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Allen C, Escoffery C, Haardörfer R, McBride C. Factors Influencing Not Perceiving Family Health History Assessments as Important: Opportunities to Improve Dissemination of Evidence-Based Population Screening for Cancer. Public Health Genomics 2019; 21:144-153. [DOI: 10.1159/000499125] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 02/25/2019] [Indexed: 11/19/2022] Open
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Tonge JE, Atack M, Crosbie PA, Barber PV, Booton R, Colligan D. "To know or not to know…?" Push and pull in ever smokers lung screening uptake decision-making intentions. Health Expect 2019; 22:162-172. [PMID: 30289583 PMCID: PMC6433322 DOI: 10.1111/hex.12838] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 08/22/2018] [Accepted: 08/24/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND In the United States, lung cancer screening aims to detect cancer early in nonsymptomatic current and former smokers. A lung screening pilot service in an area of high lung cancer incidence in the United Kingdom has been designed based on United States trial evidence. However, our understanding of acceptability and reasons for lung screening uptake or decline in a United Kingdom nontrial context are currently limited. OBJECTIVE To explore with ever smokers the acceptability of targeted lung screening and uptake decision-making intentions. DESIGN Qualitative study using semistructured focus groups and inductive thematic analysis to explore acceptability and uptake decision-making intentions with people of similar characteristics to lung screening eligible individuals. SETTING AND PARTICIPANTS Thirty-three participants (22 ex-smokers; 11 smokers) men and women, smokers and ex-smokers, aged 50-80 were recruited purposively from community and health settings in Manchester, England. RESULTS Lung screening was widely acceptable to participants. It was seen as offering reassurance about lung health or opportunity for early detection and treatment. Participant's desire to know about their lung health via screening was impacted by perceived benefits; emotions such as worry about a diagnosis and screening tests; practicalities such as accessibility; and smoking-related issues including perceptions of individual risk and smoking stigma. DISCUSSION Decision making was multifaceted with indications that current smokers faced higher participation barriers than ex-smokers. Reducing participation barriers through careful service design and provision of decision support information will be important in lung screening programmes to support informed consent and equitable uptake.
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Affiliation(s)
- Janet E. Tonge
- Macmillan Cancer Improvement PartnershipParkway Business CentreManchester Health and Care CommissioningManchesterUK
- Present address:
Leeds Institute of Health SciencesUniversity of LeedsUK
| | - Melanie Atack
- Macmillan Cancer Improvement PartnershipParkway Business CentreManchester Health and Care CommissioningManchesterUK
- Present address:
The Christie NHS Foundation TrustManchesterUK
| | - Phil A. Crosbie
- North West Lung Centre, Wythenshawe HospitalManchester University NHS Foundation TrustManchesterUK
| | - Phil V. Barber
- North West Lung Centre, Wythenshawe HospitalManchester University NHS Foundation TrustManchesterUK
| | - Richard Booton
- North West Lung Centre, Wythenshawe HospitalManchester University NHS Foundation TrustManchesterUK
| | - Denis Colligan
- Macmillan Cancer Improvement PartnershipParkway Business CentreManchester Health and Care CommissioningManchesterUK
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Hvidberg L, Virgilsen LF, Pedersen AF, Vedsted P. Cancer beliefs and participation in screening for colorectal cancer: A Danish cohort study based on data from the International Cancer Benchmarking Partnership and national registers. Prev Med 2019; 121:11-17. [PMID: 30690041 DOI: 10.1016/j.ypmed.2019.01.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 12/28/2018] [Accepted: 01/24/2019] [Indexed: 12/31/2022]
Affiliation(s)
- Line Hvidberg
- Research Unit for General Practice and Research Centre for Cancer Diagnosis in Primary Care (CaP), Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark.
| | - Line Flytkjær Virgilsen
- Research Unit for General Practice and Research Centre for Cancer Diagnosis in Primary Care (CaP), Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark.
| | - Anette Fischer Pedersen
- Research Unit for General Practice and Research Centre for Cancer Diagnosis in Primary Care (CaP), Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark; Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus N, Denmark.
| | - Peter Vedsted
- Research Unit for General Practice and Research Centre for Cancer Diagnosis in Primary Care (CaP), Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark; Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus N, Denmark.
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Health Behaviour Changes of Cutaneous Melanoma Survivors in Slovenia - A Qualitative Study. Zdr Varst 2019; 58:70-77. [PMID: 30984297 PMCID: PMC6455013 DOI: 10.2478/sjph-2019-0009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Accepted: 03/12/2019] [Indexed: 11/20/2022] Open
Abstract
Introduction Most data related to cutaneous melanoma survivors' health behaviour comes from epidemiological studies and is predominantly concerned with safe-sun behaviour and self-examination. Data regarding other changes of health behaviour are scarce and so are qualitative studies in this realm. The aim of our research is to acquire insight into the experiences of patients with cutaneous melanoma in Slovenia. How did they react to the diagnosis, which changes did they introduce in their health behaviour and how do they assess the role of family doctors? Methods Using the qualitative approach of collective case reports, a demographically diverse group of patients with different forms and stages of cutaneous melanoma was selected. Semi-structured interviews conducted by a psychologist were recorded and transcribed verbatim. For data processing, the approach of Qualitative Content Analysis was applied. Results We integrated interviewees' experiences after the diagnosis of cutaneous melanoma in several subcategories: either they did not introduce any changes or they mentioned changing their habits when exposed to the sun and performing skin self-examination; they also emphasized their ways of dealing with stress and raising awareness about melanoma among family members and friends. The role of family doctors in the prevention and care appears unclear; even contradictory. Conclusion We obtained insight into the experiences of Slovenian patients with cutaneous melanoma. The interviewees prioritised safe behaviour in the sun, strengthening of psychological stability and raising awareness about melanoma. Findings will be used in the creation of a structured questionnaire for national epidemiological survey.
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Sarma EA, Silver MI, Kobrin SC, Marcus PM, Ferrer RA. Cancer screening: health impact, prevalence, correlates, and interventions. Psychol Health 2019; 34:1036-1072. [DOI: 10.1080/08870446.2019.1584673] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Elizabeth A. Sarma
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
| | - Michelle I. Silver
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
| | - Sarah C. Kobrin
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
| | - Pamela M. Marcus
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
| | - Rebecca A. Ferrer
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
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Kaphingst KA, Ivanovich J, Lyons S, Biesecker B, Dresser R, Elrick A, Matsen C, Goodman M. Preferences for learning different types of genome sequencing results among young breast cancer patients: Role of psychological and clinical factors. Transl Behav Med 2018; 8:71-79. [PMID: 29385583 DOI: 10.1093/tbm/ibx042] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The growing importance of genome sequencing means that patients will increasingly face decisions regarding what results they would like to learn. The present study examined psychological and clinical factors that might affect these preferences. 1,080 women diagnosed with breast cancer at age 40 or younger completed an online survey. We assessed their interest in learning various types of genome sequencing results: risk of preventable disease or unpreventable disease, cancer treatment response, uncertain meaning, risk to relatives' health, and ancestry/physical traits. Multivariable logistic regression was used to examine whether being "very" interested in each result type was associated with clinical factors: BRCA1/2 mutation status, prior genetic testing, family history of breast cancer, and psychological factors: cancer recurrence worry, genetic risk worry, future orientation, health information orientation, and genome sequencing knowledge. The proportion of respondents who were very interested in learning each type of result ranged from 16% to 77%. In all multivariable models, those who were very interested in learning a result type had significantly higher knowledge about sequencing benefits, greater genetic risks worry, and stronger health information orientation compared to those with less interest (p-values < .05). Our findings indicate that high interest in return of various types of genome sequencing results was more closely related to psychological factors. Shared decision-making approaches that increase knowledge about genome sequencing and incorporate patient preferences for health information and learning about genetic risks may help support patients' informed choices about learning different types of sequencing results.
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Affiliation(s)
| | - Jennifer Ivanovich
- Division of Public Health Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Sarah Lyons
- Division of Public Health Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Barbara Biesecker
- Social and Behavioral Research Branch, National Human Genome Research Institute, Bethesda, MD, USA
| | - Rebecca Dresser
- School of Law, Washington University in St. Louis, St. Louis, MO, USA
| | - Ashley Elrick
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Cindy Matsen
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Melody Goodman
- College of Global Public Health, New York University, New York, NY, USA
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Ellis EM, Klein WMP, Orehek E, Ferrer RA. Effects of Emotion on Medical Decisions Involving Tradeoffs. Med Decis Making 2018; 38:1027-1039. [PMID: 30343624 DOI: 10.1177/0272989x18806493] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Risk perceptions for a disease can motivate use of medications that reduce disease risk. However, these medications are often accompanied by elevated risks for other adverse health effects, and perceived risk of these side effects may also influence decisions. Emotions experienced at the time of a decision influence risk judgments and decision making, and they may be important to examine in these tradeoff contexts. This study examined the effect of experimentally induced fear and anger on risk perceptions and willingness to use a hypothetical medical treatment that attenuates risk of one condition but increases the risk for another. Participants ( N = 1948) completed an induction of fear, anger, or neutral emotion and then read about a hypothetical medication that reduced risk for one health condition but increased risk for another, and they indicated their willingness to use it. Deliberative, experiential, and affective risk perceptions about both health conditions were measured, conditional on taking and not taking the medication. Fear condition participants were more willing to take the medication than those in the neutral condition (β = 0.14; P = 0.009; 95% confidence interval, 0.036-0.25). Fear also increased deliberative, experiential, and affective risk when conditioned on not using the medication, Ps < 0.05. In contrast, anger did not influence willingness to use the medication ( P = 0.22) and increased deliberative and affective risk of side effects when conditioned on using the medication ( P < 0.05). As one of the first studies to examine how emotion influences tradeoff decision making, these findings extend our understanding of how fear and anger influence such decisions.
