Perceived Barriers to Self-Management and Preventive Behaviors
Russell E. Glasgow, Ph.D. |
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Appendix 2. Mammography Screening Barriers |
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1. Compared with your other health problems, having a mammogram is not important
Agree ---------- |
strongly agree? Or |
____ (5) |
agree? |
____ (4) |
Neutral/no opinion -------------------------- |
____ (3) |
Disagree ------ |
disagree? Or |
____ (2) |
strongly disagree? |
____ (1) |
Don’t know -------------------------------- |
____ (0) |
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2. At your age, you do not need to have mammograms.
Agree ---------- |
strongly agree? Or |
____ (5) |
agree? |
____ (4) |
Neutral/no opinion -------------------------- |
____ (3) |
Disagree ------ |
disagree? Or |
____ (2) |
strongly disagree? |
____ (1) |
Don’t know -------------------------------- |
____ (0) |
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3. You do not need a mammogram if you have a breast exam by a doctor.
Agree ---------- |
strongly agree? Or |
____ (5) |
agree? |
____ (4) |
Neutral/no opinion -------------------------- |
____ (3) |
Disagree ------ |
disagree? Or |
____ (2) |
strongly disagree? |
____ (1) |
Don’t know -------------------------------- |
____ (0) |
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4. You are afraid to have a mammogram because it might show a problem.
Agree ---------- |
strongly agree? Or |
____ (5) |
agree? |
____ (4) |
Neutral/no opinion -------------------------- |
____ (3) |
Disagree ------ |
disagree? Or |
____ (2) |
strongly disagree? |
____ (1) |
Don’t know -------------------------------- |
____ (0) |
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5. Having a mammogram is a lot of trouble for you.
(If a woman says, the mammogram is not too much trouble but going to the clinic or waiting is too much trouble, ask: Is what you have to go through to have a mammogram too much trouble?)
Agree ---------- |
strongly agree? Or |
____ (5) |
agree? |
____ (4) |
Neutral/no opinion -------------------------- |
____ (3) |
Disagree ------ |
disagree? Or |
____ (2) |
strongly disagree? |
____ (1) |
Don’t know -------------------------------- |
____ (0) |
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6. Having a mammogram is painful for you.
Agree ---------- |
strongly agree? Or |
____ (5) |
agree? |
____ (4) |
Neutral/no opinion -------------------------- |
____ (3) |
Disagree ------ |
disagree? Or |
____ (2) |
strongly disagree? |
____ (1) |
Don’t know -------------------------------- |
____ (0) |
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7. Having a mammogram is embarrassing for you.
Agree ---------- |
strongly agree? Or |
____ (5) |
agree? |
____ (4) |
Neutral/no opinion -------------------------- |
____ (3) |
Disagree ------ |
disagree? Or |
____ (2) |
strongly disagree? |
____ (1) |
Don’t know -------------------------------- |
____ (0) |
|
8. You are worried about having a mammogram because you don't understand what will be done.
Agree ---------- |
strongly agree? Or |
____ (5) |
agree? |
____ (4) |
Neutral/no opinion -------------------------- |
____ (3) |
Disagree ------ |
disagree? Or |
____ (2) |
strongly disagree? |
____ (1) |
Don’t know -------------------------------- |
____ (0) |
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9. You don't have the time to get a mammogram.
Agree ---------- |
strongly agree? Or |
____ (5) |
agree? |
____ (4) |
Neutral/no opinion -------------------------- |
____ (3) |
Disagree ------ |
disagree? Or |
____ (2) |
strongly disagree? |
____ (1) |
Don’t know -------------------------------- |
____ (0) |
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10.Cost would keep you from having a mammogram.
(If woman asks how much a mammogram costs, say, "I'm not sure. It's different in different places. I just need to know if you think the cost of a mammogram would keep you from having one.")
Agree ---------- |
strongly agree? Or |
____ (5) |
agree? |
____ (4) |
Neutral/no opinion -------------------------- |
____ (3) |
Disagree ------ |
disagree? Or |
____ (2) |
strongly disagree? |
____ (1) |
Don’t know -------------------------------- |
____ (0) |
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11. Having a mammogram makes you worry about being exposed to the x-ray.
Agree ---------- |
strongly agree? Or |
____ (5) |
agree? |
____ (4) |
Neutral/no opinion -------------------------- |
____ (3) |
Disagree ------ |
disagree? Or |
____ (2) |
strongly disagree? |
____ (1) |
Don’t know -------------------------------- |
____ (0) |
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12. You have trouble remembering to get a mammogram.
Agree ---------- |
strongly agree? Or |
____ (5) |
agree? |
____ (4) |
Neutral/no opinion -------------------------- |
____ (3) |
Disagree ------ |
disagree? Or |
____ (2) |
strongly disagree? |
____ (1) |
Don’t know -------------------------------- |
____ (0) |
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13. People at the mammography centers are not friendly.
Agree ---------- |
strongly agree? Or |
____ (5) |
agree? |
____ (4) |
Neutral/no opinion -------------------------- |
____ (3) |
Disagree ------ |
disagree? Or |
____ (2) |
strongly disagree? |
____ (1) |
Don’t know -------------------------------- |
____ (0) |
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14. A mammogram can help you find breast cancer when it is just getting started.
Agree ---------- |
strongly agree? Or |
____ (5) |
agree? |
____ (4) |
Neutral/no opinion -------------------------- |
____ (3) |
Disagree ------ |
disagree? Or |
____ (2) |
strongly disagree? |
____ (1) |
Don’t know -------------------------------- |
____ (0) |
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15. Your doctor did not tell you that you should have a mammogram.
Agree ---------- |
strongly agree? Or |
____ (5) |
agree? |
____ (4) |
Neutral/no opinion -------------------------- |
____ (3) |
Disagree ------ |
disagree? Or |
____ (2) |
strongly disagree? |
____ (1) |
Don’t know -------------------------------- |
____ (0) |
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16. Having a mammogram will decrease your chances of dying from breast cancer.
Agree ---------- |
strongly agree? Or |
____ (5) |
agree? |
____ (4) |
Neutral/no opinion -------------------------- |
____ (3) |
Disagree ------ |
disagree? Or |
____ (2) |
strongly disagree? |
____ (1) |
Don’t know -------------------------------- |
____ (0) |
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17. Having a mammogram is the best way to find breast cancer when it is just getting started.
Agree ---------- |
strongly agree? Or |
____ (5) |
agree? |
____ (4) |
Neutral/no opinion -------------------------- |
____ (3) |
Disagree ------ |
disagree? Or |
____ (2) |
strongly disagree? |
____ (1) |
Don’t know -------------------------------- |
____ (0) |
Champion V, et al. The effect of telephone versus print tailoring for mammography adherence. Patient Education and Counseling, 2007;65:416-423. (vchampion@iupui.edu) |
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