Background:
Levels of adherence to mammography recommendations are not high in Israel.
Aims:
To measure the degree of association between adherence with recommended performance of mammography and social and cognitive variables such as fatalistic attitudes, susceptibility to the disease, benefits and barriers of mammography, fear of disclosure of information about mammography performance and breast cancer, social acceptance of mammography and breast cancer, and social norm and support. In addition differences between population-groups will be identified (Jews, Arabs, immigrants and ultra-orthodox women).
Hypothesis:
1) Mammography performance will be higher among women with low levels of fatalistic beliefs, higher perception of susceptibility and benefits, fewer barriers, and lower levels of fear. Those reporting positive social norms and less fear of the stigma related to mammography will have performed a mammogram.
2) Low socioeconomic levels will be associated with less mammography performance and attitudes inhibiting performance of mammography.
3) Arab, immigrants, and ultra religious women will report attitudes inhibiting performance of mammography. There will be a difference in the types of attitudes associated with performance in Arab and and Jewish women.
Methods:
A sample of women age 50-74 insured by Maccabi will be interviewed by telephone regarding their cognitive and social factors and this will be correlated with information from Maccabi's database regarding performance of mammography during the last few years before the interview. An over sampling of Arab and ultra religious Jewish women will be performed in order to obtain a large enough sample for statistical analysis.
Significance:
Effectiveness of mammography has been shown to reduce mortality from breast cancer and to be cost effective. Social and cognitive variables predicting compliance with early detection of breast cancer are an important issue when planning interventions aimed at increasing levels of adherence with recommended performance of mammography. This study will enable to implement interventions based on population specific information regarding the variables associated with the behavior. This study will use objective information regarding performance of mammography and not self-reported information as used in previous studies.
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