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Affiliation(s)
- Erin M Ellis
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, National Cancer Institute, Rockville, MD (EME, RAF).,Office of the Associate Director, Behavioral Research Program, National Cancer Institute, Bethesda, MD (WMPK).,Department of Psychology, University of Pittsburgh, Pittsburgh, PA (EO)
| | - William M P Klein
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, National Cancer Institute, Rockville, MD (EME, RAF).,Office of the Associate Director, Behavioral Research Program, National Cancer Institute, Bethesda, MD (WMPK).,Department of Psychology, University of Pittsburgh, Pittsburgh, PA (EO)
| | - Edward Orehek
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, National Cancer Institute, Rockville, MD (EME, RAF).,Office of the Associate Director, Behavioral Research Program, National Cancer Institute, Bethesda, MD (WMPK).,Department of Psychology, University of Pittsburgh, Pittsburgh, PA (EO)
| | - Rebecca A Ferrer
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, National Cancer Institute, Rockville, MD (EME, RAF).,Office of the Associate Director, Behavioral Research Program, National Cancer Institute, Bethesda, MD (WMPK).,Department of Psychology, University of Pittsburgh, Pittsburgh, PA (EO)
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Gabel P, Larsen MB, Kirkegaard P, Edwards A, Andersen B. The LEAD trial - the effectiveness of a decision aid on decision making among citizens with lower educational attainment who have not participated in FIT-based colorectal cancer screening in Denmark: study protocol for a randomized controlled trial. Trials 2018; 19:543. [PMID: 30305114 PMCID: PMC6180588 DOI: 10.1186/s13063-018-2921-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 09/17/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Colorectal cancer screening participation is a preference-sensitive choice, in which trade-offs between benefits and harms must be made by individual citizens. Often the decision is made without any contact with healthcare professionals. Citizens with lower educational attainment tend to participate less in colorectal cancer screening than citizens with average educational attainment. Further, they tend to have lower levels of knowledge about colorectal cancer screening. Providing lower educational attainment citizens with a targeted decision aid embracing their diverse information needs might increase these citizens' ability to make informed decisions. The aim of this trial is to test the effectiveness of such a newly developed self-administered decision aid. METHODS The LEAD (Lower Educational Attainment Decision aid) trial will be conducted as a two-arm randomized controlled trial among 10,000 50-74-year-old citizens, resident in the Central Denmark Region not yet invited to take up colorectal cancer screening. Citizens will receive a baseline questionnaire. Respondents will be allocated into the intervention or the control groups. Citizens in the intervention group will receive the decision aid whereas the control group will not. Those who return a stool sample within 45 days after receiving the screening invitation and those with medium or higher educational attainment are excluded. Both groups will receive a follow-up questionnaire 90 days after being invited to colorectal cancer screening. A historic cohort consisting of 5000 50-74-year-old citizens resident in the Central Denmark Region, having received their screening invitation in the beginning of 2017 will be included. This cohort will receive a follow-up questionnaire 6-9 months after they received the screening invitation. Informed choice will be evaluated by assessing levels of knowledge, attitudes, and screening uptake. Analyses will be conducted as intention-to-treat analyses. Additionally, differences between levels of worry and decisional conflict between groups will be assessed as secondary outcomes. DISCUSSION This trial will evaluate whether a targeted decision aid is a feasible way of enhancing informed choice among lower educational attainment citizens in colorectal cancer screening. Further, it may guide decisions about providing information material in cancer screening in general. TRIAL REGISTRATION ClinicalTrials.gov, NCT03253888 . Registered on 17 August 2017.
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Affiliation(s)
- Pernille Gabel
- Department of Public Health Programmes, Randers Regional Hospital, Central Denmark Region, Skovlyvej 15, 8930, Randers NØ, Denmark.
- Faculty of Health, Aarhus University, Aarhus, Denmark.
| | - Mette Bach Larsen
- Department of Public Health Programmes, Randers Regional Hospital, Central Denmark Region, Skovlyvej 15, 8930, Randers NØ, Denmark
| | - Pia Kirkegaard
- Department of Public Health Programmes, Randers Regional Hospital, Central Denmark Region, Skovlyvej 15, 8930, Randers NØ, Denmark
| | - Adrian Edwards
- Division of Population Medicine, Cardiff University School of Medicine, Cardiff, UK
| | - Berit Andersen
- Department of Public Health Programmes, Randers Regional Hospital, Central Denmark Region, Skovlyvej 15, 8930, Randers NØ, Denmark
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Quaife SL, Waller J, von Wagner C, Vrinten C. Cancer worries and uptake of breast, cervical, and colorectal cancer screening: A population-based survey in England. J Med Screen 2018; 26:3-10. [PMID: 30249158 DOI: 10.1177/0969141318796258] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Some degree of general worry about cancer may facilitate screening participation, but specific worries about the potential consequences (e.g. treatment, death) may act as deterrents. No studies have examined these associations in the same sample. We assessed associations between general versus specific cancer worries and cancer screening participation. METHODS In 2016, a population-based cross-sectional survey of adults living in England was carried out. This paper reports analyses of a subsample (n = 1694). Measures included (i) frequency of general cancer worry, (ii) specific worries about the emotional and physical consequences of a cancer diagnosis, and (iii) specific worries about the social consequences of a cancer diagnosis. Logistic regression analyses examined their association with self-reported screening uptake among participants eligible for cervical (n = 671), breast (n = 323), and colorectal (n = 368) cancer screening. RESULTS Frequency of general cancer worry was not associated with screening participation. Specific worry about the emotional and physical consequences increased the odds of participants reporting regular uptake of colorectal screening (OR 1.41, 95% CI 1.04-1.90). Specific worry about the social consequences of diagnosis was negatively associated with regular attendance for cervical and breast screening in unadjusted analyses only. In adjusted models, the associations were no longer statistically significant for cervical (OR 0.82, 95% CI 0.65-1.03) or breast (OR 0.69, 95% CI 0.45-1.04) screening. CONCLUSIONS Specific worries about cancer may be differentially associated with participation across screening programmes. Further research is needed, as interventions to optimise informed participation may be improved if the specific worries associated with low participation in each programme are understood.
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Affiliation(s)
- Samantha L Quaife
- Cancer Communication and Screening Group, Research Department of Behavioural Science and Health, University College London, Gower Street, London, UK
| | - Jo Waller
- Cancer Communication and Screening Group, Research Department of Behavioural Science and Health, University College London, Gower Street, London, UK
| | - Christian von Wagner
- Cancer Communication and Screening Group, Research Department of Behavioural Science and Health, University College London, Gower Street, London, UK
| | - Charlotte Vrinten
- Cancer Communication and Screening Group, Research Department of Behavioural Science and Health, University College London, Gower Street, London, UK
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Caycho-Rodríguez T, Ventura-León J, Noe-Grijalva M, Barboza-Palomino M, Arias Gallegos WL, Reyes-Bossio M, Rojas-Jara C. Evidencias psicométricas iniciales de una medida breve sobre preocupación por el cáncer. ACTA ACUST UNITED AC 2018. [DOI: 10.5209/psic.61438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objetivo: La preocupación por el cáncer está asociada con los comportamientos preventivos para la detección de esta enfermedad; sin embargo, no existe un instrumento con evidencias de validez y confiabilidad para medir este constructo en países latinoamericanos, entre ellos el Perú. Los objetivos de este estudio fueron evaluar la validez basada en la estructura interna y fiabilidad de la Cancer Worry Scale (CWS) en una muestra de personas sin diagnóstico oncológico con historia familiar de cáncer. Método: Se contó con la participación de 215 personas sanas con historia familiar de cáncer que acudían al servicio de consulta externa de dos instituciones públicas y privadas de salud de la ciudad de Chimbote con una edad promedio de 42,10 años (DT = 14,05). Para el recojo de información se utilizó una ficha sociodemográfica ad hoc y la Cancer Worry Scale. Resultados: El modelo unidimensional presentó un buen ajuste de los datos (SBχ2 (8) = 14,39; SB χ2 / df = 1,79; CFI = 0,991; SRMR = 0,025; RMSEA = 0,061 [IC90%: 0,000 -0,111]; AIC = 47,701) y una confiabilidad adecuada (ωcorregido = 0,90; IC95%: 0,88-0,92). Conclusión: Se concluye que la CWS presenta adecuadas propiedades psicométricas, siendo una medida que brinda interpretaciones válidas y fiables de la preocupación por el cáncer en el contexto peruano.
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Ferrer RA. Optimizing the utility of the ARC Framework. J Health Psychol 2018; 25:38-43. [PMID: 30080109 DOI: 10.1177/1359105318790074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This commentary concerns the Affect Regulation in Cancer Framework, which synthesizes theoretical perspectives and empirical evidence on emotion regulation and coping to posit that flexible use of a suite of strategies can result in optimal Affect Regulation in Cancer. The framework raises a number of questions that should be answered for it to reach its full potential. Here, I extend this framework by suggesting (1) outcomes to define adaptive regulation; (2) examples of research questions and hypotheses; (3) intervention development research; and (4) additional cancer contexts to which the framework should be applied.
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Affiliation(s)
- Rebecca A Ferrer
- Basic Biobehavioral and Psychological Sciences Branch (BBPSB), Behavioral Research Program, National Cancer Institute, USA
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Ross K, Stoler J, Carcioppolo N. The relationship between low perceived numeracy and cancer knowledge, beliefs, and affect. PLoS One 2018; 13:e0198992. [PMID: 29889890 PMCID: PMC5995386 DOI: 10.1371/journal.pone.0198992] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 05/30/2018] [Indexed: 11/30/2022] Open
Abstract
Low numeracy may skew patient perceptions of information about cancer. This paper examines the relationship between self-reported measures of perceived numeracy and cancer knowledge, beliefs, and affect, using results from 3,052 respondents to the 2007 Health Information National Trends Survey (HINTS-3). Chi-squared tests were used to identify differences in responses between high- and low-numeracy groups using three measures of perceived numeracy. Multivariable logistic regression models were used to evaluate the association between the three perceived numeracy measures and cancer information overload, cancer fatalism, cancer prevention knowledge, and cancer worry. Respondents with low perceived numeracy as expressed by discomfort with medical statistics were more likely to report information overload, to display fatalistic attitudes towards cancer, to lack knowledge about cancer prevention, and to indicate that they worried about cancer more frequently. After controlling for sociodemographic characteristics, this measure of perceived numeracy remained significantly associated with information overload, fatalism, lower prevention knowledge, and worry. The other measures of perceived numeracy, which measured understanding and use of health statistics, were not associated with cancer perceptions. Our findings suggest that individuals with low perceived numeracy broadly differ from individuals with high perceived numeracy in their perceptions of cancer and cancer prevention. By improving our understanding of how perceived numeracy affects patient perceptions of cancer, health providers can improve educational strategies and targeted health messaging.
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Affiliation(s)
- Katherine Ross
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, United States of America
| | - Justin Stoler
- Department of Geography and Regional Studies, University of Miami, Coral Gables, Florida, United States of America
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
- * E-mail:
| | - Nick Carcioppolo
- Department of Communication Studies, University of Miami, Coral Gables, Florida, United States of America
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Hay JL, Baser RE, Westerman JS, Ford JS. Prevalence and Correlates of Worry About Medical Imaging Radiation Among United States Cancer Survivors. Int J Behav Med 2018; 25:569-578. [PMID: 29872990 DOI: 10.1007/s12529-018-9730-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Cancer survivors undergo lifelong surveillance regimens that involve repeated diagnostic medical imaging. As many of these diagnostic tests use ionizing radiation, which may modestly increase cancer risks, they may present a source of worry for survivors. The aims of this paper are to describe cancer survivors' level of worry about medical imaging radiation (MIR) and to identify patterns of MIR worry across subgroups defined by cancer type, other medical and demographic factors, and physician trust. METHOD This cross-sectional study used the 2012-2013 Health Information National Trends Survey of US adults conducted by the National Cancer Institute. The analysis focused on the 452 respondents identifying as cancer survivors. Weighted logistic regression analysis was used to evaluate factors associated with higher MIR worry (reporting "some" or "a lot" of MIR worry). RESULTS Nearly half (42%) of the sample reported higher worry about MIR. Unadjusted and adjusted logistic regressions indicated higher rates of MIR worry among those with lower incomes, those who self-reported poorer health, and those who completed cancer treatment within the past 10 years. Receipt of radiation treatment was associated with higher MIR worry in unadjusted analysis. CONCLUSION Worries about MIR are relatively common among cancer survivors. An accurate assessment of the rates and patterns of worry could aid efforts to improve these individuals' survivorship care and education.
