Background The SARS outbreak served to test both local and international outbreak management and risk communication practices. Purpose The study compares SARS knowledge, perceptions, behaviors, and information between Finns and the Dutch during the SARS outbreak in 2003. Method The participants of the study, who used a modified SARS Psychosocial Research Consortium survey, were drawn from Internet panels in Finland (n=308) and the Netherlands (n =373) in June 2003. Multiple logistic regression analyses were used to calculate odds ratios (with 95% confidence intervals) to compare Finns with the Dutch for various levels of perceptions and behaviors. Results Adjusted for age, education, and income, Finns were more likely to be knowledgeable and worried about SARS as well as to have low perceived comparative SARS risk and poor personal efficacy beliefs about preventing SARS. Finns were also more likely than the Dutch to have high confidence in physicians on SARS issues but less likely to have received information from the Internet and have confidence in Internet information. Conclusions The study shed light on how two European populations differed substantially regarding lay responses to SARS. Understanding these differences is needed in formulating and executing communication and outbreak management.

Mental disorders in young adulthood are common and often co-morbid, and they may be particularly harmful for education and employment in this age group.

Further research should clarify determinants and consequences of depression and anxiety among real non-attenders. Knowledge gaps and attitudinal barriers among non-attenders require more targeted campaigns.

Objective-To study psychosocial predictors of attendance at an organised breast cancer screening programme. Setting-Finnish screening programme based on personal first round invitations in 1992-94, and with 90% attendance rate. Methods-Attenders (n=946) belonged to a 10% random sample (n=1680 women, age 50, response rate 64%) of the target population (n=16 886), non-attenders (n=641, 38%) came from the whole target population. Predictors were measured one month before the screening invitation. Measures included items for social and behavioural factors, Breast Cancer Susceptibility Scale, Illness Attitude Scale, Health Locus of Control Scale, Anxiety Inventory, and Depression Inventory. Univariate and multivariate logistic regression analyses were used to predict attendance. Results-Those most likely to attend were working, middle income, and averagely educated women, who had not had a mass mammogram recently, but who regularly visited gynaecologists, attended for Pap smear screening, practised breast self examination, and who did not smoke. Low confidence in their own capabilities in breast cancer prevention, overoptimism about the sensitivity of mammography, and perception of breast cancer risk as moderate were also predictive of attendance. Expectation of pain at mammography was predictive of non-attendance. Conclusion-Mammography screening organised as a public health service was well accepted. A recent mammogram, high reliance on self control of breast cancer, and an expectation of pain at mammography deterred attendance at screening. Further information about these factors and health information on screening are needed. (J Med Screen 1999;6:82-88) Keywords: mammography; attendance; psychosocial factors High quality mammographic screening of women aged 50-74 may significantly reduce breast cancer mortality.1 In Finland screening has been carried out since 1987 as a public health policy, with personal invitations sent to women aged between 50 and 59 every two years. Uptake is around 90%, 2 close to the Swedish figures 3 and higher than in many other countries with similar services.Several reports have looked at the diVerences between attenders and non-attenders. 4 Only a few studies, however, have used a prospective design in which background characteristics were monitored before the invitation to the first screening round, and participation was verified at the screening registry afterwards. Married, healthy women, interested in their health, especially health check-ups, who perceived their risk of breast cancer to be high and believed in the benefit of screening, were more likely to attend.5-7 Sociodemographic factors-for example, level of education or social class, were not predictive. 5-7Nonattendance may be partly explained by recent mammography elsewhere. It has been suggested that emotional factors, such as anxiety and depression, may aVect attendance, 9 but no study has included standardised, prospective measures.This study aimed at determining the influence of psychosocial factors, cognitiv...

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