Using the Multi-Theory Model (MTM) of Health Behavior Change to Explain the Correlates of Mammography Screening among Asian American Women

Abstract

Globally, breast cancer is the most common malignancy affecting women. The incidence of breast cancer has been growing among Asian American women. Mammography is a screening procedure that provides early diagnosis for the timely treatment to reduce premature mortality due to breast cancer. However, there are no national data available that summarize the rates of mammography screening among Asian American women. Some small-scale studies have reported low rates of mammography uptake among Asian American women. This cross-sectional study utilized the fourth-generation, multi-theory model (MTM) of health behavior change to explain the correlates of mammography screening among Asian American women between the ages of 45–54 years. A 44-item instrument was evaluated for face, content, and construct validity (using structural equation modeling) and reliability (Cronbach’s alpha) and administered electronically to a nationally representative sample of Asian American women (n = 374). The study found that Asian American women who have had received mammograms in the past 12 months as per recommendations, all three constructs of MTM, namely, participatory dialogue (β = 0.156, p < 0.05), behavioral confidence (β = 0.236, p < 0.001), and changes in the physical environment (β = 0.426, p < 0.001) were statistically significant and crucial in their decision to initiate getting a mammogram, accounting for a substantial 49.9% of the variance in the decision to seek mammography. The study also found that the MTM constructs of emotional transformation (β = 0.437, p < 0.001) and practice for change (β = 0.303, p < 0.001) were significant for maintaining the repeated behavior of getting annual mammograms and were responsible for 53.9% of the variance. This evidence-based study validates the use of MTM in designing and evaluating mammography screening promotion programs among Asian American women aged 45–54 years.

A multi-theory model based analysis of correlates for initiating and sustaining mammography screening behavior among Hispanic American women in the United States

“…27 This finding is also supported by a similar study about mammography and the role of MTM conducted with Asian American women that found that all three constructs of MTM were significant predictors. 25 Besides lending support to MTM, the finding emphasizes the role of several constructs to increase mammography screening for Hispanic American women, such as emphasizing the pros over cons of getting mammograms done, building surety in women to get the procedure done, and providing environmental supports in the form of measures such as health insurance, proximity to clinics, and transportation. The construct of participatory dialogue that underscores the pros over cons of getting mammograms can be facilitated by a healthcare provider or health educator in an open way to address apprehensions in the minds of women who are hesitant about mammography screening.…”

“…A 50-item questionnaire containing 13 demographic questions, 31 questions from a previously validated MTM tool 25 and 6 additional items from the Fear of Negative Appearance Evaluation scale (FNAES) 26 , 27 was used in the present study. The MTM tool is based on the fourth-generation behavioral theory, MTM, and is known for its well-established psychometric properties observed while assessing mammography behavior in a sample of Asian American women.…”

Understanding the contexts and mechanisms of bluespace prescription programmes implemented in health and social care settings: a realist review

“…However, these environmental modifications should be coupled with capability-building (knowledge sharing) and motivational strategies (social support) to promote and sustain contact with natural settings (Sharma et al, 2020), such as blue spaces.…”

Explaining Correlates of Cervical Cancer Screening among Minority Women in the United States

“…Multiple indices of goodness-of-fit were used: the relative chi-square (χ2/df; cut-off values: <2-5), the Root Mean Square Error of Approximation (RMSEA; close and acceptable fit are considered for values <0.05 and <0.11, respectively), the Tucker Lewis Index (TLI), and the Comparative Fit Index (CFI; acceptable values are ≥0.90) [44,45]. For each model, the overall fit, significance of structural paths, and amount of variability of the latent variables accounted for by the observed variables were assessed [39,45,46]. Standardized estimates for path coefficients, interpreted as regression coefficients, were calculated for all proposed relationships in the model.…”

“…There is a need to focus on newer models, such as the fourth-generation Multi-theory Model (MTM) of health behavior, to explain correlates of cervical cancer screening among minority women in the U.S. The MTM has been used in previous health behavior studies, such as for COVID-19, sleep, HPV vaccination, mammography, and melanoma, but to date, researchers have not tested the MTM on cervical cancer screening [43][44][45][46][47][48]. The purpose of this study was to examine the correlates of cervical cancer screening by Pap test using MTM as a theoretical paradigm in U.S. minority women.…”