The motivational and cognitive processes of behavior change in the area of screening mammography were investigated. A total of 676 women, 40 to 79 years old, were recruited for telephone interview through random selection from designated census tracts and were asked questions that assessed mammography stage-of-adoption and decisional balance constructs from the trans-theoretical model of behavior change. Two definitions of stage of adoption were used. Analysis of covariance showed that a history of regular screening and an intention to continue having the exam were associated with a more favorable decisional balance. Results replicated a prior investigation and demonstrated the usefulness of stage of adoption and decisional balance as guides for designing stage-matched interventions to increase rates of mammography.