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Gedefaw A, Yilma TM, Endehabtu BF. Information Seeking Behavior About Cancer and Associated Factors Among University Students, Ethiopia: A Cross-Sectional Study. Cancer Manag Res 2020; 12:4829-4839. [PMID: 32606972 PMCID: PMC7319524 DOI: 10.2147/cmar.s259849] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 06/12/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction Cancer is among the leading cause of death in sub-Saharan Africa over the last few years, putting a tremendous physical, emotional, and financial strain on individuals, families, and health systems. Many health systems in sub-Saharan Africa are least prepared to manage this burden, and a large number of individuals do not have access to quality cancer-related information to prevent and manage cancer. Understanding the information seeking behavior of individuals, especially university students who are more likely to seek health information than other people, can be seen as an opportunity to provide resources to improve lifestyle or prevent possible health-threatening behaviors of individuals. Objective This study aimed to assess cancer information seeking behavior (CISB) and its associated factors among students in Debre Tabor University, Ethiopia. Methods An institution-based cross-sectional study design was conducted among students at Debre Tabor University from March 01 to March 30, 2019. A total of 844 students were selected using a multistage stratified sampling technique. Data were collected using a structured and pre-tested questionnaire by trained data collectors. Data entry and analyses were performed using Epi info version 7.2 and SPSS version 20, respectively. Descriptive and inferential statistics were used to explore the socio-demographic information and cancer information seeking behavior. Binary logistic regression was used to identify factors associated with cancer information seeking. Results The proportion of cancer information seeking by students in the past 12 months was 30.1%. Their preferred source of information about cancer was health-care providers (48%) followed by the Internet (27.6%). Year of study, Internet access (AOR=6.07, 95% CI= 4.05, 9.10), health literacy level (AOR=1.8, 95% CI=1.21, 2.68), self-reported health condition (AOR=1.85, 95% CI=1.25, 2.73), perceived susceptibility to cancer (AOR=2.48, 95% CI=1.47, 4.2), and perceived severity of cancer (AOR=3.33, 95% CI=1.85, 6.0) were the factors associated with cancer information seeking. Conclusion The proportion of cancer information seeking among university students was low. Being 3rd- and 4th-year student, internet access, being healthy, adequate health literacy level, concerning about cancer, and higher perceived severity of cancer were significantly associated with cancer information seeking. Increase health literacy and awareness creation about cancer for students will help to seek cancer information.
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Affiliation(s)
- Adugna Gedefaw
- Department of Health Informatics, Debre Tabor Health Science College, Gondar, Ethiopia
| | - Tesfahun Melese Yilma
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Berhanu Fikadie Endehabtu
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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52
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Petrova D, Okan Y, Salamanca-Fernández E, Domínguez-López S, Sánchez MJ, Rodríguez-Barranco M. Psychological factors related to time to help-seeking for cancer symptoms: a meta-analysis across cancer sites. Health Psychol Rev 2020; 14:245-268. [PMID: 31284829 DOI: 10.1080/17437199.2019.1641425] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 07/05/2019] [Indexed: 12/19/2022]
Abstract
The time patients wait before seeking help for cancer symptoms is among the most important factors contributing to diagnostic delays in cancer. We reviewed the association between time to help-seeking and three psychological factors: symptom knowledge, symptom interpretation, and beliefs about cancer. Forty-seven studies met the inclusion criteria, providing data from 22 countries concerning seven cancer sites. Better symptom knowledge was related to lower odds of a long help-seeking interval in both studies with healthy populations (OR = .73, 95% CI [.63, .84], k = 19) and patients (OR = .40, 95% CI [.23, .69], k = 12), and so was interpreting experienced symptoms as cancer-related (OR = .52, 95% CI [.36, .75], k = 13 studies with patients). More positive beliefs about cancer (i.e., that cancer is treatable) were associated with lower odds of a long help-seeking interval in both studies with healthy populations (OR = .70, 95% CI [.52, .92], k = 11) and with patients (OR = .51, 95% CI [.32, .82], k = 7). Symptom knowledge, interpretation, and beliefs about cancer are likely to be universal predictors of help-seeking and should be incorporated into theoretical models of patient help-seeking and interventions aiming to reduce delays.
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Affiliation(s)
- Dafina Petrova
- Cancer Registry of Granada, Escuela Andaluza de Salud Pública, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, University of Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Yasmina Okan
- Centre for Decision Research, Leeds University Business School, University of Leeds, Leeds, UK
| | - Elena Salamanca-Fernández
- Cancer Registry of Granada, Escuela Andaluza de Salud Pública, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, University of Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - María-José Sánchez
- Cancer Registry of Granada, Escuela Andaluza de Salud Pública, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, University of Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Miguel Rodríguez-Barranco
- Cancer Registry of Granada, Escuela Andaluza de Salud Pública, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, University of Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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53
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Cancer Perceptions Among Smokeless Tobacco Users: A Qualitative Study of US Firefighters. Saf Health Work 2020; 11:284-290. [PMID: 32995053 PMCID: PMC7502578 DOI: 10.1016/j.shaw.2020.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/04/2020] [Accepted: 04/12/2020] [Indexed: 11/25/2022] Open
Abstract
Background Prevalence rates of smokeless tobacco (SLT) use among firefighters are remarkably high and substantially higher than similar occupational groups and the general U.S. population. The purpose of this study was to explore the perspectives of fire service personnel regarding cancer and its associations with tobacco and SLT use. Methods This descriptive study used a qualitative approach. Key informant interviews were conducted in 39 career firefighters and fire service administration from across the U.S. Discussion were recorded, transcribed verbatim and transferred to NVivo software for narrative analysis. Topics explored included cancer perceptions, attitudes and beliefs, and cultural factors related to SLT use behaviors. Results: Major themes that emerged among fire service personnel included concerns about cancer and its risk factors including firefighting tasks, such as fire overhaul operations, and from their lifestyle behaviors, such as alcohol and tobacco use. Firefighters also suggested a number of reasons for their increased SLT use, such as fire department tobacco-free policy and fire service culture. Conclusion The current study provides a rich foundation for future research, prevention, and intervention efforts for the fire service and research communities regarding tobacco and SLT use and cancer risk. Additional research on firefighters' cancer beliefs deserves future research in order to improve messaging about the risks of cancer due to firefighting.
