International Journal of Psychological Studies; Vol. 5, No. 3; 2013 ISSN 1918-7211 E-ISSN 1918-722X Published by Canadian Center of Science and Education 98 Mammography Screening within the Context of the Theory of Planned Behavior: The Role of Personality Traits and Personal Factors Fay Griva 1 , Fotios Anagnostopoulos 1 , Kleanthi Gourounti 1 , Philippa Kolokotroni 1 & Natalia Koutrouli 1 1 Department of Psychology, Panteion University of Social and Political Sciences, Athens, Greece Correspondence: Fotios Anagnostopoulos, Department of Psychology, Panteion University of Social and Political Science, 136 Syggrou Ave. 176 71, Athens, Greece. E-mail: fganagn@hol.gr Received: May 15, 2013 Accepted: July 8, 2013 Online Published: August 15, 2013 doi:10.5539/ijps.v5n3p98 URL: http://dx.doi.org/10.5539/ijps.v5n3p98 Abstract The present study examined the associations between optimism, personal characteristics and theory of planned behavior (TPB) components for mammography screening. Most of the results were in line with TPB which proposed that intention would be the most proximal determinant of a behavior and the effects of other factors including attitudes and perceived behavioral control on behavior would be mediated through intention. However, a number of demographic and health-related factors, including age and a previous benign breast disease emerged as independent factors associated with mammography screening, providing evidence that personal factors should be taken into account in future applications of the TPB when examining mammography screening behavior. Keywords: mammography screening, theory of planned behavior, optimism 1. Introduction Mammography screening is considered an effective way to detect breast cancer early. Although there is considerable evidence to suggest that mammography screening is associated with reduced rates of mortality (Humphrey, Helfand, Chan & Woolf, 2002; Madlensky, Goel, Polzer, & Ashbury, 2003; Schopper & de Wolf, 2009), there is often a discrepancy reported between recommended and actual use of mammograms (Botha et al., 2003). In an attempt to identify the factors associated with mammography screening, a number of social cognition models such as the health belief model (HBM; Becker, 1974; Rosenstock, Strecher, & Becker, 1988), or the common-sense model of illness representations (CSM; Leventhal, Nerenz, & Steele, 1984; Leventhal; Leventhal, & Contrada, 1998) and the theory of planned behavior (TPB) (Ajzen, 1991) have been applied in various settings and populations. A recent study in Greece used an integrated framework combing the HBM and the CSM applied to screening for breast cancer (Anagnostopoulos et al., 2012). The present study makes use of the TPB framework to examine mammography screening. The TPB identifies intention as the most proximal determinant of behavior, and attitude, subjective norm (influence and pressure from important others) (SN) and perceived behavioral control (PBC), as the socio-cognitive determinants of intention to engage in a behavior. Meta-analyses provide empirical support for the predictive utility of the TPB (Armitage & Conner, 2001; Cooke & French, 2007). According to Armitage and Conner (2001) the TPB accounts for 39% of the variance in intention and 27% of the variance in predicting behavior. Although substantial variance is explained, a large proportion of it is left unexplained and may be attributed to other factors external to the model. In an attempt to increase its predictive utility, recent research has focused on expanding the TPB with the inclusion of other factors, such as moral norms (e.g., McMillan, Higgins, & Conner, 2005), self-identity (e.g., Moan & Rise, 2006), anticipated regret (e.g., Richard, van der Pligt, & de Vries, 1996), desire (e.g., Taylor, Bagozzi, & Gaither, 2005), and personality traits (e.g., Rhodes, Courneya, & Jones, 2002). Ajzen (1991) has proposed that external variables such as personal variables, personality traits, or other individual differences variables, may influence behavior indirectly by affecting the main components of the TPB. However, research has provided some evidence for the existence of a direct relation between external variables of this kind and health behaviors. A systematic review of prospective studies on physical exercise revealed that the relation between personality, including conscientiousness and extraversion traits, and exercise behavior was unmediated by the TPB components (McEachan, 2004). In addition, a recent study on eating behavior (Churchill, Jessop, & Sparks, 2008) found that impulsivity predicted consumption of high-calorie snacks over and above the TPB components.