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Affiliation(s)
- Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, 7th floor, New York, NY, 10022, USA.
| | - Raymond E Baser
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Joy S Westerman
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, 7th floor, New York, NY, 10022, USA
| | - Jennifer S Ford
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, 7th floor, New York, NY, 10022, USA
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Understanding Cancer Worry Among Patients in a Community Clinic-Based Colorectal Cancer Screening Intervention Study. Nurs Res 2018; 67:275-285. [PMID: 29870517 DOI: 10.1097/nnr.0000000000000275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND To reduce colorectal cancer (CRC) screening disparities, it is important to understand correlates of different types of cancer worry among ethnically diverse individuals. OBJECTIVES The current study examined the prevalence of three types of cancer worry (i.e., general cancer worry, CRC-specific worry, and worry about CRC test results) as well as sociodemographic and health-related predictors for each type of cancer worry. METHODS Participants were aged 50-75, at average CRC risk, nonadherent to CRC screening guidelines, and enrolled in a randomized controlled trial to increase CRC screening. Participants completed a baseline questionnaire assessing sociodemographics, health beliefs, healthcare experiences, and three cancer worry measures. Associations between study variables were examined with separate univariate and multivariable logistic regression models. RESULTS Responses from a total of 416 participants were used. Of these, 47% reported experiencing moderate-to-high levels of general cancer worry. Predictors of general cancer worry were salience and coherence (aOR = 1.1, 95% CI [1.0, 1.3]), perceived susceptibility (aOR = 1.2, 95% CI [1.1, 1.3), and social influence (aOR = 1.1, 95% CI [1.0, 0.1]). Fewer (23%) reported moderate-to-high levels of CRC-specific worry or CRC test worry (35%). Predictors of CRC worry were perceived susceptibility (aOR = 1.4, 95% CI [1.3, 1.6]) and social influence (aOR = 1.1, 95% CI [1.0, 1.2]); predictors of CRC test result worry were perceived susceptibility (aOR = 1.2, 95% CI [1.1, 1.3) and marital status (aOR = 2.0, 95% CI [1.1, 3.7] for married/partnered vs. single and aOR = 2.3, 95% CI [1.3, 4.1] for divorced/widowed vs. single). DISCUSSION Perceived susceptibility consistently predicted the three types of cancer worry, whereas other predictors varied between cancer worry types and in magnitude of association. The three types of cancer worry were generally predicted by health beliefs, suggesting potential malleability. Future research should include multiple measures of cancer worry and clear definitions of how cancer worry is measured.
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Ngu SF, Wei N, Kwan TTC, Chu MMY, Tse KY, Chan KKL, Ngan HYS. Impact of different educational interventions on psychosocial well-being of women with a positive high-risk human papillomavirus and normal cervical cytology: a randomised trial. J Psychosom Obstet Gynaecol 2018; 39:146-155. [PMID: 28391730 DOI: 10.1080/0167482x.2017.1312335] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
INTRODUCTION The aim of this study was to compare the effect of two educational interventions on the psychosocial well-being of Hong Kong Chinese women who have a positive high-risk human papillomavirus (HPV) test and normal cervical cytology. METHODS Participants were randomised into either leaflet group, in which a written HPV factsheet was provided; or counselling group, in which a didactic HPV presentation in person in addition to the factsheet was provided. Women's psychological conditions were assessed by self-administered questionnaires at pre, post (within one week) and 6 months after the educational interventions. Main outcome measures were psychosocial well-being (cervical cancer worry, anxiety and depression, screening-related anxieties, HPV-related shame) and knowledge of cervical screening and HPV. RESULTS Data from 121 women (52 in leaflet group; 69 in counselling group) were analysed. There was no significant difference in the psychosocial well-being between the two groups at alltime points. Irrespective of the two educational interventions, cervical cancer worry and anxiety decreased over time. The counselling group had a significantly higher score in knowledge of cervical screening and HPV compared with leaflet group (mean score 4.65 ± 0.19 versus 3.71 ± 0.23, p = 0.002) at post-educational intervention, but there was no significant difference (mean score 4.14 ± 0.22 versus 3.58 ± 0.24, p = 0.084) at 6 months. DISCUSSION Both educational interventions were comparable in relieving adverse HPV-related psychosocial effects. Combination of counselling and leaflet were more effective than leaflet only in improving women's knowledge on cervical screening and HPV soon after educational interventions but the benefit was not apparent after 6 months.
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Affiliation(s)
- Siew Fei Ngu
- a Department of Obstetrics and Gynaecology , The University of Hong Kong, Queen Mary Hospital , Hong Kong
| | - Na Wei
- a Department of Obstetrics and Gynaecology , The University of Hong Kong, Queen Mary Hospital , Hong Kong
| | - Tracy T C Kwan
- b Research Office, Technological and Higher Education Institute of Hong Kong , Tsing Yi , Hong Kong
| | - Mandy M Y Chu
- a Department of Obstetrics and Gynaecology , The University of Hong Kong, Queen Mary Hospital , Hong Kong
| | - Ka Yu Tse
- a Department of Obstetrics and Gynaecology , The University of Hong Kong, Queen Mary Hospital , Hong Kong
| | - Karen K L Chan
- a Department of Obstetrics and Gynaecology , The University of Hong Kong, Queen Mary Hospital , Hong Kong
| | - Hextan Y S Ngan
- a Department of Obstetrics and Gynaecology , The University of Hong Kong, Queen Mary Hospital , Hong Kong
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Carter-Harris L, Davis LL, Rawl SM. Lung Cancer Screening Participation: Developing a Conceptual Model to Guide Research. Res Theory Nurs Pract 2018; 30:333-352. [PMID: 28304262 DOI: 10.1891/1541-6577.30.4.333] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE To describe the development of a conceptual model to guide research focused on lung cancer screening participation from the perspective of the individual in the decision-making process. METHODS Based on a comprehensive review of empirical and theoretical literature, a conceptual model was developed linking key psychological variables (stigma, medical mistrust, fatalism, worry, and fear) to the health belief model and precaution adoption process model. RESULTS Proposed model concepts have been examined in prior research of either lung or other cancer screening behavior. To date, a few studies have explored a limited number of variables that influence screening behavior in lung cancer specifically. Therefore, relationships among concepts in the model have been proposed and future research directions presented. CONCLUSION This proposed model is an initial step to support theoretically based research. As lung cancer screening becomes more widely implemented, it is critical to theoretically guide research to understand variables that may be associated with lung cancer screening participation. Findings from future research guided by the proposed conceptual model can be used to refine the model and inform tailored intervention development.
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Cossu G, Saba L, Minerba L, Mascalchi M. Colorectal Cancer Screening: The Role of Psychological, Social and Background Factors in Decision-making Process. Clin Pract Epidemiol Ment Health 2018; 14:63-69. [PMID: 29643929 PMCID: PMC5872199 DOI: 10.2174/1745017901814010063] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 02/08/2018] [Accepted: 02/19/2018] [Indexed: 12/27/2022]
Abstract
Since ColoRectal Cancer (CRC) remains the third cause of cancer death in the world, a better understanding of the reasons underlying poor adherence to and delay in undergoing CRC screening programs is important. CRC screening decision-making process can be conceptualized as the relationship between intention and behavior and needs to be investigated including the impact on patients' decision of a broad range of psychological factors and personal predisposition as fear of a positive screening test, poor understanding of the procedure, psychological distress, anxiety, anticipation of pain, feelings of embarrassment and vulnerability. Also socioeconomic, ethnic and sociological influences, and organizational barriers have been identified as factors influencing CRC screening adherence. Decision-making process can finally be influenced by the healthcare background in which the intervention is promoted and screening programs are carried out. However, there is still a gap on the scientific knowledge about the influences of diverse elements on screening adherence and this deserves further investigations in order to carry out more focused and effective prevention programs.
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Affiliation(s)
- Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Luca Saba
- Department of Radiology, AOU, University of Cagliari, Cagliari, Italy
| | - Luigi Minerba
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Mario Mascalchi
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
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Lemogne C, Turinici M, Panjo H, Ngo C, Canoui‐Poitrine F, Chauvet‐Gelinier J, Limosin F, Consoli SM, Goldberg M, Zins M, Ringa V. Personality and breast cancer screening in women of the GAZEL cohort study. Cancer Med 2018; 7:515-524. [PMID: 29277970 PMCID: PMC5806114 DOI: 10.1002/cam4.1268] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 09/25/2017] [Accepted: 10/19/2017] [Indexed: 12/24/2022] Open
Abstract
The potential benefit of breast cancer screening is mitigated by the risk of false positives and overdiagnosis, thus advocating for a more personalized approach, based on the individual benefit-harm balance. Since personality might influence the women's appraisal of this balance, this prospective observational cohort study examined whether it could influence mammography use. A total of 2691 postmenopausal women of the GAZEL Cohort Study completed the Bortner Type A Rating Scale and the Buss and Durkee Hostility Inventory in 1993. Associations between personality scores and subsequent mammography use, self-reported through up to five triennial follow-up questionnaires, were estimated with Odds Ratio (OR) and 95% confidence interval (CI) with logistic mixed model regressions, adjusting for age, occupational grade, marital status, family history of breast cancer, age at menarche, age at first delivery, gynecological follow-up, hormone therapy use, and depressive symptoms. Individual propensity scores were used to weight the analyses to control for potential selection biases. More than 90% of the participants completed at least two follow-up questionnaires. Type A personality, but not hostility, was associated with mammography use in both univariate (crude OR [95% CI]: 1.62 [1.24-2.11], P < 0.001) and multivariate analyses (OR [95% CI]: 1.46 [1.13-1.90], P < 0.01). Type A personality traits (i.e., sense of time urgency, high job involvement, competitiveness) independently predicted mammography use among postmenopausal women. While paying more attention to the adherence of women with low levels of these traits, clinicians may help those with higher levels to better consider the risks of false positives and overdiagnosis.
