Testing the Health Belief Model Using Prostate Cancer Screening Intention: Comparing Four Statistical Approaches Applied to Data from the 2008-09 Nashville Men’s Preventive Health Survey

Abstract

Utility of prostate cancer screening is a hotly debated topic among medical professionals and health agencies. As such, men are often conflicted regarding whether to follow guidelines for screening. With data from the 2008-09 Nashville Men’s Preventive Health Survey (NMPHS), which sampled white and black men aged 40-70 years old living in Davidson County, TN, this study examines prostate cancer screening intention using the health belief model (HBM). This study also addresses methodological confusion regarding how to test the HBM by comparing results from four statistical approaches: (1) logistic regression, (2) logistic regression with interactions, (3) path analysis, and (4) structural equation modeling (SEM) with latent variables. Overall, little empirical support was found for the HMB in its current form. Even so, the present study recommends using path analysis as the standard to test the HBM. It also recommends that the HBM be revised. Revisions would include (1) adding a direct path from modifying factors to preventive health behavior and (2) adding a direct path from cues to action to preventive health behavior.