Interest in a free breast self-examination (BSE) teaching program offered to a patient population (n = 1590) was assessed, and a follow-up survey of refusers undertaken to determine difference between participants and refusers. Fifty-one percent of the known, eligible women patients expressed interest in the program and 24% ultimately had the teaching. Participants differed from refusers most notably in terms of less previous experience with BSE, more family history of cancer, a longer relationship with their physicians, and different health beliefs. They state more confidence in the effectiveness of breast cancer detection and treatment, less fear and embarrassment, and more personal and physician responsibility for health outcomes, as measured by the Health Locus of Control Scales. Self-selection thus seems rationally based on the kind of program and the needs of the women. Such self-selection can be cost-effective in delivering health education to the people most in need of it and most likely to benefit from it.