title: Structural equation modeling for implementation intentions, cancer worry, and stages of mammography adoption.
abstract: OBJECTIVE
  This study aimed to develop a structural model for mammography adoption in Japanese middle-aged women by using constructs from the transtheoretical model (TTM), the theory of planned behavior (TPB), implementation intentions, and cancer worry.
  
  
  METHODS
  Questionnaires based on items including TTM, TPB, implementation intentions, cancer worry-related variables, and demographic variables were distributed to 1000 adult women aged 40 to 59 years, with 641 subjects being used in the final analysis (response rate = 64.1%).
  
  
  RESULTS
  Regarding the stage of adoption, 79 participants (12.3%) were at the precontemplation stage, 30 (4.7%) were at the relapse stage, 142 (22.2%) were at the contemplation stage, 88 (13.7%) were at the action stage, and 302 (47.1%) were at the maintenance stage. Our model, derived from structural equation modeling, revealed that the stage of mammography adoption was significantly affected by goal intentions, implementation intentions, perceived barriers, history of breast cancer screening, and relative risk. A logistic regression analysis revealed that goal intentions and implementation intentions significantly predicted mammography uptake within 1 year.
  
  
  CONCLUSIONS
  This study developed an integrated model constructed from TTM, TPB, implementation intentions, and cancer worry to account for mammography adoption in Japan, and also confirmed the predictive validity of the model.
authors: Department of Complementary and Alternative Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors: Kei
authors: K
authors: Hirai
authors: Graduate School of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan.|Japan Society for the Promotion of Sciences, Chiyoda-ku, Tokyo, Japan.
authors: Kazuhiro
authors: K
authors: Harada
authors: Graduate School of Human Sciences, Osaka University, Japan, Suita, Osaka, Japan.
authors: Aiko
authors: A
authors: Seki
authors: National Hospital Organization Osaka Medical Center, Tyuo-ku, Osaka, Japan.
authors: Miwa
authors: M
authors: Nagatsuka
authors: Department of Psychology, Faculty of Letters, Hosei University, Chiyoda-ku, Tokyo, Japan.
authors: Hirokazu
authors: H
authors: Arai
authors: Public Health Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors: Ayako
authors: A
authors: Hazama
authors: Department of Public Health, Jichi Medical School, Shimono City, Tochigi, Japan.
authors: Yoshiki
authors: Y
authors: Ishikawa
authors: Screening Assessment and Management Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Chuo-ku, Tokyo, Japan.
authors: Chisato
authors: C
authors: Hamashima
authors: Screening Assessment and Management Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Chuo-ku, Tokyo, Japan.
authors: Hiroshi
authors: H
authors: Saito
authors: Cancer Detection Center, Miyagi Cancer Society, Sendai, Miyagi, Japan.
authors: Daisuke
authors: D
authors: Shibuya
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology*; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000523:psychology*; D055088:Early Detection of Cancer / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D033182:Intention; D007564:Japan; D016015:Logistic Models; D008327:Mammography / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged; D008960:Models, Psychological; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011582:Psychological Theory
keywords: cancer; implementation intentions; mammography; oncology; theory of planned behavior; transtheoretical model