Correlates of Breast Self-Examination in Women 18 to 35 Years of Age

Abstract

This study was a retrospective, cross-sectional, correlational inquiry of breast self-examination (BSE) behavior in young women. The variables intrinsic motivation, self-efficacy, knowledge, benefits, barriers, susceptibility, seriousness, and demographic variables were examined in relationship to three dependent variables, frequency, proficiency, and combined frequency and proficiency of BSE, to determine which variables predicted BSE in a sample of young women. The sample comprised n = 255 college women (M age = 23 years). Subjects were classified as low, moderate, or high performers based on reported frequency of BSE. Kruskal- Wallis and chi-square tests revealed significant group differences were evident for the variables insurance (x2= 6.8,_p = .024) and high risk status (%2 = 7.6, p = .022). A previous PAP smear and having been taught BSE approached significance at the alpha .05 level. No significant group differences were found for the variables age, race, marital status, education, previous clinical breast examination (CBE), or having been recommended to perform BSE. Low performers were typically younger (< 21 years), undergraduate students, who were unmarried and uninsured; who reported never having a PAP smear or CBE, never being recommended to perform, and never been taught BSE. Bivariate correlations showed intrinsic motivation, self-efficacy, knowledge, benefits, and barriers were significantly related to BSE behavior, and in the predicted direction. Subsequent hierarchical regression analyses revealed only four significant predictors: self-efficacy, knowledge, barriers, and the interaction between knowledge and self-efficacy. Barriers was directly and negatively predictive of BSE. However, analyses of the significant interaction showed a moderating and enhancing, rather than direct effect o f self-efficacy on BSE behavior. More knowledge produced increased BSE behavior only when moderate to high degrees of self-efficacy were evident. For those subjects with low self-efficacy scores more knowledge did not increase BSE behavior. Both knowledge and self-efficacy were needed to maximize BSE performance for these young women.