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Affiliation(s)
- Cédric Lemogne
- Faculté de MédecineSorbonne Paris CitéUniversité Paris DescartesParisFrance
- Psychiatry departmentParis‐Ouest University HospitalsAP‐HPParisFrance
- Inserm, U894ParisFrance
| | - Monica Turinici
- Psychiatry departmentParis‐Ouest University HospitalsAP‐HPParisFrance
| | - Henri Panjo
- UVSQCESP, Inserm, INEDUniversité Paris‐SaclayUniv. Paris‐Sudle Kremlin‐BicêtreFrance
| | - Charlotte Ngo
- Faculté de MédecineSorbonne Paris CitéUniversité Paris DescartesParisFrance
- Gynecologic Surgery DepartmentParis‐Ouest University HospitalsAP‐HPParisFrance
| | - Florence Canoui‐Poitrine
- Public Health departmentHenri‐Mondor HospitalAP‐HPCréteilFrance
- UPEC, DHU A‐TVB, IMRB, EA7376 CEpiA (Clinical Epidemiology And Ageing)Paris‐Est UniversityF‐94000CréteilFrance
| | - Jean‐Christophe Chauvet‐Gelinier
- Psychiatry unitNeurosciences department, Marion buildingCHU Le BocageDijonFrance
- Laboratory of psychopathology and medical psychology (IFR 100)Bourgogne UniversityDijonFrance
| | - Frédéric Limosin
- Faculté de MédecineSorbonne Paris CitéUniversité Paris DescartesParisFrance
- Psychiatry departmentParis‐Ouest University HospitalsAP‐HPParisFrance
- Inserm, U894ParisFrance
| | - Silla M. Consoli
- Faculté de MédecineSorbonne Paris CitéUniversité Paris DescartesParisFrance
- Psychiatry departmentParis‐Ouest University HospitalsAP‐HPParisFrance
| | - Marcel Goldberg
- Inserm, UMS 011Population‐based Epidemiological CohortsVillejuifFrance
- Inserm, UMR 1168, VIMAVillejuifFrance
| | - Marie Zins
- Inserm, UMS 011Population‐based Epidemiological CohortsVillejuifFrance
- Inserm, UMR 1168, VIMAVillejuifFrance
| | - Virginie Ringa
- UVSQCESP, Inserm, INEDUniversité Paris‐SaclayUniv. Paris‐Sudle Kremlin‐BicêtreFrance
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Abstract
Appalachia has a higher incidence of and mortality from colon cancer (CC) than other regions of the United States; thus, it is important to know the potential impact of elevated risk on cancer worry. Guided by the Self-regulation model, we investigated the association of demographic, cultural (e.g., fatalism, religious commitment), and psychological factors (e.g., perceived risk, general mood) with CC worry among a sample of Appalachian women. A mixed method design was utilized. Appalachian women completed surveys in the quantitative section (n = 134) and semi-structured interviews in the qualitative section (n = 24). Logistic regression was employed to calculate odds ratios (OR) for quantitative data, and immersion/crystallization was utilized to analyze qualitative data. In the quantitative section, 45% of the participants expressed some degree of CC worry. CC worry was associated with higher than high school education (OR 3.63), absolute perceived risk for CC (OR 5.82), high anxiety (OR 4.68), and awareness of easy access (OR 3.98) or difficult access (OR 3.18) to health care specialists as compared to not being aware of the access. there was no association between CC worry and adherence to CC screening guidelines. The qualitative section revealed fear, disengagement, depression, shock, and worry. Additionally, embarrassment, discomfort, and worry were reported with regard to CC screening. Fears included having to wear a colostomy bag and being a burden on family. CC worry was common in Appalachians and associated with higher perceptions of risk for CC and general anxiety, but not with adherence to screening guidelines. The mixed method design allowed for enhanced understanding of CC-related feelings, especially CC worry, including social/contextual fears.
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Affiliation(s)
- Omar F Attarabeen
- Department of Pharmacy Practice, Administration, & Research, Marshall University, Coon Education Building, One John Marshall Drive, Huntington, WV, 25755, USA
| | - Usha Sambamoorthi
- Department of Pharmaceutical Systems & Policy, Robert C. Byrd Health Sciences Center (North), West Virginia University, P.O. Box 9510, Morgantown, WV, 26506-9510, USA
| | - Kevin T Larkin
- Department of Psychology, Eberly College of Arts and Sciences, West Virginia University, Room 2220, Life Sciences Building, P. O. Box 6040, Morgantown, WV, 26506, USA
| | - Kimberly M Kelly
- Department of Pharmaceutical Systems & Policy, Robert C. Byrd Health Sciences Center (North), West Virginia University, P.O. Box 9510, Morgantown, WV, 26506-9510, USA.
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Murphy PJ, Marlow LAV, Waller J, Vrinten C. What is it about a cancer diagnosis that would worry people? A population-based survey of adults in England. BMC Cancer 2018; 18:86. [PMID: 29361912 PMCID: PMC5781324 DOI: 10.1186/s12885-017-3963-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 12/07/2017] [Indexed: 02/08/2023] Open
Abstract
Background Surveys indicate quite high prevalence of cancer worry in the general population, but little is known about what it is about cancer that worries people. A better understanding of the origins of cancer worry may help elucidate previously found inconsistencies in its behavioural effect on cancer prevention, screening uptake, and help-seeking for symptoms. In this study, we explore the prevalence and population distribution of general cancer worry and worries about specific aspects of cancer previously identified. Methods A population-based survey of 2048 English adults (18–70 years, April–May 2016), using face-to-face interviews to assess demographic characteristics, general cancer worry and twelve sources of cancer worry (adapted from an existing scale), including the emotional, physical, and social consequences of a diagnosis. Results In general, a third of respondents (37%) never worried about cancer, 57% worried occasionally/sometimes, and 6% often/very often. In terms of specific worries, two thirds would be ‘quite a bit’ or ‘extremely’ worried about the threat to life and emotional upset a diagnosis would cause. Half would worry about surgery, radiotherapy, chemotherapy, and loss of control over life. Worries about the social consequences were less commonly anticipated: just under half would worry about financial problems or their social roles, and a quarter would be worried about effects on identity, important relationships, gender role, and sexuality. Women and younger people reported more frequent worry about getting cancer, and would be more worried about the emotional, physical, and social consequences of a cancer diagnosis (p < .001). Those from ethnic minority backgrounds reported less frequent worry about getting cancer than their white counterparts, but would be equally worried about the emotional and physical impact of a cancer diagnosis, and worried more about the social consequences of a cancer diagnosis (p < .05). Conclusions The majority of English adults worry at least occasionally about getting cancer, and would be most worried about the emotional and physical impact of a cancer diagnosis. Distinguishing between the various worries that cancer can evoke may help inform efforts to allay undue worries in those who are deterred by them from engaging with cancer prevention and early detection. Electronic supplementary material The online version of this article (10.1186/s12885-017-3963-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Philippa J Murphy
- Department of Behavioural Science and Health, UCL, Gower Street, London, WC1E 6BT, UK
| | - Laura A V Marlow
- Department of Behavioural Science and Health, UCL, Gower Street, London, WC1E 6BT, UK
| | - Jo Waller
- Department of Behavioural Science and Health, UCL, Gower Street, London, WC1E 6BT, UK
| | - Charlotte Vrinten
- Department of Behavioural Science and Health, UCL, Gower Street, London, WC1E 6BT, UK.
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Reynolds LM, Bissett IP, Porter D, Consedine NS. The "ick" Factor Matters: Disgust Prospectively Predicts Avoidance in Chemotherapy Patients. Ann Behav Med 2017; 50:935-945. [PMID: 27411331 DOI: 10.1007/s12160-016-9820-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Chemotherapy can be physically and psychologically demanding. Avoidance and withdrawal are common among patients coping with these demands. PURPOSE This report compares established emotional predictors of avoidance during chemotherapy (embarrassment; distress) with an emotion (disgust) that has been unstudied in this context. METHODS This report outlines secondary analyses of an RCT where 68 cancer patients undergoing chemotherapy were randomized to mindfulness or relaxation interventions. Self-reported baseline disgust (DS-R), embarrassment (SES-SF), and distress (Distress Thermometer) were used to prospectively predict multiple classes of avoidance post-intervention and at 3 months follow-up. Measures assessed social avoidance, cognitive and emotional avoidance (IES Avoidance), as well as information seeking and treatment adherence (General Adherence Scale). RESULTS Repeated-measures ANOVAs evaluated possible longitudinal changes in disgust and forward entry regression models contrasted the ability of the affective variables to predict avoidance. Although disgust did not change over time or vary between groups, greater disgust predicted greater social, cognitive, and emotional avoidance, as well as greater information seeking. Social avoidance was predicted by trait embarrassment and distress predicted non-adherence. CONCLUSIONS This report represents the first investigation of disgust's ability to prospectively predict avoidance in people undergoing chemotherapy. Compared to embarrassment and distress, disgust was a more consistent predictor across avoidance domains and its predictive ability was evident across a longer period of time. Findings highlight disgust's role as an indicator of likely avoidance in this health context. Early identification of cancer patients at risk of deleterious avoidance may enable timely interventions and has important clinical implications (ACTRN12613000238774).
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Affiliation(s)
- Lisa M Reynolds
- Department of Psychological Medicine, The University of Auckland, Private bag 92019, Victoria Street West, Auckland, 1142, New Zealand.
| | - Ian P Bissett
- Department of Surgery, The University of Auckland, Private bag 92019, Victoria Street West, Auckland, 1142, New Zealand
| | - David Porter
- Auckland Regional Cancer and Blood Service, Auckland, New Zealand
| | - Nathan S Consedine
- Department of Psychological Medicine, The University of Auckland, Private bag 92019, Victoria Street West, Auckland, 1142, New Zealand
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73
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Landau MJ, Zhong CB, Swanson TJ. Conceptual metaphors shape consumer psychology. ACTA ACUST UNITED AC 2017. [DOI: 10.1002/arcp.1002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Mark J. Landau
- Department of Psychology; University of Kansas; Lawrence KS USA
| | - Chen-bo Zhong
- Rotman School of Management; University of Toronto; Toronto Canada
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Smits S, Boivin J, Menon U, Brain K. Influences on anticipated time to ovarian cancer symptom presentation in women at increased risk compared to population risk of ovarian cancer. BMC Cancer 2017; 17:814. [PMID: 29202783 PMCID: PMC5716383 DOI: 10.1186/s12885-017-3835-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 11/23/2017] [Indexed: 02/06/2023] Open
Abstract
Background In the absence of routine ovarian cancer screening, promoting help-seeking in response to ovarian symptoms is a potential route to early diagnosis. The factors influencing women’s anticipated time to presentation with potential ovarian cancer symptoms were examined. Methods Cross-sectional questionnaires were completed by a sample of women at increased familial risk (n = 283) and population risk (n = 1043) for ovarian cancer. Measures included demographic characteristics, symptom knowledge, anticipated time to symptom presentation, and health beliefs (perceived susceptibility, worry, perceived threat, confidence in symptom detection, benefits and barriers to presentation). Structural equation modelling was used to identify determinants of anticipated time to symptomatic presentation in both groups. Results Associations between health beliefs and anticipated symptom presentation differed according to risk group. In increased risk women, high perceived susceptibility (r = .35***), ovarian cancer worry (r = .98**), perceived threat (r = −.18**), confidence (r = .16**) and perceiving more benefits than barriers to presentation (r = −.34**), were statistically significant in determining earlier anticipated presentation. The pattern was the same for population risk women, except ovarian cancer worry (r = .36) and perceived threat (r = −.03) were not statistically significant determinants. Conclusions Associations between underlying health beliefs and anticipated presentation differed according to risk group. Women at population risk had higher symptom knowledge and anticipated presenting in shorter time frames than the increased risk sample. The cancer worry component of perceived threat was a unique predictor in the increased risk group. In increased risk women, the worry component of perceived threat may be more influential than susceptibility aspects in influencing early presentation behaviour, highlighting the need for ovarian symptom awareness interventions with tailored content to minimise cancer-related worry in this population. Electronic supplementary material The online version of this article (10.1186/s12885-017-3835-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Stephanie Smits
- Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK.
| | - Jacky Boivin
- School of Psychology, Cardiff University, Cardiff, UK
| | - Usha Menon
- Institute for Women's Health, University College London, London, UK
| | - Kate Brain
- Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK
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Landau MJ, Arndt J, Cameron LD. Do Metaphors in Health Messages Work? Exploring Emotional and Cognitive Factors. JOURNAL OF EXPERIMENTAL SOCIAL PSYCHOLOGY 2017; 74:135-149. [PMID: 33833472 DOI: 10.1016/j.jesp.2017.09.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Health communicators publicize messages that use metaphors to compare abstract health-related concepts to concrete concepts in other domains. Such messages aim to change health attitudes and behavior, but do they work? According to Conceptual Metaphor Theory, metaphors can shape thought by transferring personalized knowledge of a concrete concept to understand and relate to an abstraction, despite their superficial differences. The authors extend this claim to specify emotional and cognitive factors potentially moderating the productivity (and counter-productivity) of metaphoric health messages. A source resonance hypothesis predicts that when a message frames a health risk metaphorically in terms of a concrete hazard (versus literally), individual differences in fear surrounding that particular hazard will differentially predict risk-related worry and thus prevention intentions. A metaphoric fit hypothesis predicts that a risk metaphor will be more persuasive when the recommended prevention response is itself framed metaphorically as addressing the concrete hazard (versus literally). These hypotheses were supported in three experiments conducted with online, undergraduate, and community samples (N = 539). With skin cancer as a case study, the studies tested the impact of messages framing sun exposure and sun-safe practices with or without metaphors of enemy combat. Findings illuminate how, when, and for whom metaphoric messages are persuasive, with theoretical and practical implications for health communication and metaphoric construal.
