Mammography screening : the role of the fear appeals and message framing, and the application of the health belief model and the extended parallel process model

Abstract

Breast cancer is a prominent and severe disease affecting Australian women and a decrease in breast cancer mortality rates has been attributed to mammography screening. Phase one of this study tests the application of the Health Belief Model (HBM) with mammography screening behaviour, and further tests the value of an extended HBM involving three additional variables. Phase two of this study tests the Framing Postulate of Prospect Theory and attempts to explain results by using the Extended Parallel Process Model (EPPM) and the HBM. Participants included 269 women aged 50 to 69 years and included women who do, and women who do not, obtain regular mammograms. Participation involved completing an initial survey before reading one of three framed messages randomly assigned, and completing a subsequent survey. Survey items were based on the HBM and the EPPM. Results showed that the basic 4-factor HBM was significantly associated with screening behaviour - despite only one core HBM factor, perceived barriers, having an association on its own. The extended 7-factor HBM was found to be significantly more associated with screening behaviour than the 4-factor HBM. Results of the present study provide support for the use of fear appeals but indicate the HBM does not adequately account for the perceived benefits of the appeals. Results further showed the EPPM accounted for pre-existing screening behaviour, but not for the effects of the fear appeal. Results suggest further clarification is required as to the effects and explanations of fear appeals and message framing in applied settings related to mammography screening.