Explicating perceived barriers to mammography for the USCREEN project: concerns about breast implants, faith violations, and perceived recommendations.

In line with the health belief model, perceived barriers have proven to be a key determinant of intentions to screen for breast cancer. The standard measure of perceived barriers to breast cancer screening is an 11 item scale developed by Victoria Champion. However, perceived barriers emerge and change over time, and Champion's perceived barriers scale was last revised in 1999. Moreover, the original scale did not address barriers which may be more pronounced in particular populations, such as congruity of action with faith. As part of the Utah Screening Project, a sample of women 40-74 (N = 341, Mage = 51.19, SD = 8.11) were recruited from four Utah counties in 2014 to complete a survey. The results revealed that the four new perceived barrier items explained 6.4 % of intentions to screen, above and beyond other predictors. In addition to barriers identified in past research, the current study identified several novel barriers including (a) concerns about negative effects to breast implants, (b) perceived conflict with faith, and the (c) perception that mammography is no longer recommended. The new perceived barriers items are useful to researchers interested in exploring barriers not addressed by the original instrument. The barriers also suggest potential belief-based targets and channels (e.g., plastic surgery clinics, faith-based interventions) for delivering mammography interventions.

Targeted communication and race: explicating perceived message relevance.

Objectives: Targeting is a communication strategy in which a message is designed to address a particular group. It has been postulated that targeting increases message relevance; however, researchers are still explicating relevance and its impact on downline cognitive processes (e.g. message quality, cognitive cost). The current study addresses both gaps by evaluating the impact of targeted materials for White and African American audiences. Design: Adult women (N = 266) aged 18-74 (Mage = 47.12, SD = 1.40) were recruited to participate in a 2 (targeting: multiracial, African American) × 2 (race: White participants, African American participants) × 2 (topic: Hypertension, Environmental Breast Cancer) message experiment. Results: Across both topics, African American participants in the African American condition had reduced cognitive costs, increased message clarity, and increased message relevance. An indirect serial mediation model was supported wherein the relationship between targeting and behavioral intention was mediated by perceived relevance and perceived message quality. Conclusion: Targeting enhances perceived message relevance which, in turn, impacts behavioral intentions via perceived message quality. This model is consistent with the postulates of relevance theory and informs both intervention design and evaluation.