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54
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Sinclair JMA, Dutey-Magni PF, Anderson AS, Baird J, Barker ME, Cutress RI, Kaner EFS, McCann M, Priest CK, Copson ER. A Context-Specific Digital Alcohol Brief Intervention in Symptomatic Breast Clinics (Abreast of Health): Development and Usability Study. JMIR Res Protoc 2020; 9:e14580. [PMID: 32012091 PMCID: PMC7007589 DOI: 10.2196/14580] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/25/2019] [Accepted: 09/07/2019] [Indexed: 12/28/2022] Open
Abstract
Background Potentially modifiable risk factors account for approximately 23% of breast cancer cases. In the United Kingdom, alcohol consumption alone is held responsible for 8% to 10% of cases diagnosed every year. Symptomatic breast clinics focus on early detection and treatment, but they also offer scope for delivery of low-cost lifestyle interventions to encourage a cancer prevention culture within the cancer care system. Careful development work is required to effectively translate such interventions to novel settings. Objective The aim of this study was to develop a theory of change and delivery mechanism for a context-specific alcohol and lifestyle brief intervention aimed at women attending screening and symptomatic breast clinics. Methods A formative study combined evidence reviews, analysis of mixed method data, and user experience research to develop an intervention model, following the 6 Steps in Quality Intervention Development (6SQuID) framework. Results A Web app focused on improving awareness, encouraging self-monitoring, and reframing alcohol reduction as a positive choice to improve health was found to be acceptable to women. Accessing this in the clinic waiting area on a tablet computer was shown to be feasible. An important facilitator for change may be the heightened readiness to learn associated with a salient health visit (a teachable moment). Women may have increased motivation to change if they can develop a belief in their capability to monitor and, if necessary, reduce their alcohol consumption. Conclusions Using the 6SQuID framework supported the prototyping and maximized acceptability and feasibility of an alcohol brief intervention for women attending symptomatic breast clinics, regardless of their level of alcohol consumption.
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Affiliation(s)
- Julia M A Sinclair
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Peter F Dutey-Magni
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Institute of Health Informatics, University College London, London, United Kingdom
| | - Annie S Anderson
- Centre for Research into Cancer Prevention and Screening, Division of Population Health & Genomics, University of Dundee Medical School, Dundee, United Kingdom
| | - Janis Baird
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.,National Institute of Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Mary E Barker
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.,National Institute of Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Ramsey I Cutress
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Eileen F S Kaner
- Institute of Health and Society, Newcastle University, Newcastle, United Kingdom
| | - Mark McCann
- Medical Research Council/Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Caspian K Priest
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Ellen R Copson
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
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55
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Chung JE, Lee CJ. The impact of cancer information online on cancer fatalism: education and eHealth literacy as moderators. HEALTH EDUCATION RESEARCH 2019; 34:543-555. [PMID: 31550372 DOI: 10.1093/her/cyz027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 08/21/2019] [Indexed: 06/10/2023]
Abstract
One critical yet understudied concept associated with cancer information is cancer fatalism, i.e. deterministic thoughts about the cause of cancer, the inability to prevent it and the unavoidability of death upon diagnosis. The aim of this study is to understand how information seeking about cancer online influences cancer fatalism and whether and to what extent education and eHealth literacy moderate the relationship between them. Findings from an online survey of a nationally representative sample in the United States (N = 578) showed differential impacts of using the internet to search for information about cancer among the more and the less educated. For the less educated, more exposure to information about cancer via medical and health websites led to an increased level of cancer fatalism, whereas among the more educated, greater exposure lowered cancer fatalism. These differences were explained by the fact that the more educated were equipped with a higher level of eHealth literacy skills than the less educated. Findings show that only when one has necessary skills to apply digital resources can those resources help mitigate cancer fatalism. We suggest the need to enhance eHealth literacy skills among the less educated to reduce cancer fatalism.
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Affiliation(s)
- Jae Eun Chung
- Cathy Hughes School of Communications, Howard University, 525 Bryant St. NW, Washington, DC 20059, USA
| | - Chul-Joo Lee
- Department of Communication, Seoul National University, 504 IBK Communication Center, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea
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56
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Mackert M, Mabry-Flynn A, Donovan EE, Champlin S, Pounders K. Health Literacy and Perceptions of Stigma. JOURNAL OF HEALTH COMMUNICATION 2019; 24:856-864. [PMID: 31630662 DOI: 10.1080/10810730.2019.1678705] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Calls for progress in health literacy argue that efforts across society are promising for increasing capacities at a broader level. However, it is unknown how the general public perceives people who struggle with health information. While it may be ideal to establish interventions beyond the individual, stigma held by others could limit this work. This study explores whether one's personal health literacy skills are associated with stigma enacted toward others who struggle with health literacy. Adults (N = 5,151) responded to a survey consisting of health literacy assessments and a vignette in which a patient made a health-related mistake. Differences were observed regarding the number of participants who self-reported (n = 251) versus objectively scored as having low health literacy (n = 794). Participants who self-reported (MlowHL = 5.67, MhighHL = 5.99, p < .01) or had low objective health literacy (MlowHL = 5.75, MhighHL = 6.01, p < .001) exhibited less pity for the person in the vignette than health literate participants. Participants were more demanding of a young person featured in the vignette (33-year old), indicating greater personal responsibility (M72 = 5.12, M33 = 5.67), anger (M72 = 4.54, M33 = 5.57), and less pity (M72 = 6.18, M33 = 5.75) compared to an older person (72-year old). Results from the present study suggest contradictory perceptions among patients who are likely to feel stigma themselves.
