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SUMMARY
This study analyzed the influence of two interacting sets of factors, (1) the health care provider recommendations and symptoms of cancer, and (2) social networks and media, on breast cancer screening behavior decisions. Qualitative interviews were conducted with breast cancer patients to gather data to test the Health Belief Model construct. Results supported previous studies that found positive correlation relationships between a physician's recommendation and women's decision to have a mammogram. Results also showed that symptoms influence perceived susceptibility and act on a women's choice to seek screening. Women commented that the presence of both factors combine as a stronger cue to action. Finally, this project revealed that media coupled with interpersonal communication (i.e., with social networks) was more effective than media alone.
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FINDINGS
6.1 A recommendation from a health care provider and symptoms are both influential cues to action in spurring women to have mammograms.
6.2 Over 60% (n=56) of study participants expressly communicated that a doctor’s recommendation had influenced their screening behaviors (doctors’ recommendations seemed to personalize the disease, increasing perceived susceptibility, particularly when other risk factors were present [e.g., age]).
6.3 Health care provider advice was influential among women in this study. This may be interpreted as (a) having trust in a health care provider (b) with the potential that participants gave their providers too much control over their health, eventually leading to delayed diagnosis, more radical procedures, and fewer treatment options.
6.4 Nearly 49% (n= 43) of the 88 participants communicated that symptoms also served as a cue to action in having a mammogram, namely diagnostic mammograms.
6.5 No participant reported pursuing a second opinion or questioning her doctor’s advice; every woman in this category appeared to accept the initial diagnosis and returned for semiannual or annual check-ups.
6.6 Symptoms not only motivated women to participate in repeat screening, but they also initiated action in women at different stages on the screening continuum.
6.7 Nineteen participants reported being influenced by both a symptom and a recommendation from a HCP, reinforcing how important multiple and simultaneously occurring cues are in motivating women toward healthy actions.
6.8 These findings follow the Health Belief Model’s tenant that as perceived susceptibility increases, healthy behaviors such as screening also increase (Champion, 1999).
6.9 Media were found to be most influential when complemented by social networks.
6.10 Social networks tended to be perceived as providing credible information, especially about pain expectations.
6.11 Screening avoidance …fear of having breast cancer …without contradiction (e.g., from a doctor or a social network member) potentially results in screening-avoidance by some women.
6.12 Media coupled with interpersonal communication (i.e., with social networks) was more effective than media alone.
6.13 Health education and promotion efforts need further examination in order to better understand how social networks complement and contradict health messages, thereby affecting perceived susceptibility, severity, benefits, and barriers.
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