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Affiliation(s)
| | - Jamie Arndt
- Department of Psychological Sciences, University of Missouri-Columbia
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Driedger SM, Annable G, Brouwers M, Turner D, Maier R. Can you un-ring the bell? A qualitative study of how affect influences cancer screening decisions. BMC Cancer 2017; 17:647. [PMID: 28903742 PMCID: PMC5598010 DOI: 10.1186/s12885-017-3596-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 08/23/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The belief that early detection is the best protection against cancer underlies cancer screening. Emerging research now suggests harms associated with early detection may sometimes outweigh the benefits. Governments, cancer agencies, and organizations that publish screening guidelines have found it is difficult to "un-ring the bell" on the message that "early detection is your best protection" because of its widespread communication and enduring resonance. This study explores affective factors-and their interplay with relevant analytical factors-in public/laypersons' decision making about cancer screening. METHODS A total of 93 people (47 men, 46 women) attended focus groups about, respectively, prostate cancer screening and breast cancer screening in two Canadian cities. RESULTS Affective factors were a major influence on many focus group participants' decision making about cancer screening, including fear of cancer and a generalized enthusiasm for prevention/screening, and they were often inspired by anecdotes about the cancer experiences of family and friends. Affect also existed alongside more analytical factors including assessments of reduced risk in the management of any cancer diagnosis if caught early, and, for men, the belief that an unreliable test is "better than nothing," and that men deserve prostate cancer screening because women have breast and cervical cancer screening. Affective factors were particularly noticeable in the sub-groups most supportive of screening and the "early detection" message: older women who felt that mammogram screening should begin at age 40 rather than 50, and older men who felt that prostate cancer screening should be expanded beyond its current unorganized, opportunistic usage. In contrast, younger participants displayed less affective attachments to "early detection" messages and had greater concerns about harms of screening and were more receptive to nuanced messages informed by evidence. CONCLUSION Policymakers attempting to communicate more nuanced versions of the "early detection" message need to understand the role of affect alongside other judgments brought into laypersons' decision making processes and anticipate how affective responses to their messages will be shaped, transformed, and potentially subverted by external forces beyond their control. Particularly overt external factors are campaigns by cancer advocacy organizations actively promoting breast and prostate cancer awareness and screening to younger women and men using affectively-charged messages.
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Affiliation(s)
- S. Michelle Driedger
- Community Health Sciences, College of Medicine, Faculty of Health Sciences, University of Manitoba, S113-750 Bannatyne Avenue, Winnipeg, MB R3E 0W3 Canada
| | - Gary Annable
- Community Health Sciences, College of Medicine, Faculty of Health Sciences, University of Manitoba, S113-750 Bannatyne Avenue, Winnipeg, MB R3E 0W3 Canada
| | - Melissa Brouwers
- Department of Oncology, McMaster University, Juravinski Site, 60 (G) Wing, 711 Concession Street, Hamilton, ON L8V 1C3 Canada
| | - Donna Turner
- Population Oncology, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, MB R3E 0V9 Canada
| | - Ryan Maier
- Community Health Sciences, College of Medicine, Faculty of Health Sciences, University of Manitoba, S113-750 Bannatyne Avenue, Winnipeg, MB R3E 0W3 Canada
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Lee M, Zhu L, Wang MQ, Wei Z, Tan Y, Nguyen MT, Ogunwobi OO, Ma GX. Psychosocial Predictors of HBV Screening Behavior among Vietnamese Americans. Am J Health Behav 2017; 41:561-570. [PMID: 28760178 PMCID: PMC5633084 DOI: 10.5993/ajhb.41.5.5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE We evaluated the influence of psychosocial factors on HBV screening. METHODS Sample consisted of 1716 Vietnamese participants in our previous HBV intervention trial, recruited from 36 community-based organizations in Pennsylvania, New Jersey, and New York City between 2009 and 2014. Using the Health Belief Model and Social Cognitive Theory, we measured self-efficacy, knowledge, perceived barriers, perceived benefits, perceived severity, and risk susceptibility. Analysis of covariance was used to compare pre- and post-intervention changes of psychosocial variables. Structural equation modeling was used to explore the direct and indirect effects of the psychosocial variables on HBV screening. RESULTS Knowledge, self-efficacy, perceived benefits, and perceived barriers were directly associated with HBV screening; knowledge had the strongest effect. Perceived severity and risk susceptibility had indirect association with HBV screening through other variables. Indirect paths among the 6 psychosocial variables were also identified. CONCLUSION To promote HBV screening among Vietnamese Americans, intervention efforts should focus on increasing knowledge, self-efficacy, and perceived benefits, decreasing perceived barriers, and accounting for the dynamic cognitive processing.
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Affiliation(s)
- Minsun Lee
- Postdoctoral Associate, Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Lin Zhu
- Postdoctoral Associate, Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Min Qi Wang
- Professor, Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD
| | - Zhengyu Wei
- Research Associate, Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | | | - Minhhuyen T Nguyen
- Director, Section of Clinical Gastroenterology, Department of Medicine, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
| | - Olorunseun O Ogunwobi
- Associate Professor, Department of Biological Sciences, Hunter College of the City University of New York, New York, NY
| | - Grace X Ma
- Associate Dean for Health Disparities, Director, Center for Asian Health, Laura H. Carnell Professor and Professor in Clinical Sciences, Lewis Katz School of Medicine, Temple University Philadelphia, PA;,
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Russo S, Mccaffery K, Ellard J, Poynten M, Prestage G, Templeton DJ, Hillman R, Law C, Grulich AE. Experience and psychological impact of anal cancer screening in gay, bisexual and other men who have sex with men: a qualitative study. Psychooncology 2017. [PMID: 28635044 DOI: 10.1002/pon.4480] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Human papillomavirus-related anal cancer rates are increasing and are particularly high in gay, bisexual and other men who have sex with men (GBM/MSM), especially HIV-positive individuals. Although screening programs for high-risk populations have been advocated, concerns about possible adverse psychological consequences exist. This study aimed to investigate GBM/MSM's experience, understanding and emotional response to screening techniques for anal cancer to determine how best to minimise psychological distress in future programs. METHODS In-depth qualitative face-to-face interviews were conducted with 21 GBM/MSM participating in the "Study of the Prevention of Anal Cancer" in Sydney, Australia, between June 2013 and June 2014. Nonrandom, purposive sampling was used to ensure heterogeneity with respect to HIV status and screening test results. Framework analysis method was used to organise the data and identify emerging themes. RESULTS Knowledge about anal cancer, human papillomavirus and the link between them was limited. Abnormal screening results affected participants' sense of well-being and were associated with anxiety and concern about developing anal cancer. HIV-negative men receiving abnormal results showed higher levels of distress compared to their HIV-positive counterparts. Consultations with general practitioners about abnormal results had an important role in increasing participants' understanding and in moderating their anxiety. CONCLUSION Anal cancer screening should be accompanied by health education around anal cancer, its aetiology and the meaning of associated test results. Simple and effective communication strategies should be encouraged. Collaboration with general practitioners could assist the process of education and reporting test results.
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Affiliation(s)
- S Russo
- Behavioural Sciences Unit, School of Women's and Children's Health, UNSW, Sydney, Australia
| | - K Mccaffery
- School of Public Health, University of Sydney, Sydney, Australia
| | - J Ellard
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - M Poynten
- The Kirby Institute, UNSW, Sydney, Australia
| | - G Prestage
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia.,The Kirby Institute, UNSW, Sydney, Australia
| | - D J Templeton
- The Kirby Institute, UNSW, Sydney, Australia.,RPA Sexual Health, Sydney Local Health District, Sydney, Australia.,Central Clinical School, University of Sydney, Australia
| | - R Hillman
- The Kirby Institute, UNSW, Sydney, Australia.,St Vincent's Hospital, Sydney, Australia
| | - C Law
- St Vincent's Hospital, Sydney, Australia
| | - A E Grulich
- The Kirby Institute, UNSW, Sydney, Australia
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79
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Young B, Bedford L, Kendrick D, Vedhara K, Robertson JFR, das Nair R. Factors influencing the decision to attend screening for cancer in the UK: a meta-ethnography of qualitative research. J Public Health (Oxf) 2017; 40:315-339. [DOI: 10.1093/pubmed/fdx026] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 02/24/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- B Young
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - L Bedford
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - D Kendrick
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - K Vedhara
- Division of Primary Care, University of Nottingham, Nottingham, UK
| | - J F R Robertson
- Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, UK
| | - R das Nair
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
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80
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Padamsee TJ, Wills CE, Yee LD, Paskett ED. Decision making for breast cancer prevention among women at elevated risk. Breast Cancer Res 2017; 19:34. [PMID: 28340626 PMCID: PMC5366153 DOI: 10.1186/s13058-017-0826-5] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Several medical management approaches have been shown to be effective in preventing breast cancer and detecting it early among women at elevated risk: 1) prophylactic mastectomy; 2) prophylactic oophorectomy; 3) chemoprevention; and 4) enhanced screening routines. To varying extents, however, these approaches are substantially underused relative to clinical practice recommendations. This article reviews the existing research on the uptake of these prevention approaches, the characteristics of women who are likely to use various methods, and the decision-making processes that underlie the differing choices of women. It also highlights important areas for future research, detailing the types of studies that are particularly needed in four key areas: documenting women's perspectives on their own perceptions of risk and prevention decisions; explicit comparisons of available prevention pathways and their likely health effects; the psychological, interpersonal, and social processes of prevention decision making; and the dynamics of subgroup variation. Ultimately, this research could support the development of interventions that more fully empower women to make informed and values-consistent decisions, and to move towards favorable health outcomes.
