Application of a health belief model for explaining mammography behavior by using structural equation model in women in Sanandaj

In Iran like other developing countries, age of breast cancer is lower, in comparison to the developed countries. The purpose of this study was to investigate the relationship of mammography behavior with demographic factors and health belief model constructs to perform mammography behavior and also to assess the predictive power of this model. In this cross-sectional study we selected 593 non lactating and non-pregnant women of 40 years of age and older without breast cancer by random clustered sampling method. Demographic data, history of previous mammography and data about HBM (perceived susceptibility, severity, self-efficacy, health motivation, benefits, and barriers) were collected by using self-report questionnaires. SPSS and LISREL software were used for data analysis. Following perceived susceptibility (r=0.48) and perceived barriers, (r=0.17), self-efficacy showed the highest correlation (r=0.61) with mammogram performance (p<0.001). Breast problem, marital status, family history of breast cancer had significant effects on mammography performance. Self-efficacy (regression coefficient=0.86) and perceived susceptibility (regression coefficient=0.65) had the most direct effect on mammography (p<0.01-0.001). High power exponent of the variance in mammography behavior shows efficacy of HBM as a theoretical framework for studying the behavior of mammography. Low rate of mammogram performance indicates the need for intervention programs aimed at increasing mammography behavior.