Breast cancer screening has the potential of early detection, more effective treatment, and possible arrest of certain breast cancers, yet many women do not adhere to screening guidelines. With research showing that people use social comparison while making risk judgments, often holding optimistically biased beliefs about their health, women who maintain an optimism bias about their breast cancer risk may not practice routine breast cancer surveillance. Therefore, effective interventions designed to inform women of their breast cancer risks and to encourage adherence to breast cancer screening guidelines are necessary. This study investigated the role that social comparison plays in risk judgments for breast cancer. Additionally, an intervention using a computerized program on breast cancer risks was evaluated. Women (N=322) between the ages of 17-80 years from five ethnic groups participated in the study (45 Native Americans, 49 Asian Americans, 44 African Americans, 79 Hispanic Americans and 105 Anglo Americans). Pretest assessments for perceived and actual breast cancer risk, comparative perceived breast cancer risk, and other breast cancer beliefs were followed by a 5-7 minute lecture and 15 minute computer program on breast cancer risks. A posttest assessed for changes in comparative perceived breast cancer risk scores and ratings of the computer program as an educational tool. Overall, women were found to be unrealistically optimistic while making comparative breast cancer risk appraisals. At pretest, Anglo and Native Americans did not show unrealistic optimism in their comparative risk scores; however, African, Asian, and Hispanic Americans revealed an optimism bias. Anglo and Asian Americans showed significant positive correlations between perceived and actual breast cancer risk (r=0.264, p=0.007 and r=0.412, p=0.004, respectively) whereas Hispanic Americans showed a nonsignificant positive correlation (r=0.200), and both African Americans and Native Americans showed nonsignificant negative correlations (r=-0.041 and r=-0.180, respectively). Following the intervention, posttest comparative breast cancer risk scores were higher across all ethnic groups with significantly higher scores for Asian, Native, and African Americans. The educational computer program was rated as "good" to "excellent" by most participants. An intervention informing women of their breast cancer risks appeared to reduce the amount of unrealistic optimism about personal breast cancer risk in this study.

LLU Discipline





Graduate School

First Advisor

Helen Hopp Marshak

Second Advisor

Hector Betancourt

Third Advisor

Kiti Freier

Fourth Advisor

Michael Galbraith

Fifth Advisor

Matt Riggs

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Breast Neoplasms -- psychology; Breast Neoplasms -- prevention and control; Risk Factors; Risk Assessment; Attitude to health; Treatment Outcome



Page Count

xii; 177

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives