While mammography rates are increasing, timely repetition of mammography remains underutilized, particularly for low-income African American women. This study examined the decision-making process used by women during a culturally sensitive attitude change intervention designed to increase adherence to mammography guidelines. The sample included 318 low-income, urban African American women. A Solomon Four design was used to test the intervention in three public health clinics. Participants were followed for 12 months. Women used four different decisional styles (information seeking, 22%; information processing, 22%; advice following, 47%; and ruminating, 8%). Those engaging in information-seeking and information-processing decisional styles demonstrated more pro-attitudes toward mammography, greater intention to obtain a mammogram, and actual increase in mammography utilization. Furthermore, the link between intention and action was significant for those in the information-seeking decisional style but not in the other decisional styles.
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