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Affiliation(s)
- Tasleem J. Padamsee
- Division of Health Services Management & Policy, College of Public Health, The Ohio State University, 280F Cunz Hall, 1841 Neil Avenue, Columbus, OH 43220 USA
| | - Celia E. Wills
- College of Nursing, The Ohio State University, Columbus, OH USA
| | - Lisa D. Yee
- College of Medicine, The Ohio State University, Columbus, OH USA
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81
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Effects of a Randomized Controlled Trial to Increase Repeat Mammography Screening in Iranian Women. Cancer Nurs 2017; 33:309-15. [PMID: 25122130 DOI: 10.1097/ncc.0000000000000185] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although mammography use has increased in developed countries, regular screening in developing countries including Iran remains low. Multiple frameworks, including the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB), have been used to understand screening practices among Iranians. The HBM includes intrapersonal constructs such as perceptions of breast cancer and mammography. The TPB includes interpersonal and environmental constructs, such as perceived control and subjective norms. OBJECTIVES The current study had 2 objectives: (1) to examine changes in the HBM and TPB constructs and repeat mammography screening in women receiving either intervention and women in the control group and (2) to compare changes in the HBM and TPB constructs and repeat mammography screening across the 2 interventions. METHODS One hundred eight-four women from 3 randomly selected health centers in Sanandaj, Iran, participated. Eligibility criteria were being 50 years or older, having received a mammogram in the past 2 to 3 years, and no intention to obtain a mammogram within the next year. RESULTS The TPB and HBM participants exhibited greater changes in the HBM and TPB constructs and were more likely to have a mammogram relative to control participants. The TPB and HBM participants exhibited comparable changes in constructs and repeat mammography. CONCLUSION Findings suggest both interventions equally improved mammography screening. Additional studies are furthermore warranted to address nonadherent Iranian women's needs in line with these conceptual models. IMPLICATIONS FOR PRACTICE Use of the HBM and TPB constructs in clinical practice may be helpful to promote continued screening among this population.
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82
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Fielden HG, Brown SL, Saini P, Beesley H, Salmon P. How do women at increased breast cancer risk perceive and decide between risks of cancer and risk-reducing treatments? A synthesis of qualitative research. Psychooncology 2016; 26:1254-1262. [PMID: 27983769 PMCID: PMC5599983 DOI: 10.1002/pon.4349] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 12/12/2016] [Accepted: 12/13/2016] [Indexed: 11/30/2022]
Abstract
Objective Risk‐reducing procedures can be offered to people at increased cancer risk, but many procedures can have iatrogenic effects. People therefore need to weigh risks associated with both cancer and the risk‐reduction procedure in their decisions. By reviewing relevant literature on breast cancer (BC) risk reduction, we aimed to understand how women at relatively high risk of BC perceive their risk and how their risk perceptions influence their decisions about risk reduction. Methods Synthesis of 15 qualitative studies obtained from systematic searches of SCOPUS, Web of Knowledge, PsychINFO, and Medline electronic databases (inception‐June 2015). Results Women did not think about risk probabilistically. Instead, they allocated themselves to broad risk categories, typically influenced by their own or familial experiences of BC. In deciding about risk‐reduction procedures, some women reported weighing the risks and benefits, but papers did not describe how they did so. For many women, however, an overriding wish to reduce intense worry about BC led them to choose aggressive risk‐reducing procedures without such deliberation. Conclusions Reasoning that categorisation is a fundamental aspect of risk perception, we argue that patients can be encouraged to develop more nuanced and accurate categorisations of their own risk through their interactions with clinicians. Empirically‐based ethical reflection is required to determine whether and when it is appropriate to provide risk‐reduction procedures to alleviate worry.
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Affiliation(s)
- Hannah G Fielden
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Stephen L Brown
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Pooja Saini
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK.,CLAHRC North West, University of Liverpool, Liverpool, UK
| | - Helen Beesley
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Peter Salmon
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
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83
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Abstract
BACKGROUND With improved treatments, the survival rate for breast cancer patients is increasing. With the improvements in quantity of life, research in the field of cancer survivorship has turned its attention to psychosocial functioning and health behaviors. OBJECTIVES The purpose of this study was to examine how those currently under treatment and those completing treatment engaged in health behaviors (ie, diet, vitamin use, exercise, and cancer screening) and if psychosocial predictors, guided by the Self-regulation Model, also play a role. METHODS Using the Self-regulation Model, the current survey and medical record review examined health behaviors (diet, vitamin use, exercise, cancer screening) in individuals in active treatment for breast cancer and in those completing treatment (n = 141). RESULTS Regression models revealed that those in active treatment had less healthy food consumption, vitamin use, and clinical examinations than did treatment completers. Greater perceived treatment efficacy was associated with diet and vitamin use but not exercise or cancer screening. Greater perceived risk of recurrence was associated with less exercise. Greater distress was associated with greater mammography use. Those from metro areas had greater healthy food consumption. RESULTS Qualitative data indicated that chemotherapy interfered with health behaviors for those in active treatment; treatment completers wished to have a healthier lifestyle. CONCLUSION Cancer treatment interferes with health behaviors, and these health behaviors might help individuals manage their cancer treatment more effectively. IMPLICATIONS FOR PRACTICE Those currently undergoing treatment desire assistance with a healthier lifestyle, and relevant clinical interventions should stress treatment efficacy.
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84
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Choi E, Lee YY, Suh M, Park B, Jun JK, Kim Y, Choi KS. Associations of perceived risk and cancer worry for colorectal cancer with screening behaviour. J Health Psychol 2016; 23:840-852. [PMID: 27872387 DOI: 10.1177/1359105316679721] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We investigated the associations of perceived risk and cancer worry with colorectal cancer screening by the faecal occult blood test, colonoscopy or both. This study was based on the 2013 Korean National Cancer Screening Survey, including 2154 randomly selected, cancer-free and over 50-year-old adults. Individuals with higher cancer worry were 1.53 times more likely to undergo colorectal cancer screening, influenced by emotional reaction; individuals with greater perceived risk were 1.61 times more, affected by subjective awareness. However, cancer worry was only associated with the faecal occult blood test. Better understanding of cancer worry and perceived risk on screening behaviours may help to increase colorectal cancer screening rates.
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Affiliation(s)
- Eunji Choi
- 1 Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea
| | - Yoon Young Lee
- 2 National Cancer Control Institute, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - Mina Suh
- 2 National Cancer Control Institute, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - Boyoung Park
- 1 Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea
| | - Jae Kwan Jun
- 2 National Cancer Control Institute, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - Yeol Kim
- 2 National Cancer Control Institute, National Cancer Center, Goyang, Gyeonggi-do, Korea
| | - Kui Son Choi
- 1 Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea
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85
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April-Sanders A, Oskar S, Shelton RC, Schmitt KM, Desperito E, Protacio A, Tehranifar P. Predictors of Breast Cancer Worry in a Hispanic and Predominantly Immigrant Mammography Screening Population. Womens Health Issues 2016; 27:237-244. [PMID: 27863982 DOI: 10.1016/j.whi.2016.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 09/01/2016] [Accepted: 10/10/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Worry about developing breast cancer (BC) has been associated with participation in screening and genetic testing and with follow-up of abnormal screening results. Little is known about the scope and predictors of BC worry in Hispanic and immigrant populations. METHODS We collected in-person interview data from 250 self-identified Hispanic women recruited from an urban mammography facility (average age 50.4 years; 82% foreign-born). Women reported whether they worried about developing breast cancer rarely/never (low worry), sometimes (moderate worry), or often/all the time (high worry). We examined whether sociocultural and psychological factors (e.g., acculturation, education, perceived risk), and risk factors and objective risk for BC (e.g., family history, Gail model 5-year risk estimates, parity) predicted BC worry using multinomial and logistic regression. RESULTS In multivariable models, women who perceived higher absolute BC risk (odds ratio, 1.66 [95% confidence interval, 1.28-2.14] for a one-unit increase in perceived lifetime risk) and comparative BC risk (e.g., odds ratio, 2.73, 95% confidence interval, 1.23-6.06) were more likely to report high BC worry than moderate or low BC worry. There were no associations between BC worry and indicators of objective risk or acculturation. CONCLUSIONS In Hispanic women undergoing screening mammography, higher perceptions of BC risk, in both absolute and comparative terms, were associated independently with high BC worry, and were stronger predictors of BC worry than indicators of objective BC risk, including family history, mammographic density, and personal BC risk estimates.
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Affiliation(s)
- Ayana April-Sanders
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Sabine Oskar
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Rachel C Shelton
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Karen M Schmitt
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York; Division of Academics, School of Nursing, Columbia University, New York, New York; Avon Foundation Breast Imaging Center-New York Presbyterian, New York, New York
| | - Elise Desperito
- Department of Radiology, Columbia University Medical Center-New York Presbyterian, New York, New York
| | - Angeline Protacio
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Parisa Tehranifar
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York; Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, New York.
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86
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Vrinten C, McGregor LM, Heinrich M, von Wagner C, Waller J, Wardle J, Black GB. What do people fear about cancer? A systematic review and meta-synthesis of cancer fears in the general population. Psychooncology 2016; 26:1070-1079. [PMID: 27643482 PMCID: PMC5573953 DOI: 10.1002/pon.4287] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 08/15/2016] [Accepted: 09/15/2016] [Indexed: 12/13/2022]
Abstract
Background Cancer has long inspired fear, but the effect of fear is not well understood; it seems both to facilitate and to deter early diagnosis behaviours. To elucidate fear's behavioural effects, we systematically reviewed and synthesised qualitative literature to explore what people fear about cancer. Methods We searched Medline, Embase, PsycInfo, Web of Science, AnthroSource, and Anthrobase for studies on cancer fear in breast, cervical, and colorectal cancer screening and analysed 102 studies from 26 countries using thematic synthesis. Results Fears of cancer emanated from a core view of cancer as a vicious, unpredictable, and indestructible enemy, evoking fears about its proximity, the (lack of) strategies to keep it at bay, the personal and social implications of succumbing, and fear of dying from cancer. Conclusions This view of cancer as ‘an enemy’ reprises the media's ‘war on cancer’ theme and may affect the acceptance of cancer early detection and prevention messages, since cancer's characteristics influenced whether ‘fight’ or ‘flight’ was considered appropriate.
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Affiliation(s)
| | | | | | | | - Jo Waller
- Department of Epidemiology and Public Health, UCL, London, UK
| | - Jane Wardle
- Department of Epidemiology and Public Health, UCL, London, UK
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87
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Sepulveda-Pacsi AL, Hiraldo G, Frederickson K. Cancer Worry Among Urban Dominican Women: A Qualitative Study. J Transcult Nurs 2016; 29:30-37. [PMID: 27758840 DOI: 10.1177/1043659616672062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Two thirds of respondents of a recent survey, primarily self-identified urban immigrant Dominican females, indicated that cancer was the health problem they worried about the most. PURPOSE The purpose of this qualitative study was to gain a greater understanding of the cancer worry experienced by Dominican women. DESIGN Giorgi's descriptive existential phenomenological framework and methodology guided the study. SETTING Washington Heights/Inwood community, New York City, New York. PARTICIPANTS Thirty-eight urban Dominican immigrant women were included in the study. METHOD Data were gathered using focus group interviews. All interviews were digitally recorded, transcribed verbatim from Spanish to English. The transcripts were analyzed using Giorgi's existential phenomenological data analysis process. FINDINGS Four essences unfolded: Cancer as Destiny, Faith, Influential Relationships, and Knowledge Acquisition. CONCLUSION New knowledge was generated on the contextual factors that influence cancer worry among a major Hispanic subgroup. Implications for nursing research and practice are described.
