An application of an extended health belief model to the prediction of breast self-examination among women with a family history of breast cancer

Objectives. This study reports an application of the health belief model (HBM) to the prediction of breast self-examination (BSE) among women with a family history of breast cancer. The study also considered the influence of breast cancer worries and past behaviour. Methods. Eight hundred and thirty-three women completed questionnaires, based on the HBM, to assess their beliefs about breast cancer and BSE. Of these women, 567 were followed-up at 9 months when BSE frequency was assessed. Results. Discriminant function analysis was employed to discriminate among infrequent, appropriate and excessive BSE. Two functions were calculated which were predictive of group membership. The first function maximally discriminated between the infrequent BSE group and the other two groups, with infrequent self-examiners reporting a greater number of self-efficacy and emotion barriers, fewer benefits and less frequent BSE at Time I. The second function maximally discriminated between the excessive BSE group and the appropriate BSE group, with excessive self-examiners reporting higher levels of breast cancer worries and perceived severity and fewer self-efficacy barriers. Conclusions. The results highlight the importance of focusing on excessive as well as infrequent BSE. Interventions designed to enhance women's confidence in their ability to perform BSE, coupled with attempts to reduce breast cancer worries, may encourage more appropriate and effective BSE.