Health beliefs and breast examination behaviors: Analyses of linear structural relations

A survey of 619 Detroit-area women was conducted in order to understand why women do or do not perform breast self-examination and obtain or not obtain professional breast examinations. The survey assessed these behaviors and women's beliefs about (a) their susceptibility to breast cancer, (b) the severity or seriousness of breast cancer, (c) the benefits of breast examinations and (d) the costs or disadvantages of the examinations. Separate sets of questions measured severity of breast cancer when it is treated (a) late (severity-late) and (b) promptly (severity-early). Predictions were derived by combining the health belief model with the theory of subjective expected utility. Path analysis supported most. predictions of the combined theory. As predicted, high severity-late increased perceived benefit, high severity-early decreased benefit, and perceived benefit mediated the effects of severity on behavior. Implications for understanding health decisions, measuring health beliefs, and modifying health behaviors are discussed.