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Affiliation(s)
- Michael Mackert
- Center for Health Communication, Stan Richards School of Advertising and Public Relations and the Department of Population Health, The University of Texas, Austin, Texas, USA
| | - Amanda Mabry-Flynn
- Charles H. Sandage Department of Advertising in the College of Media, University of Illinois, Urbana, Illinois, USA
| | - Erin E Donovan
- Department of Communication Studies, Center for Health Communication, Moody College of Communication, The University of Texas, Austin, TX, USA
| | - Sara Champlin
- Mayborn School of Journalism, The University of North Texas, Denton, Texas, USA
| | - Kathrynn Pounders
- Stan Richards School of Advertising and Public Relations, Center for Health Communication, The University of Texas, Austin, Texas, USA
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57
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Fleary SA, Paasche-Orlow MK, Joseph P, Freund KM. The Relationship Between Health Literacy, Cancer Prevention Beliefs, and Cancer Prevention Behaviors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:958-965. [PMID: 30022378 PMCID: PMC6339599 DOI: 10.1007/s13187-018-1400-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
While cancer prevention behaviors have been clearly defined, many people do not engage in these risk-reduction behaviors. Factors such as cancer prevention beliefs and limited health literacy may undermine cancer prevention behavior recommendations. This study explored the relationships between cancer prevention beliefs, health literacy, and cancer prevention behaviors. Data were analyzed from the 2013 Health Information National Trends Survey (n = 1675). Regression analyses for four cancer prevention belief (prevention is not possible, cancer is fatal, there are too many recommendations for prevention, everything causes cancer) statements were modeled, including health literacy and sociodemographic variables as predictors. In addition, separate regression analyses predicted four cancer prevention behaviors (fruit and vegetable consumption, physical activity, cigarette smoking) from cancer prevention beliefs, health literacy, and sociodemographic variables. Participants with low health literacy were more likely to hold fatalistic cancer prevention beliefs than those with higher health literacy. Cancer prevention beliefs were related to less fruit and vegetable consumption, fewer days of physical activity, and with being a nonsmoker after controlling for sociodemographic variables. Health literacy was not a significant predictor of cancer prevention behaviors. Given the relationship between health literacy and cancer prevention beliefs, research is needed to ascertain how to empower patients with low health literacy to have a more realistic understanding of cancer.
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Affiliation(s)
- Sasha A Fleary
- Eliot-Pearson Department of Child Study and Human Development, Tufts University, Medford, MA, 02155, USA.
| | | | - Patrece Joseph
- Eliot-Pearson Department of Child Study and Human Development, Tufts University, Medford, MA, 02155, USA
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58
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Giri VN, Selvan P, Mohanty S, Lum R, Serrao S, Leader AE. Exploring Asian Indian views about cancer and participation in cancer research: an evaluation of a culturally tailored educational intervention. J Community Genet 2019; 11:193-203. [PMID: 31522341 DOI: 10.1007/s12687-019-00436-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 08/29/2019] [Indexed: 01/22/2023] Open
Abstract
Asian Indians (AIs) are a growing population in the United States (US) with increased cancer incidence and mortality. However, screening rates among this population are low, and the population has been underrepresented in clinical research. This pilot study aims to address gaps in the literature in order to understand if a culturally tailored educational intervention will improve knowledge, risk perceptions, and awareness of cancer risk assessments among AIs. We delivered an educational intervention comprised of culturally tailored case studies describing risk factors for developing cancer in both males and females. We assessed knowledge gaps about cancer risk and genetic testing, cancer risk perceptions, and willingness to participate in medical research studies, pre- and post-intervention. Among 23 participants, knowledge of genetic testing use and screening recommendations significantly improved post-intervention, with increased willingness to discuss cancer with family members, participate in medical research, and undergo genetic testing for cancer risk assessment. However, findings at the 1-month follow-up time did not show significant changes, except for one knowledge item. Culturally tailored educational interventions, delivered in a community setting, can influence knowledge and risk perceptions about cancer risk and genetics among AIs. Our findings lay the groundwork to continue educational efforts in the area of cancer risk and genetic testing in the AI population, a growing population that has been understudied in the US.
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Affiliation(s)
- Veda N Giri
- Division of Population Science, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, 19107, USA.
| | - Preethi Selvan
- Division of Population Science, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Salini Mohanty
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, 3141 Chestnut St, Philadelphia, PA, 19104, USA.,Department of Family and Community Health, University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - Ray Lum
- Department of Management and Health Policy, Dornsife School of Public Health, Drexel University, 3141 Chestnut St, Philadelphia, PA, 19104, USA
| | - Samantha Serrao
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, 3141 Chestnut St, Philadelphia, PA, 19104, USA
| | - Amy E Leader
- Division of Population Science, Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, 19107, USA
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59
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Upadhyay S, Lord J, Gakh M. Health-Information Seeking and Intention to Quit Smoking: Do Health Beliefs Have a Mediating Role? Tob Use Insights 2019; 12:1179173X19871310. [PMID: 31488954 PMCID: PMC6712759 DOI: 10.1177/1179173x19871310] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 07/31/2019] [Indexed: 11/26/2022] Open
Abstract
Background: Smoking is a leading cause of preventable deaths. Smoking cessation can reduce the risk of smoking-associated disease and death. But smoking cessation involves behaviour change. Existing research indicates that health-information seeking and health-promoting behaviours can be positively associated. However, in the context of smoking, the relationship between seeking health information and intending to quit smoking remains only partially understood. Aim: This study aimed to examine the relationship between seeking health information and intending to quit smoking and to determine whether this relationship is mediated by health beliefs. Methods: We used data from the fourth cycle of the US National Cancer Institute’s Health Information National Trends Survey (HINTS). Logistic regression was used to assess the independent variable (ie, health-information seeking) and dependent variable (ie, intention to quit smoking) as mediated by health belief. Results: Our findings suggest that smokers who seek health information have a 2.67 times higher odds of intending to quit smoking than smokers who do not seek health information. However, health beliefs do not have an intervening effect between seeking health information and intending to quit smoking. Discussion: Seeking health information is important in predicting attempts to quit smoking, regardless of the smokers’ pre-existing health beliefs. Our findings support cessation efforts that encourage smokers to seek health information. Determining optimal ways to encourage smokers to seek smoking-related information could support achieving and maintaining smoking cessation. Conclusion: Cessation programmes and policies should encourage smokers to seek health information. Additional research should further examine smokers’ motivators and cues for health-information seeking and should further probe smokers’ beliefs about the risks of smoking.
