O'Sullivan, Ian James; (2002) Why do some women re-attend for routine breast cancer screening while others do not? Explaining non-reattendance and developing belief based interventions. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

There were two main objectives of this thesis; the first was to establish why some women re-attend for breast cancer screening, while others do not; the second was to increase the rate of re-attendance for routine breast screening by targeting women with a belief-based intervention. The thesis consisted of three separate studies. The first was a cross-sectional, postal survey study that investigated the socio-demographic, previous experience and attitudinal variables associated with having re-attended for one's most recent breast cancer screening. The second study was a retrospective cohort analysis of the call/recall records of all the women invited to re-attend for routine screening during 1997. The final study was a controlled trial of a health education style intervention designed to encourage women to re-attend. The results of study 1 demonstrated that re-attendance was predicted by a combination of socio-economic and demographic factors, previous experiences of breast screening, and psychological variables. Study 2 demonstrated that the experience of a false positive result had no impact of the uptake of subsequent screening behaviour. Finally, the results of study 3 demonstrated that the women in the study group were more like to re-attend than the women who did not receive the intervention. Women who re-attended for routine breast cancer screening differed from women who did not re-attend in terms of their socio-economic and demographic profile, in terms of their evaluation of previous screening experiences and also in terms of the attitudes, beliefs, and intentions they have towards re-attending. The belief-based variables predictive of re-attendance are potentially amenable to change and as such may help improve the rate of re-attendance by careful targeting. Indeed, the results of study 3 provide some tentative evidence that a controlled trial of an intervention targeting some of these beliefs can positively effect the rate of re-attendance.

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