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Stages of Change for Mammography Among Mexican Women and a Decisional Balance Comparison Across Countries

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Abstract

An analysis of the adoption of secondary preventive behaviors is significant in regions with disparities in mammography use and breast cancer survival. Therefore, we determined the cognitive factors and the degree to which they differentiate stages of change in mammography among Mexican women. We also compared the decisional balance performance at Mexico, Switzerland, South Korea, and the USA. A cross-sectional study was designed for women in the stages of precontemplation (n = 240), contemplation (n = 243), action (n = 205), maintenance (n = 311), and relapse (n = 348). We only considered those ≥40 years with no cancer history. We measured the pros, cons, and self-efficacy, among other components. The decisional balance was estimated, and the result was transformed into T-scores. Odds ratios (OR) and 95% confidence intervals (CI) were estimated with multinomial logistic regression using precontemplation as the reference group. The decisional balance distinguished stages partially: in contemplation, the OR was 1.26 (95%CI 1.08, 1.47) and in maintenance, 1.34 (95%CI 1.13, 1.59); in action and relapse, the statistical significance was marginal (p < 0.10). The decisional balance T-score performance registered variations among countries. Additionally, the effect of self-efficacy progressively ascended from contemplation to action and maintenance (OR = 1.29 [95%CI 1.05, 1.58], 1.53 [95%CI 1.20, 1.96], and 2.48 [95%CI 1.82, 3.39], respectively). Furthermore, risk perception and severity did not have an effect on stages of change among Mexican women. Recognition of what provokes action in a population is a key factor in the efficacy of screening programs. Variations among countries highlight the necessity for importance of investigating cognitive determinants for mammography in specific areas.

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Acknowledgments

We gratefully acknowledge the unconditional collaboration of Dr. Rebeca Thelma Martínez and Dr. José Guadalupe Sánchez, whose support was essential to the development of this study.

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Authors and Affiliations

  1. Epidemiologic and Health Services Research Unit, Mexican Institute of Social Security, Ave. Lincoln S/N esquina Ma. Jesús Candia. Col. Valle Verde, 2° sector, Monterrey, N.L., CP 64360, Mexico

    Ana María Salinas-Martínez & Norma Edith Oliva-Sosa

  2. School of Public Health and Nutrition, Autonomous University of Nuevo Leon, Monterrey, N.L., Mexico

    Ana María Salinas-Martínez, David Emmanuel Castañeda-Vásquez, Norma Guadalupe García-Morales & Georgina Mayela Núñez-Rocha

  3. Health Planning Division, Mexican Institute of Social Security, Monterrey, N.L., Mexico

    Laura Hermila de-la-Garza-Salinas

  4. School of Medicine, Family Medicine Department, Autonomous University of Nuevo Leon, Monterrey, N.L., Mexico

    José Manuel Ramírez-Aranda

Authors
  1. Ana María Salinas-Martínez
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  2. David Emmanuel Castañeda-Vásquez
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  3. Norma Guadalupe García-Morales
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  4. Norma Edith Oliva-Sosa
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  5. Laura Hermila de-la-Garza-Salinas
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  6. Georgina Mayela Núñez-Rocha
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Corresponding author

Correspondence to Ana María Salinas-Martínez.

Ethics declarations

All procedures performed in the study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent was obtained from all individual participants included in the study.

This article does not contain any studies with animals performed by any of the authors.

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The authors declare that they have no conflict of interest.

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Salinas-Martínez, A.M., Castañeda-Vásquez, D.E., García-Morales, N.G. et al. Stages of Change for Mammography Among Mexican Women and a Decisional Balance Comparison Across Countries. J Canc Educ 33, 1230–1238 (2018). https://doi.org/10.1007/s13187-017-1236-1

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  • DOI: https://doi.org/10.1007/s13187-017-1236-1

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