility, perceived barriers, self-efficacy, and subjective norm of husband were significant in explaining women's intention to have a mammogram within a year. The findings from this study can be used to guide the design and implementation of health education and promotion programs in order to promote mammography usage among Korean women.