Breast Cancer Family History and Behavioral Health Intentions: An Esteem-Relevant Mechanism Informed by the Terror Management Health Model

The terror management health model (TMHM) offers a framework to investigate how concerns about mortality can motivate health-related behaviors through actions that bolster self-esteem. This framework may be especially useful for examining how a family history of breast cancer influences preventative breast health behaviors. Women with no family history, a family history where a family member survived breast cancer, and those who lost a family member to the disease were recruited to participate in one of two preregistered online studies. Participants completed measures of perceived susceptibility, associations of breast cancer with death, breast health esteem, and behavioral breast health intentions. In both studies, the effect of family history on behavioral intentions was serially mediated by susceptibility perceptions, breast cancer-death association, and feelings of esteem related to breast health behaviors. There were no effects of priming mortality. Taken together, the results suggest that both susceptibility perceptions and death associations are critical for encouraging breast health behaviors among women with family history, and this works through a mechanism relevant to self-esteem. Interventions may be more effective when they emphasize the esteem value of breast health behaviors for individuals at increased risk.