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Affiliation(s)
- Soumya Upadhyay
- Department of Healthcare Administration and Policy, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Justin Lord
- James K. Elrod Department of Health Administration and Department of Accounting, School of Business, Louisiana State University at Shreveport, Shreveport, LA, USA
| | - Maxim Gakh
- School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, USA
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60
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Haga SB, Liu Y. Patient characteristics, experiences and perceived value of pharmacogenetic testing from a single testing laboratory. Pharmacogenomics 2019; 20:581-587. [PMID: 31190624 DOI: 10.2217/pgs-2019-0006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Aims: Patients' use of and experience with pharmacogenetic (PGx) testing may be impacted by several factors including patient and provider knowledge, health status, and perceived understanding of results. Materials & Methods: We conducted an online survey of individuals who had subscribed to a newsletter service offered by a US commercial PGx testing company, Genelex. Results: We find that about half of respondents that had PGx testing reviewed one or more of the lab's web-pages, 43% believed they understood the test results very well, but 40% did not know or could not recall whether their provider had changed their prescription based on the test result. Conclusions: There was limited use of the laboratory's online resources by respondents undergoing PGx testing. Increased awareness of the website may improve understanding of test results and facilitate discussions with providers about medication changes.
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Affiliation(s)
- Susanne B Haga
- Center for Applied Genomics & Precision Medicine, Duke University School of Medicine, 304 Research Drive, Durham, NC 27708, USA
| | - Yiling Liu
- Center for Applied Genomics & Precision Medicine, Duke University School of Medicine, 304 Research Drive, Durham, NC 27708, USA
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61
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Moreno PI, Yanez B, Schuetz SJ, Wortman K, Gallo LC, Benedict C, Brintz CE, Cai J, Castaneda SF, Perreira KM, Gonzalez P, Gonzalez F, Isasi CR, Penedo FJ. Cancer fatalism and adherence to national cancer screening guidelines: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Cancer Epidemiol 2019; 60:39-45. [PMID: 30904827 PMCID: PMC10424711 DOI: 10.1016/j.canep.2019.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 02/05/2019] [Accepted: 03/03/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Sociocultural factors, such as health insurance status, income, education, and acculturation, predict cancer screening among U.S. Hispanics/Latinos. However, these factors can be difficult to modify. More research is needed to identify individual-level modifiable factors that may improve screening and subsequent cancer outcomes in this population. The aim of this study was to examine cancer fatalism (i.e., the belief that there is little or nothing one can do to lower his/her risk of developing cancer) as a determinant of adherence to national screening guidelines for colorectal, breast, prostate, and cervical cancer among Hispanics/Latinos. METHODS Participants were from the multi-site Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study (N = 5313). The National Cancer Institute (NCI) Health Interview National Trends Survey was used to assess cancer fatalism and receipt of cancer screening. Adherence was defined as following screening guidelines from United States Preventive Services Task Force and the American Cancer Society during the study period. RESULTS Adjusting for well-established determinants of cancer screening and covariates (health insurance status, income, education, acculturation, age, Hispanic/Latino background), lower cancer fatalism was marginally associated with greater adherence to screening for colorectal (OR 1.13, 95% CI [.99-1.30], p = .07), breast (OR 1.16, 95% CI [.99-1.36], p = .08) and prostate cancer (OR 1.18, 95% CI [.97-1.43], p = .10), but not cervical cancer. CONCLUSIONS The associations of cancer fatalism were small and marginal, underlining that sociocultural factors are more robust determinants of cancer screening adherence among Hispanics/Latinos.
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Affiliation(s)
- Patricia I Moreno
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Betina Yanez
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Steven J Schuetz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Katy Wortman
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Linda C Gallo
- Department of Psychology, San Diego State University, SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States
| | - Catherine Benedict
- Department of Medicine, Hofstra Northwell School of Medicine, Manhasset, NY, United States
| | - Carrie E Brintz
- Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jianwen Cai
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Sheila F Castaneda
- Graduate School of Public Health, San Diego State University, San Diego, CA, United States
| | - Krista M Perreira
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Patricia Gonzalez
- Graduate School of Public Health, San Diego State University, San Diego, CA, United States
| | - Franklyn Gonzalez
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Carmen R Isasi
- Departments of Epidemiology & Population Health and Pediatrics, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Frank J Penedo
- Department of Psychology and Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, United States.
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Information needs, communication and usage of social media by cancer patients and their relatives. J Cancer Res Clin Oncol 2019; 145:1865-1875. [PMID: 31123824 DOI: 10.1007/s00432-019-02929-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 05/02/2019] [Indexed: 12/30/2022]
Abstract
PURPOSE The aim of this study was to evaluate cancer patients' need for information, their communication and usage of social media. METHODS We developed a standardized questionnaire comprising sections on information needs, communication behavior and usage of social media with respect to cancer and combined this with a validated instrument on eHealth literacy for patients. This questionnaire was provided online and with the help of bloggers and leaders of social media groups, distributed in their networks. RESULTS The Internet was the most important information source (n = 308; 77.4%). Yet, most of the participants wanted to get information from their doctor (n = 342; 85.9%). With respect to trust in a source of information, oncologists were named most often (n = 285; 71.6%). On the one hand, many participants got in contact with others, especially peers, via social media (n = 319; 80.3%) with a growing bond to their family members on the other hand (n = 324; 81.6%). The cancer diagnosis was an impulse for starting with active participation in social media for some participants (n = 196; 49.2%). CONCLUSIONS With social media gaining importance as source of information for patients, improving the quality of information in these networks is an important task in health care systems.