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88
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Comello MLNG, Myrick JG, Raphiou AL. A health fundraising experiment using the "foot-in-the-door" technique. Health Mark Q 2016; 33:206-20. [PMID: 27484742 DOI: 10.1080/07359683.2016.1199209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Foot-in-the-door (FITD) involves obtaining compliance with a small request to boost compliance with a larger request. Only a few studies to date have tested the technique in health and fundraising contexts, and even fewer have examined the psychological processes involved. To address these gaps, we conducted an experiment as an actual fundraiser for a cancer-awareness organization. The technique activated a self-concept as a supporter of cancer awareness among those in the FITD condition. Donation amount was also higher among those in FITD, but only among those with higher levels of worry and low to moderate levels of preference for consistency.
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Affiliation(s)
| | | | - April Little Raphiou
- a School of Media and Journalism , University of North Carolina , Chapel Hill , North Carolina , USA
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89
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Harada K, Lee S, Shimada H, Lee S, Bae S, Anan Y, Harada K, Suzuki T. Psychological predictors of participation in screening for cognitive impairment among community‐dwelling older adults. Geriatr Gerontol Int 2016; 17:1197-1204. [DOI: 10.1111/ggi.12841] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 05/05/2016] [Accepted: 05/10/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Kazuhiro Harada
- Graduate School of Human Development and Environment Kobe University Kobe Japan
- Department of Preventive Gerontology National Center for Geriatrics and Gerontology Obu Japan
| | - Sangyoon Lee
- Department of Preventive Gerontology National Center for Geriatrics and Gerontology Obu Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology National Center for Geriatrics and Gerontology Obu Japan
| | - Sungchul Lee
- Department of Preventive Gerontology National Center for Geriatrics and Gerontology Obu Japan
| | - Seongryu Bae
- Department of Preventive Gerontology National Center for Geriatrics and Gerontology Obu Japan
| | - Yuya Anan
- Department of Preventive Gerontology National Center for Geriatrics and Gerontology Obu Japan
| | - Kenji Harada
- Department of Preventive Gerontology National Center for Geriatrics and Gerontology Obu Japan
| | - Takao Suzuki
- Institute for Gerontology J. F. Oberlin University Machida Japan
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90
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Elrick A, Ashida S, Ivanovich J, Lyons S, Biesecker BB, Goodman MS, Kaphingst KA. Psychosocial and Clinical Factors Associated with Family Communication of Cancer Genetic Test Results among Women Diagnosed with Breast Cancer at a Young Age. J Genet Couns 2016; 26:173-181. [PMID: 27422778 DOI: 10.1007/s10897-016-9995-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 07/07/2016] [Indexed: 12/18/2022]
Abstract
Genetic test results have medical implications beyond the patient that extend to biological family members. We examined psychosocial and clinical factors associated with communication of genetic test results within families. Women (N = 1080) diagnosed with breast cancer at age 40 or younger completed an online survey; 920 women that reported prior cancer genetic testing were included in analysis. We examined the proportion of immediate family members to whom they communicated genetic test results, and built multivariable regression models to examine clinical and psychosocial variables associated with the proportion score. Participants were most likely to communicate test results to their mother (83 %) and least likely to their son (45 %). Participants who carried a BRCA mutation (OR = 1.34; 95 % CI = 1.06, 1.70), had higher interest in genomic information (OR = 1.55; 95 % CI = 1.26, 1.91) and lower genetic worry (OR = 0.91; 95 % CI = 0.86, 0.96) communicated genetic test results to a greater proportion of their immediate family members. Participants with a BRCA1/2 mutation shared their genetic test results with more male family members (OR = 1.72; 95 % CI = 1.02, 2.89). Our findings suggest that patients with high worry about genetic risks, low interest in genomic information, or receive a negative genetic test result will likely need additional support to encourage family communication.
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Affiliation(s)
- Ashley Elrick
- Department of Communication, University of Utah, 255 Central Campus Drive, LNCO, Salt Lake City, UT, 84112, USA.
| | - Sato Ashida
- College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Jennifer Ivanovich
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Sarah Lyons
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Barbara B Biesecker
- Social and Behavioral Research Branch, National Human Genome Research Institute, Bethesda, MD, USA
| | - Melody S Goodman
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Kimberly A Kaphingst
- Department of Communication, University of Utah, 255 Central Campus Drive, LNCO, Salt Lake City, UT, 84112, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
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91
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Castañeda SF, Malcarne VL, Foster-Fishman PG, Davidson WS, Mumman MK, Riley N, Sadler GR. Health care access and breast cancer screening among Latinas along the California-Mexican border. J Immigr Minor Health 2016; 16:670-81. [PMID: 24150421 DOI: 10.1007/s10903-013-9938-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Latinas are more likely to exhibit late stage breast cancers at the time of diagnosis and have lower survival rates compared to white women. A contributing factor may be that Latinas have lower rates of mammography screening. This study was guided by the Behavioral Model of Health Services Use to examine factors associated with mammography screening utilization among middle-aged Latinas. An academic-community health center partnership collected data from community-based sample of 208 Latinas 40 years and older in the San Diego County who completed measures assessing psychosocial factors, health care access, and recent mammography screening. Results showed that 84.6 % had ever had a mammogram and 76.2 % of women had received a mammogram in the past 2 years. Characteristics associated with mammography screening adherence included a lower acculturation (OR 3.663) a recent physician visit in the past year (OR 6.304), and a greater confidence in filling out medical forms (OR 1.743), adjusting for covariates. Results demonstrate that an annual physical examination was the strongest predictor of recent breast cancer screening. Findings suggest that in this community, improving access to care among English-speaking Latinas and addressing health literacy issues are essential for promoting breast cancer screening utilization.
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Affiliation(s)
- Sheila F Castañeda
- Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, 9245 Sky Park Court, Suite 110, San Diego, CA, 92123, USA,
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92
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Hirai K, Ishikawa Y, Fukuyoshi J, Yonekura A, Harada K, Shibuya D, Yamamoto S, Mizota Y, Hamashima C, Saito H. Tailored message interventions versus typical messages for increasing participation in colorectal cancer screening among a non-adherent population: A randomized controlled trial. BMC Public Health 2016; 16:431. [PMID: 27220976 PMCID: PMC4877938 DOI: 10.1186/s12889-016-3069-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 04/21/2016] [Indexed: 11/29/2022] Open
Abstract
Background The purpose of this study was to examine the effectiveness and cost-efficiency of a tailored message intervention compared with a non-tailored message intervention for increasing colorectal cancer (CRC) screening rates among a non-adherent population, in a community-based client reminder program. Methods After a baseline survey for psychological segmentation, 2140 eligible individuals were randomly assigned either to a group with a tailored matched-message condition (N = 356), a group with a non-tailored unmatched-message condition (N = 355), or to two control groups, one using a typical message with a professional design (N = 717) and one without a professional design (N = 712). The main outcome measure was attendance rates in a community-organized CRC screening program within five months of receiving a print reminder. Results There was a significant difference in fecal occult blood test (FOBT) attendance rates at follow-up assessments between the tailored matched-message condition (14.0 %) and the control (9.9 %; OR = 1.48, p = 0.026), while there was no significant difference between the unmatched-message condition (11.0 %) and the control (OR = 1.12, p = 0.558), and between the matched-message condition and the unmatched-message condition (OR = 1.32, p = 0.219). The cost of a one-person increase in FOBT screening was 3,740 JPY for the tailored matched-message condition, while it was 2,747 JPY for the control. Conclusions A tailored-message intervention for segmented individuals designed to increase CRC screening rates in a community-based client reminder program was significantly effective compared to a usual reminder, but not more effective than an unmatched message in a randomized controlled trial, and was not sufficiently effective to highlight its value from a cost perspective. Therefore, the tailored intervention including target segmentation needs to be improved for future implementation in a CRC screening program for a non-adherent population. Trial registration UMIN Clinical Trials Registry UMIN000004384. Date of Registration: March 2011. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3069-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kei Hirai
- Graduate School of Human Sciences, and Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita-shi, Osaka, 565-0871, Japan.
| | - Yoshiki Ishikawa
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | | | | | - Kazuhiro Harada
- Graduate School of Human Development and Environment, Kobe University, Kobe, Japan
| | - Daisuke Shibuya
- Cancer Detection Center, Miyagi Cancer Society, Miyagi, Japan
| | - Seiichiro Yamamoto
- Public Health Policy Research Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
| | - Yuri Mizota
- Public Health Policy Research Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
| | - Chisato Hamashima
- Screening Assessment and Management Division, National Cancer Center, Tokyo, Japan
| | - Hiroshi Saito
- Screening Assessment and Management Division, National Cancer Center, Tokyo, Japan
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93
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Abstract
Dementia worry, an anxiety-related response to the possibility of developing dementia, represents an important yet underexplored health concern for an aging population. Such a construct is likely impacted by stereotypes concerning aging, including biased associations of aging with inevitable cognitive decline. The present article explores the impact of mixed positive and negative aging stereotype messages on levels of dementia worry. The Fear of Alzheimer's Disease Scale (FADS) was used to measure impact of priming with different proportions of positive and negative aging stereotype words. The priming intervention was modeled after Levy (J Pers Soc Psychol 71:1092-1107, 1996, doi:10.1037/0022-3514.71.6.1092). Eighty older adult participants (Mage = 71.65, SD = 6.57) were exposed to mostly positive aging stereotype words, half positive/half negative words, mostly negative words, all negative words, or non-stereotype words. Mean FADS item response was significantly impacted by priming such that those in the all negative condition had highest levels of dementia worry, F(4, 75) = 2.48, p = .05, [Formula: see text]. This effect was strengthened when relevance of aging stereotypes was controlled for, p < .01. Results suggested that brief exposure to negative aging stereotype content increased levels of dementia worry, particularly when stereotypes were self-relevant. These findings indicate addressing aging stereotypes may be one way of impacting dementia worry.
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Affiliation(s)
- Joie Molden
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, CO 80918 USA
| | - Molly Maxfield
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, CO 80918 USA
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94
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Abstract
Dementia worry, an anxiety-related response to the possibility of developing dementia, represents an important yet underexplored health concern for an aging population. Such a construct is likely impacted by stereotypes concerning aging, including biased associations of aging with inevitable cognitive decline. The present article explores the impact of mixed positive and negative aging stereotype messages on levels of dementia worry. The Fear of Alzheimer's Disease Scale (FADS) was used to measure impact of priming with different proportions of positive and negative aging stereotype words. The priming intervention was modeled after Levy (J Pers Soc Psychol 71:1092-1107, 1996, doi:10.1037/0022-3514.71.6.1092). Eighty older adult participants (Mage = 71.65, SD = 6.57) were exposed to mostly positive aging stereotype words, half positive/half negative words, mostly negative words, all negative words, or non-stereotype words. Mean FADS item response was significantly impacted by priming such that those in the all negative condition had highest levels of dementia worry, F(4, 75) = 2.48, p = .05, [Formula: see text]. This effect was strengthened when relevance of aging stereotypes was controlled for, p < .01. Results suggested that brief exposure to negative aging stereotype content increased levels of dementia worry, particularly when stereotypes were self-relevant. These findings indicate addressing aging stereotypes may be one way of impacting dementia worry.
