Considerations for extending the transtheoretical model of behavior change to screening mammography

This paper reviews issues that have arisen in the process ofextending the Transtheoretical Model of behavior change (TTM)from smoking cessation to screening mammography. Conceptualand empirical considerations are discussed. Topics covered includedefining the stages-of-adoption, writing items for the prosand cons, and identifying processes-of-change. Differences betweensmoking cessation and mammography as health-related behaviorsare reviewed, as they have affected the adaptation of the model(e.g. prevention versus early detection; cessation versus initiation;periodicity; role of the provider). The fundamental appropriatenessof mammography as a behavior to which the TTM should be extendedis also addressed (i.e. clear behavioral guidelines, effectivetechnology, a definitive target population). Several areas forfurther development of the TTM and mammography are presented.