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Di Sebastiano KM, Murthy G, Campbell KL, Desroches S, Murphy RA. Nutrition and Cancer Prevention: Why is the Evidence Lost in Translation? Adv Nutr 2019; 10:410-418. [PMID: 30915435 PMCID: PMC6520044 DOI: 10.1093/advances/nmy089] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 07/27/2018] [Accepted: 10/08/2018] [Indexed: 01/20/2023] Open
Abstract
With the high burden of cancer worldwide, primary prevention has been identified as a key cancer control strategy to reduce this burden. Diet and nutrition are important modifiable factors that may alter the risk of developing cancer, because several dietary components including alcohol consumption, fruit and vegetable intake, and dietary fiber have been shown to significantly impact cancer risk. Consequently, a number of organizations have developed cancer prevention guidelines that highlight the importance of nutrition (and related factors including body size and physical activity) to reduce the risk of cancer. However, there are barriers to the uptake of these guidelines, particularly with respect to diet and nutrition including awareness, communication, and other factors that influence eating behavior. Improved knowledge translation (KT) of recommendations may help facilitate uptake. The purposes of this narrative review are: 1) to examine issues and challenges related to KT of diet and nutrition evidence in the context of cancer prevention, including public awareness and attitudes towards cancer prevention, engagement in cancer prevention strategies, and effects of KT on diet-cancer preventive behaviors; 2) to discuss examples of effective and ineffective KT of diet and nutrition evidence; and 3) to provide recommendations for improving KT to help move the field of diet, nutrition, and cancer prevention forward. Evidence shows that adherence to nutrition recommendations for cancer prevention significantly reduces the risk of cancer; however, engagement in nutrition-based preventative behaviors is low. Skepticism and confusion around evidence linking diet and nutrition with cancer may arise, in part, through ineffective media KT; the primary source of health information for many people. Simple, tailored, targeted KT communication strategies aimed at increasing the general public's awareness, attitudes, and engagement in cancer preventive behavior should be emphasized to encourage cancer control.
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Affiliation(s)
| | | | - Kristin L Campbell
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
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Vanderpool RC, Huang B, Deng Y, Bear TM, Chen Q, Johnson MF, Paskett ED, Robertson LB, Young GS, Iachan R. Cancer-Related Beliefs and Perceptions in Appalachia: Findings from 3 States. J Rural Health 2019; 35:176-188. [PMID: 30830984 DOI: 10.1111/jrh.12359] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Appalachians experience increased rates of cancer incidence and mortality compared to non-Appalachians. Many factors may contribute to the elevated cancer burden, including lack of knowledge and negative beliefs about the disease. METHODS Three National Cancer Institute (NCI)-designated cancer centers with Appalachian counties in their respective population-based geographic service areas-Kentucky, Ohio, and Pennsylvania-surveyed their communities to better understand their health profiles, including 5 items assessing cancer beliefs. Weighted univariate and bivariate statistics were calculated for each of the 3 state's Appalachian population and for a combined Appalachian sample. Weighted multiple linear regression was used to identify factors associated with a cancer beliefs composite score. Data from the combined Appalachian sample were compared to NCI's Health Information National Trends Survey (HINTS). RESULTS Data from 1,891 Appalachian respondents were included in the analysis (Kentucky = 798, Ohio = 112, Pennsylvania = 981). Significant differences were observed across the 3 Appalachian populations related to income, education, marital status, rurality, perceptions of present income, and body mass index (BMI). Four of 5 cancer beliefs were significantly different across the 3 states. Education, BMI, perceptions of financial security, and Kentucky residence were significantly associated with a lower composite score of cancer beliefs. When comparing the combined Appalachian population to HINTS, 3 of 5 cancer belief measures were significantly different. CONCLUSIONS Variations in cancer beliefs were observed across the 3 states' Appalachian populations. Interventions should be tailored to specific communities to improve cancer knowledge and beliefs and, ultimately, prevention and screening behaviors.
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Affiliation(s)
| | - Bin Huang
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky
| | | | - Todd M Bear
- Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Quan Chen
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky
| | - Meghan F Johnson
- Markey Cancer Center, University of Kentucky, Lexington, Kentucky
| | - Electra D Paskett
- The Ohio State University Comprehensive Cancer Center, Columbus, Ohio
| | - Linda B Robertson
- Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Gregory S Young
- The Ohio State University Comprehensive Cancer Center, Columbus, Ohio
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Maercker A, Ben-Ezra M, Esparza OA, Augsburger M. Fatalism as a traditional cultural belief potentially relevant to trauma sequelae: Measurement equivalence, extent and associations in six countries. Eur J Psychotraumatol 2019; 10:1657371. [PMID: 31528270 PMCID: PMC6735334 DOI: 10.1080/20008198.2019.1657371] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 07/30/2019] [Accepted: 08/11/2019] [Indexed: 11/01/2022] Open
Abstract
Background: Fatalism, known as the propensity to believe that one's destiny is externally determined, has so far been examined selectively, and not yet in a cross-cultural study. Moreover, a general, non-data-based speculation assumes that fatalism occurs to a lesser extent in countries of the Global North than in the Global South. Objective: Fatalism as a global psychological belief seems to have a prima facie validity, but this is to be investigated by measurement equivalence calculations across different countries from different world regions. Furthermore, socio-demographic and cultural geographic associations with fatalism scores will be investigated. Method: A six items fatalism scale was introduced in six large population-based samples from Europe, Africa, and Latin America (total n = 6'537). Testing of invariance followed standardized procedures for cross-cultural comparisons with a comprehensive parallel analysis. Regression analyses provided information on associations with socio-demography and cultural geography. Results: The fatalism construct divided into accentuated pessimistic and non-judgmental subscores in five of the six countries. The German sample showed the highest fatalism scores compared to almost all other countries. In particular higher age and lower educational attainment determine fatalism scores across countries. An explorative analysis of the associations between PTSD symptoms and fatalism scores for African countries revealed small correlations. Discussion: Fatalism as indicated by its subscores seems not to be an exclusive phenomenon of countries with higher economic and socio-cultural vulnerability. For all countries, sociodemographic groups can be identified in which these parts of a traditional belief system are more pronounced. Only for a subset of the countries examined has it been possible to analyse the associations with trauma. Further elaborated analyses in other samples should follow.
