title: Relationships between decisional balance and stage of adopting mammography and Pap testing among Chinese American women.
abstract: BACKGROUND
  The Transtheoretical Model has not been applied to explain cancer screening behavior among a large sample of Chinese Americans. This study examines the stage of adopting mammography and Pap testing in relation to women's decisional balance of cancer screening.
  
  
  METHODS
  We surveyed a sample of 507 Chinese American women aged 50 and older in the DC area in 2003 and 2004. We categorized women into six screening stages (pre-contemplation, contemplation, action, relapse, risk of relapse, and maintenance) based on the frequency and regularity of past screening behaviors and future intentions. We measured women's attitudes toward mammography and Pap testing by 22 pro and con statements. Decisional balance was calculated by the mean difference between pro and con scores. Multinomial regression analyses were used to examine the associations between decisional balance and stage of adoption, controlling for sociodemographics, English fluency, and physician and family recommendations.
  
  
  RESULTS
  Maintenance was the largest group among six stages (45% for mammography; 44% for Pap testing). Women in the maintenance group had the highest decisional balance scores, indicating more positive attitudes toward screening. Decisional balance was significantly related to stages of adopting mammograms and Pap testing after adjusting for other covariates.
  
  
  CONCLUSIONS
  This study demonstrated that Chinese American women's cancer screening behavior was associated with decisional balance, as described in the Transtheoretical Model. Cancer screening messages should be tailored to the needs of women in different stages of adopting mammography and Pap testing.
authors.affiliation: Department of Health, Behavior & Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA. cstrong@jhsph.edu
authors.forename: Carol
authors.initials: C
authors.lastname: Strong
authors.forename: Wenchi
authors.initials: W
authors.lastname: Liang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000208:ethnology / Q000523:psychology / Q000706:statistics & numerical data; D001294:Attitude to Health / Q000208:ethnology*; D001943:Breast Neoplasms / Q000517:prevention & control; D002755:Choice Behavior; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008327:Mammography / Q000523:psychology / Q000706:statistics & numerical data*; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control; D014626:Vaginal Smears / Q000523:psychology / Q000706:statistics & numerical data*