Applying the transtheoretical model to breast self-examination

The Transtheoretical Model of behavior change (Prochaska & DiClemente, 1992) posits that people move through identifiable stages as they change their behavior. This study tested whether or not women could be classified into the stages of change based on the barriers and benefits that they perceived to breast self-examination and their confidence or self efficacy for performing the exams. A total of 214 women, ages 22 to 76 years, completed the Stages of Change Algorithm (DiClemente & Prochaska, 1982, modified with permission), and the Barriers, Benefits, and Confidence subscales from the Health Belief Model Instrument, which was developed and revised by Champion (1984; 1993). The results of a discriminant analysis indicate that women can be classified into the stages of change, based on the variables of benefits, barriers, and confidence or self efficacy. Additional analyses revealed that age is a significant predictor of stage membership. Also, with the exception of the maintenance stage, there was a higher proportion of women who had not had a lump detected in their breasts in all of the stages of change than would be expected by chance. There was also a lower proportion of women who had a lump detected in all of the stages than would be expected by chance, except in the maintenance stage. In the maintenance stage, the opposite was true: there was a lower proportion of women than would be expected by chance who had never had a lump detected in their breast and there was a higher proportion of women than would be expected by chance who did have a lump detected in their breast. Thus, the Transtheoretical Model seems to describe women in terms of their breast self-examination behavior. This has implications for health care workers in terms of helping women acquire the behavior of breast self-examination