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Affiliation(s)
- Andreas Maercker
- Department of Psychology, Division of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland.,Wissenschaftskolleg Berlin-Institute of Advanced Study, Berlin, Germany
| | | | - Oscar A Esparza
- Institute of Social Sciences and Administration, Universidad Autónoma de Ciudad Juárez, Ciudad Juárez, Chihuahua, México
| | - Mareike Augsburger
- Department of Psychology, Division of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland
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Ellis EM, Ferrer RA, Klein WMP. Factors beyond Lack of Knowledge That Predict "I Don't Know" Responses to Surveys That Assess HPV Knowledge. JOURNAL OF HEALTH COMMUNICATION 2018; 23:967-976. [PMID: 30526402 DOI: 10.1080/10810730.2018.1554729] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Accurately assessing the public's knowledge about the human papilloma virus (HPV) and the HPV vaccine remains critical for informing health education interventions aimed at increasing vaccine uptake. Responding "don't know" (DK) to survey questions that assess knowledge is common and DK responders are often systematically different from other responders, resulting in potential for bias. This study aimed to advance our understanding of DK responding to HPV knowledge items. Data from the nationally representative Health Information National Trends Survey Wave 5 Cycle 1 (N = 2,034) were used. Information seeking about cancer, information avoidance, health-related self-efficacy, and several cancer beliefs were examined as predictors of DK responding to six items that assessed HPV knowledge. DKs represented nearly half of responses. Adjusting for demographic factors, lower health-related self-efficacy, and greater information avoidance, cancer-mortality salience, and perceived ambiguity were associated with more DK responding, ps < .05. Even participants with incorrect responses had greater health-related self-efficacy, and less information avoidance, perceived ambiguity, and cancer-mortality salience than those who responded with DK. DK responding to HPV knowledge items is common and reflects factors beyond insufficient knowledge or motivation. Addressing causes of DK responding may reduce bias and improve interventions informed by surveys.
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Affiliation(s)
- Erin M Ellis
- a Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program , National Cancer Institute , Rockville , MD , USA
| | - Rebecca A Ferrer
- a Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program , National Cancer Institute , Rockville , MD , USA
| | - William M P Klein
- b Office of the Associate Director, Behavioral Research Program , National Cancer Institute , Rockville , MD , USA
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Kinney AY, Howell R, Ruckman R, McDougall JA, Boyce TW, Vicuña B, Lee JH, Guest DD, Rycroft R, Valverde PA, Gallegos KM, Meisner A, Wiggins CL, Stroup A, Paddock LE, Walters ST. Promoting guideline-based cancer genetic risk assessment for hereditary breast and ovarian cancer in ethnically and geographically diverse cancer survivors: Rationale and design of a 3-arm randomized controlled trial. Contemp Clin Trials 2018; 73:123-135. [PMID: 30236776 PMCID: PMC6214814 DOI: 10.1016/j.cct.2018.09.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 09/06/2018] [Accepted: 09/08/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Although national guidelines for cancer genetic risk assessment (CGRA) for hereditary breast and ovarian cancer (HBOC) have been available for over two decades, less than half of high-risk women have accessed these services, especially underserved minority and rural populations. Identification of high-risk individuals is crucial for cancer survivors and their families to benefit from biomedical advances in cancer prevention, early detection, and treatment. METHODS This paper describes community-engaged formative research and the protocol of the ongoing randomized 3-arm controlled Genetic Risk Assessment for Cancer Education and Empowerment (GRACE) trial. Ethnically and geographically diverse breast and ovarian cancer survivors at increased risk for hereditary cancer predisposition who have not had a CGRA are recruited through the three statewide cancer registries. The specific aims are to: 1) compare the effectiveness of a targeted intervention (TP) vs. a tailored counseling and navigation(TCN) intervention vs. usual care (UC) on CGRA utilization at 6 months post-diagnosis (primary outcome); compare the effectiveness of the interventions on genetic counseling uptake at 12 months after removal of cost barriers (secondary outcome); 2) examine potential underlying theoretical mediating and moderating mechanisms; and 3) conduct a cost evaluation to guide dissemination strategies. DISCUSSION The ongoing GRACE trial addresses an important translational gap by developing and implementing evidence-based strategies to promote guideline-based care and reduce disparities in CGRA utilization among ethnically and geographically diverse women. If effective, these interventions have the potential to reach a large number of high-risk families and reduce disparities through broad dissemination. TRIAL REGISTRATION NUMBER NCT03326713; clinicaltrials.gov.
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Affiliation(s)
- Anita Y Kinney
- Department of Epidemiology, School of Public Health, Rutgers University, New Brunswick, Jersey; Cancer Institute of New Jersey, Rutgers University, New Brunswick, Jersey.
