Longitudinal predictors of nonadherence to maintenance of mammography.
BACKGROUND
Regular adherence to screening mammography, also known as maintenance of mammography, reduces breast cancer morbidity and mortality. However, mammography maintenance is uncommon and little is known about why women do not maintain regular screening schedules. We investigated longitudinal predictors of women not maintaining adherence.


METHODS
Participants were insured women enrolled in an intervention trial who had screening mammograms 8 to 9 months before study enrollment (n = 1,493). Data were collected from 2003 to 2008. We used discrete event history analysis to model nonadherence to mammography maintenance over three successive annual screening intervals (+ 2 months).


RESULTS
Most (54%) women did not maintain screening adherence over 3 years. Women who did not maintain adherence were more likely to be ages 40 to 49 years, rate their health fair or poor, be less satisfied with their last mammography experiences, report one or more barriers to getting mammograms, be less than completely confident about getting their next mammograms (lower self-efficacy), or have weaker behavioral intentions. The odds of not maintaining adherence decreased over time.


CONCLUSIONS
Although great strides have been achieved in increasing the proportion of women who have received mammograms, most women still are not maintaining regular mammography use over time. Our findings provide insights into targets for future mammography maintenance interventions.
Gierisch
Jennifer M
JM
Duke University Medical Center-Division of General Internal Medicine, Durham, NC, USA. j.gierisch@duke.edu
Earp
Jo Anne
JA
Brewer
Noel T
NT
Rimer
Barbara K
BK
D000328:Adult; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000517:prevention & control*; D005260:Female; D015438:Health Behavior; D006297:Health Services Accessibility; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D016387:Women's Health