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Affiliation(s)
- Joie Molden
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, CO 80918 USA
| | - Molly Maxfield
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, CO 80918 USA
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95
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Hay JL, Gold GS, Baser RE, Hricak H, Dauer LT. Prevalence and Correlates of Worry About the Health Harms of Medical Imaging Radiation in the General Population. J Prim Care Community Health 2016; 7:219-25. [PMID: 27162081 DOI: 10.1177/2150131916648917] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In recent years, there have been dramatic increases in medical imaging use and increasing media attention to increased exposure to ionizing radiation in the United States. Patient perspectives on medical imaging radiation (MIR) use is understudied, but could guide primary care discussions. This study examines prevalence of worry about the health harms from MIR in the US general population. METHODS This cross-sectional study used the 2012-2013 Health Information National Trends Survey conducted by the National Cancer Institute. A nationally representative sample (N = 3532) was drawn from the US general population to observe prevalence of worry about MIR as well as potential covariates, including demographic, medical, and psychological factors, health information-seeking, physician trust in providing cancer information, and cancer fatalism. RESULTS About 65% of the sample population reported experiencing at least some worry about MIR. Univariable and multivariable logistic regressions indicate higher rates of MIR worry among women, racial/ethnic minorities, those with lower educational attainment, foreign-born Americans, those who self-report poorer health, and those with a personal history of cancer. Lower trust in cancer information from physicians and greater attention to cancer information from popular media were each associated with higher rates of worry about health harms of MIR. CONCLUSIONS An accurate assessment of public worry about MIR will aid primary care providers' efforts to understand patient responses to medical imaging and identify addressable knowledge gaps regarding benefits and risks of medical imaging. These data may improve risk communication regarding medical imaging among referring primary care physicians, radiologists, and patients.
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Affiliation(s)
- Jennifer L Hay
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | - Hedvig Hricak
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
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96
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Jensen JD, Liu M, Carcioppolo N, John KK, Krakow M, Sun Y. Health information seeking and scanning among US adults aged 50–75 years: Testing a key postulate of the information overload model. Health Informatics J 2016; 23:96-108. [DOI: 10.1177/1460458215627290] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Past research has found that older US adults (aged 50–75 years) exhibit high levels of cancer information overload and cancer worry; however, no study to date has examined whether these perceptions are related to information seeking/scanning. To explore this relationship, older adults ( N = 209, Mage = 55.56, SD = 4.24) were recruited to complete a survey measuring seeking, scanning, cancer information overload, and cancer worry. Most participants were high-scan/seekers (40.2%) followed by low-scan/seekers (21.1%), high-scan/no seekers (19.6%), and low-scan/no seekers (19.1%). Low-scan/no seekers had significantly higher cancer information overload compared to all other groups, consistent with the postulate that overload and seeking/scanning are negatively related. Low-scan/no seekers and high-scan/seekers both exhibited higher cancer worry severity, consistent with past research suggesting that cancer worry explains high levels of activity/inactivity.
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97
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Vrinten C, Wardle J, Marlow LA. Cancer fear and fatalism among ethnic minority women in the United Kingdom. Br J Cancer 2016; 114:597-604. [PMID: 26867159 PMCID: PMC4782206 DOI: 10.1038/bjc.2016.15] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 12/14/2015] [Accepted: 12/26/2015] [Indexed: 11/13/2022] Open
Abstract
Background: Cancer fear and fatalism are believed to be higher in ethnic minorities and may contribute to lower engagement with cancer prevention and early detection. We explored the levels of cancer fear and fatalism in six ethnic groups in the United Kingdom and examined the contribution of acculturation and general fatalism. Methods: A cross-sectional survey of 720 White British, Caribbean, African, Indian, Pakistani, and Bangladeshi women (120 of each) was conducted. Three items assessed cancer fear and two cancer fatalism. Acculturation was assessed using (self-reported) migration status, ability to speak English, and understanding of health leaflets; general fatalism with a standard measure. Results: Relative to White British women, African and Indian women were more fearful of cancer, Bangladeshi women less fearful, and Pakistani and Caribbean women were similar to White British women. Cancer fatalism was higher in all the ethnic minority groups compared with White British women. Less acculturated women were less likely to worry (ORs 0.21–0.45, all P<0.05) or feel particularly afraid (ORs 0.11–0.31, all P<0.05) but more likely to feel uncomfortable about cancer (ORs 1.97–3.03, all P<0.05). Lower acculturation (ORs 4.30–17.27, P<0.05) and general fatalism (OR 2.29, P<0.05) were associated with the belief that cancer is predetermined. Conclusions: In general, cancer fear and fatalism are more prevalent among ethnic minority than White British women and even more so in less acculturated ethnic minorities. This may affect their participation in cancer prevention and early detection.
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Affiliation(s)
- Charlotte Vrinten
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, UCL, Gower Street, London WC1E 6BT, UK
| | - Jane Wardle
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, UCL, Gower Street, London WC1E 6BT, UK
| | - Laura Av Marlow
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, UCL, Gower Street, London WC1E 6BT, UK
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98
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Rice LJ, Brandt HM, Hardin JW, Ingram LA, Wilson SM. Exploring perceptions of cancer risk, neighborhood environmental risks, and health behaviors of blacks. J Community Health 2016; 40:419-30. [PMID: 25315713 DOI: 10.1007/s10900-014-9952-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Cancer risk perceptions and cancer worry are shaped by race/ethnicity, and social, economic, and environmental factors, which in turn shape health decision-making. A paucity of studies has explored risk perceptions and worry in metropolitan areas with disparate environmental conditions and cancer outcomes. This study examined perceptions of cancer risk, neighborhood environmental health risks, and risk-reducing health behaviors among Blacks. A 59-item survey was administered to respondents in Metropolitan Charleston, South Carolina from March to September 2013. A convenience sample of males and females was recruited at local venues and community events. Descriptive statistics, bivariate analyses (Chi square tests), and logistic regression models were estimated using SAS 9.3 software. Respondents (N = 405) were 100% Black, 81% female (n = 323), and ranged from 18 to 87 years of age (M = 49.55, SD = 15.27). Most respondents reported lower perceptions of cancer risk (37%) and equated their cancer beliefs to direct or indirect (i.e. personal or family) experiences. Low perceived cancer risk (absolute risk) was significantly associated (p < .05) with non-alcohol consumption, having a colon cancer screening test, being female, and being age 25-44 or 45-64. Cancer worry was significantly associated (p < .05) with being a current smoker, having a "fair" diet, non-alcohol consumption, and having any colon cancer screening test. Perceived cancer risk is an important indicator of health behaviors among Blacks. Direct or indirect experiences with cancer and/or the environment and awareness of family history of cancer may explain cancer risk perceptions.
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Affiliation(s)
- LaShanta J Rice
- Hollings Cancer Center, Center for Population Health and Outcomes, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 68 President Street Suite BE 103, Charleston, SC, 29425, USA,
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99
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Hidalgo JLT, Sotos JR, Herráez MJS, Rosa MC, López JLT, Ortiz MPS. Factors Associated With Cancer Worry Among People Aged 50 or Older, Spain, 2012-2014. Prev Chronic Dis 2015; 12:E226. [PMID: 26704444 PMCID: PMC4692477 DOI: 10.5888/pcd12.150398] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Cancer worry varies among patients and may influence their participation in preventive activities. We tested whether sociodemographic characteristics, lifestyle, locus of control, comorbidity, and perceived health status were associated with the level of cancer worry among adults aged 50 or older. METHODS We conducted an observational cross-sectional study of 666 adults in Spain aged 50 or older. Participants were selected by simple random sampling and asked to visit their designated health center for a personal interview. The study variables were level of cancer worry (measured by Cancer Worry Scale [CWS]), sociodemographic characteristics, lifestyle, personal history or family history of cancer, comorbidity, self-perceived health, locus of control, and social support. RESULTS More than half of participants, 58.1%, were women; mean age was 60.5 years (standard deviation [SD], 6.8 y). Measurement of the frequency and severity of cancer worry (possible scale of 6-24 points) yielded a mean CWS score of 9.3 (95% confidence interval, 9.0-9.5); 31.9% of participants reported being concerned about cancer. Scores were higher among women (9.7 [SD, 3.3]) than men (8.7 [SD, 2.7]) (P < .001) and among participants in rural settings (10.0 [SD, 3.4]) than in urban settings (9.0 [SD, 3.0]) (P < .001). Multiple linear regression showed a greater degree of cancer worry among people with personal or family history of cancer, more health problems, worse self-perceived health, and lower social support. CONCLUSION Cancer worry is frequent among older adults, and the level of such concern is related not only to personal characteristics but also to lifestyle and health status. Further research is required to understand how contextual factors can influence cancer worry and how such concern changes behavior patterns related to cancer prevention activities.
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Affiliation(s)
- Jesús López-Torres Hidalgo
- Centro de Salud Universitario Zona IV, c/ Seminario No. 4, 02006, Albacete, Spain. E-mail: . Dr López-Torres Hidalgo is also affiliated with Albacete Zone IV Health Center, Castile-La Mancha Health Service, and Albacete Faculty of Medicine, University of Castile-La Mancha, Albacete
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100
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Kelly KM, Schoenberg N, Wilson TD, Atkins E, Dickinson S, Paskett E. Cervical cancer worry and screening among appalachian women. J Prim Prev 2015; 36:79-92. [PMID: 25416153 DOI: 10.1007/s10935-014-0379-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Although many have sought to understand cervical cancer screening (CCS) behavior, little research has examined worry about cervical cancer and its relationship to CCS, particularly in the underserved, predominantly rural Appalachian region. Our mixed method investigation aimed to obtain a more complete and theoretically-informed understanding of the role of cancer worry in CCS among Appalachian women, using the Self-Regulation Model (SRM). Our quantitative analysis indicated that the perception of being at higher risk of cervical cancer and having greater distress about cancer were both associated with greater worry about cancer. In our qualitative analysis, we found that, consistent with the SRM, negative affect had a largely concrete-experiential component, with many women having first-hand experience of the physical consequences of cervical cancer. Based on the results of this manuscript, we describe a number of approaches to lessen the fear associated with CCS. Intervention in this elevated risk community is merited and may focus on decreasing feelings of worry about cervical cancer and increasing communication of objective risk and need for screening. From a policy perspective, increasing the quantity and quality of care may also improve CCS rates and decrease the burden of cancer in Appalachia.
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Affiliation(s)
- Kimberly M Kelly
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, Mary Babb Randolph Cancer Center, Robert C. Byrd Health Sciences Center, West Virginia University, PO Box 9510, Morgantown, WV, 26506, USA,
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