| | - Rachel Howell
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, Mexico
| | - Rachel Ruckman
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, Mexico
| | - Jean A McDougall
- Department of Internal Medicine, University of New Mexico, Albuquerque, Mexico; Comprehensive Cancer Center, University of New Mexico, Albuquerque, Mexico
| | - Tawny W Boyce
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, Mexico
| | - Belinda Vicuña
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, Mexico; Department of Psychology, University of New Mexico, Albuquerque, Mexico
| | - Ji-Hyun Lee
- Department of Internal Medicine, University of New Mexico, Albuquerque, Mexico; Comprehensive Cancer Center, University of New Mexico, Albuquerque, Mexico
| | - Dolores D Guest
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, Mexico
| | - Randi Rycroft
- Colorado Central Cancer Registry, Colorado Department of Public Health and Environment, Denver, CO, United States
| | - Patricia A Valverde
- Colorado School of Public Health, University of Colorado, Aurora, CO, United States
| | | | - Angela Meisner
- New Mexico Tumor Registry, University of New Mexico, Albuquerque, Mexico
| | - Charles L Wiggins
- Department of Internal Medicine, University of New Mexico, Albuquerque, Mexico; Comprehensive Cancer Center, University of New Mexico, Albuquerque, Mexico; New Mexico Tumor Registry, University of New Mexico, Albuquerque, Mexico
| | - Antoinette Stroup
- Department of Epidemiology, School of Public Health, Rutgers University, New Brunswick, Jersey; Cancer Institute of New Jersey, Rutgers University, New Brunswick, Jersey
| | - Lisa E Paddock
- Department of Epidemiology, School of Public Health, Rutgers University, New Brunswick, Jersey; Cancer Institute of New Jersey, Rutgers University, New Brunswick, Jersey
| | - Scott T Walters
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, School of Public Health, Fort Worth, TX, United States
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Hall MB, Vos P. Comparison of Cancer Fatalism Among Rural Smokers and Nonsmokers. J Community Health 2018; 44:215-221. [DOI: 10.1007/s10900-018-0576-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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69
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Champlin S, Hoover DS, Mackert M. Health Literacy in Adult Education Centers: Exploring Educator and Staff Needs. Health Promot Pract 2018; 21:198-208. [PMID: 30070148 DOI: 10.1177/1524839918789690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Objective. Incorporating health content into adult education courses is promising for increasing health literacy skills among "hard-to-reach" populations. The purpose of this study was to gain previously untapped knowledge of adult education personnel (i.e., educators, staff) about the strategies and programs that would be beneficial for helping students learn about health. Method. Personnel (N = 53) from three literacy coalitions completed an online survey that assessed interest and preferences for developing a health literacy curriculum. Results. Personnel indicated general concepts such as health services and insurance as those of greatest priority. Additionally, tools designed for general use (completion of forms) were favored. Personnel preferred programs that focused on general skills over those designed to address specific health topics, χ2(1) = 11.52, p = .001. Conclusions. Adult education personnel find greatest value in health literacy programs aimed at increasing general skills rather than disease-/topic-specific content. There were several mismatches in topics noted as a "priority" and those for which personnel felt comfortable teaching. A focus on fostering general health skills will help all students-not just those with specific health concerns such as diabetes and asthma. Teaching health literacy through general skill development could make health programs exciting, engaging, and accessible for students.
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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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Valera P, Lian Z, Brotzman L, Reid A. Fatalistic Cancer Beliefs and Information Seeking in Formerly Incarcerated African-American and Hispanic Men: Implications for Cancer Health Communication and Research. HEALTH COMMUNICATION 2018; 33:576-584. [PMID: 28278604 PMCID: PMC5623655 DOI: 10.1080/10410236.2017.1283564] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
African-American and Hispanic men are disproportionately affected by cancer experiencing higher rates of cancer-related morbidity and mortality for many cancers (but not all). These challenges may be magnified for a subpopulation of African-American and Hispanic men who have been incarcerated. A survey assessing demographics, incarceration experience, psychosocial, behavioral, and cancer health information seeking was administered to 230 previously incarcerated men aged 35 years and older. Data analysis was performed to assess the association between fatalism, perceived susceptibility, and health information seeking in this population. This study revealed the following: the majority of the participants (68.7%) held the fatalistic belief: "When I think of cancer, I automatically think of death." Second, the fatalistic belief, "There's not much you can do to lower your chances of getting cancer," is more prevalent among those who perceived a higher risk of developing cancer. Third, older participants (those between 55 and 70 years old) and widowed are less likely to think of death when they think of cancer. In addition, those who use the Internet to look for health or medical information (i.e., engaging in health information seeking) are less likely to agree with the fatalistic belief: "It seems like everything causes cancer." Given the high incidence of certain cancers among African-American and Hispanic men and the vulnerability of those involved in the criminal justice system, our findings highlight the importance of understanding perceived susceptibility to cancer, fatalistic beliefs about cancer, and information seeking in formerly incarcerated men.
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Affiliation(s)
- Pamela Valera
- Nathan Kline Institute for Psychiatric Research, Division of Social Solutions and Services Research
- Department of Psychiatry, New York School of Medicine
| | - Zi Lian
- Teachers College, Columbia University
| | - Laura Brotzman
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health
| | - Andrea Reid
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health
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Soto Mas F, Schmitt CL, Jacobson HE, Myers OB. A Cardiovascular Health Intervention for Spanish Speakers: The Health Literacy and ESL Curriculum. J Community Health 2018; 43:717-724. [PMID: 29428986 DOI: 10.1007/s10900-018-0475-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Spanish speakers in the United States are in need of effective interventions that address both cardiovascular disease (CVD) and health literacy. However, the literature lacks interventions that have used and evaluated a strategies that focus on both, particularly at the community level. The aim of this study was to explore the effect of a health literacy curriculum on cardiovascular health behavior among Spanish speaking adults. It used a randomized controlled pre-posttest design. Participants included Hispanic adults with a low-to-intermediate level of English proficiency. The intervention group received the health literacy and English as a second language (ESL) Curriculum with CVD specific content, while the control group received a conventional ESL curriculum. Tools included the Spanish Cardiovascular Health Questionnaire (CSC), the test of functional health literacy in adults (TOFHLA), and the Combined English Language Skills Assessment. Analysis of change scores included independent sample t test and multiple linear regression. A total of 155 participants completed the study. There was a significant greater improvement for the intervention group in change of CSC score from pretest to posttest (P = 0.049) compared to controls. The study also found significantly improved TOFHLA (P = 0.011), however it did not find a relationship between changes in CVD behavior and health literacy or English proficiency. The Health Literacy and ESL Curriculum constitutes a valuable resource for addressing the cardiovascular health, literacy, and language needs of Spanish-speaking adults. Interventions that take a multilevel education and health approach may be more effective in addressing the needs of immigrants. Research should further explore the interactions between CVD behavior, health literacy, and English proficiency.
