A Longitudinal Examination of Stages of Change Model Applied to Mammography Screening

Frances Lee-Lin, Thuan Nguyen, Nisreen Pedhiwala, Nathan F. Dieckmann, Usha Menon

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Application of behavior change theories to ethnically diverse groups is limited. In a secondary analysis of intervention study data, we tested the validity of the transtheoretical model (TTM) of change among Chinese American immigrant women. Three hundred mammography non-adherent women were randomized to an intervention or control group. Compared with contemplators (60%), precontemplators reported higher perceived mammography barriers (p.001) and lower breast cancer susceptibility (p.01). Baseline contemplators were 1.5 times more likely to have a mammogram post intervention compared with precontemplators. Upward shift in stage of change was higher in the intervention than the control group at 3 months (odds ratio [OR] = 6.14), 6 months (OR = 4.82), and 12 months (OR = 2.85). Women with an upward shift at 3 months were more likely to complete mammography at 12 months (OR = 15.44). The results supported the TTM stages of change. Education targeted to Chinese women’s stages of change has significant potential to decrease breast cancer screening disparities.

Original languageEnglish (US)
Pages (from-to)441-458
Number of pages18
JournalWestern journal of nursing research
Issue number4
StatePublished - Apr 1 2016


  • Chinese immigrants
  • mammography screening
  • transtheoretical model of change

ASJC Scopus subject areas

  • Nursing(all)


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