Attitudes and uptake of a screening test: The moderating role of ambivalence

Abstract

This study examined the extent to which ambivalence moderates the relationship between attitudes and screening behaviour in a clinical setting using an objective measure of behaviour. For this study 979 pregnant women eligible for prenatal Down syndrome screening completed questionnaire measures of attitudes, ambivalence and intentions towards undergoing the test. Screening behaviour, assessed by test uptake, was determined from medical records. Attitudes predicted intentions to undergo the test and screening behaviour. The correlations between attitudes and intentions and between attitudes and behaviour were greater in women with lower levels of ambivalence (r = 0.85 and r = 0.58, respectively) than in those with higher levels of ambivalence (r = 0.50 and r = 0.27, respectively). Regression analyses revealed that ambivalence moderated the relationships between attitudes and intention and between attitude and behaviour. In addition, a three-way interaction was found between ambivalence, attitudes and intention when predicting behaviour. Given that behaving consistently with attitudes is central to making an informed choice, ambivalence appears to undermine the making of such choices.

Keywords:

• Ambivalence
• attitudes
• informed choice
• prenatal screening

Acknowledgements

We thank the women who participated in this study, and the midwifery and obstetric staff at the Luton and Dunstable NHS Trust. This study was funded by NHS Executive London Regional Office (grant number RDC02020).