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Affiliation(s)
- Francisco Soto Mas
- College of Population Health MSC09 5070, 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA.
| | - Cheryl L Schmitt
- School of Medicine, Family & Community Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Holly E Jacobson
- Department of Linguistics, University of New Mexico, Albuquerque, NM, USA
| | - Orrin B Myers
- School of Medicine, Family & Community Medicine, University of New Mexico, Albuquerque, NM, USA
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Smith SG, Jackson SE, Kobayashi LC, Steptoe A. Social isolation, health literacy, and mortality risk: Findings from the English Longitudinal Study of Ageing. Health Psychol 2017; 37:160-169. [PMID: 29172607 DOI: 10.1037/hea0000541] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To investigate the relationships between social isolation, health literacy, and all-cause mortality, and the modifying effect of social isolation on the latter relationship. METHODS Data were from 7731 adults aged ≥50 years participating in Wave 2 (2004/2005) of the English Longitudinal Study of Ageing. Social isolation was defined according to marital/cohabiting status and contact with children, relatives, and friends, and participation in social organizations. Scores were split at the median to indicate social isolation (yes vs. no). Health literacy was assessed as comprehension of a medicine label and classified as "high" (≥75% correct) or "low" (<75% correct). The outcome was all-cause mortality up to February 2013. Cox proportional hazards models were adjusted for sociodemographic factors, health status, health behaviors, and cognitive function. RESULTS Mortality rates were 30.3% versus 14.3% in the low versus high health literacy groups, and 23.5% versus 13.7% in the socially isolated versus nonisolated groups. Low health literacy (adj. HR = 1.22, 95% CI 1.02-1.45 vs. high) and social isolation (adj. HR = 1.28, 95% CI 1.10-1.50) were independently associated with increased mortality risk. The multiplicative interaction term for health literacy and social isolation was not statistically significant (p = .81). CONCLUSIONS Low health literacy and high social isolation are risk factors for mortality. Social isolation does not modify the relationship between health literacy and mortality. Clinicians should be aware of the health risks faced by socially isolated adults and those with low health literacy. (PsycINFO Database Record
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Affiliation(s)
| | - Sarah E Jackson
- Institute of Epidemiology and Health Care, University College London
| | | | - Andrew Steptoe
- Institute of Epidemiology and Health Care, University College London
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Grenen E, Kent EE, Hennessy E, Hamilton JG, Ferrer RA. Association Between Nutrition Resource Stress and Dietary Consumption: Results From a U.S. Nationally Representative Survey. HEALTH EDUCATION & BEHAVIOR 2017; 45:524-531. [PMID: 29143540 DOI: 10.1177/1090198117741940] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is little research on how affective reactions (e.g., stress) to perceptions of nutritious food accessibility contribute to dietary behaviors. AIMS This study explores whether stress associated with limited access to nutritious foods-termed nutrition resource stress (NRS)-contributes to diet outcomes, and whether these associations are mediated by health-related self-efficacy. METHOD Using data from the cross-sectional National Cancer Institute's Health Information National Trends Survey, analyses were conducted to examine whether reported NRS was associated with specific dietary behaviors (i.e., fewer servings of fruit/vegetables; more servings of sugar-sweetened soda; N = 3,112). RESULTS Analyses revealed a main association such that NRS was negatively associated with fruit/vegetable consumption (β = -0.08, p = .016). There was a negative association between NRS and self-efficacy (β = -0.11, p < .001). There was no significant association between NRS and soda consumption. Mediation analyses revealed a significant indirect association between NRS and fruit/vegetable consumption, mediated by perceived health-related self-efficacy (β = -0.03, 95% confidence interval [-.04, -.01], p < .0001). Given that self-efficacy (the mediator) was not significantly associated with soda consumption (β = 0.01, p = .912), mediation analyses were not conducted for this outcome. CONCLUSION This study suggests that stress associated with perceptions of inability to access nutritious foods may influence dietary behaviors, and points to a psychological mechanism (i.e., self-efficacy) that may explain the association. In addition to improving objective barriers of access to healthy foods, future interventions might address ways of improving nutritious food-related self-efficacy or perceived stress related to obtaining healthy foods.
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Affiliation(s)
- Emily Grenen
- 1 ICF, Rockville, MD, USA
- 2 National Cancer Institute, Rockville, MD, USA
| | - Erin E Kent
- 2 National Cancer Institute, Rockville, MD, USA
| | - Erin Hennessy
- 3 Tufts University Friedman School of Nutrition Science and Policy, Boston, MA, USA
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Kye SY, Shim M, Kim YC, Park K. Sharing health information online in South Korea: motives, topics, and antecedents. Health Promot Int 2017; 34:182-192. [DOI: 10.1093/heapro/dax074] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Y Kye
- Cancer Information and Education Branch, National Cancer Control Institute, National Cancer Center, Goyang-si, Republic of Korea
| | - M Shim
- Department of Communication and Information, Inha University, Incheon, Republic of Korea
| | - Y C Kim
- College of Communication, Yonsei University, Seoul, Republic of Korea
| | - K Park
- Cancer Policy Branch, National Cancer Control Institute, National Cancer Center, Goyang-si, Republic of Korea
- Department of Cancer Control and Policy, National Cancer Center, Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
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Abbass MAA, Keshava HB, Delaney CP. The Bigger Picture: Picking the Right Soap Box-Is it Possible to Connect with Different Audience Targets (Practitioners and Patients) from the Same Platform? Clin Colon Rectal Surg 2017; 30:281-290. [PMID: 28924403 DOI: 10.1055/s-0037-1604258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The use of Internet and social media has skyrocketed in the past decade. It did not take long until physicians realized that they could use social media as a tool for communication with patients and colleagues. Since then use of social media has exploded and the information that has become available for physicians and their patients is remarkable. In addition, because of the immediacy of the platform, messages that are incorrect or not desired can be rapidly promoted, whether deliberately or accidentally. To obtain the best use of social media, the right platform should be chosen, and this varies depending on the group one is trying to reach, and the message or visibility desired. In this article, we review the variety of options available to users.
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Affiliation(s)
- Mohammed Ali A Abbass
- Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Hari B Keshava
- Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Conor P Delaney
- Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, Ohio
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77
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Amuta AO, Chen X, Mkuu R. The Effect of Cancer Information Seeking on Perceptions of Cancer Risks, Fatalism, and Worry Among a U.S. National Sample. AMERICAN JOURNAL OF HEALTH EDUCATION 2017. [DOI: 10.1080/19325037.2017.1358119] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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78
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Haga SB. Informational Quest. CIRCULATION. CARDIOVASCULAR GENETICS 2017; 10:CIRCGENETICS.117.001860. [PMID: 28779018 DOI: 10.1161/circgenetics.117.001860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Susanne B Haga
- From the Department of Population Health Sciences, Duke School of Medicine, Durham, NC.
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Lumpkins CY, Mabachi N, Lee J, Pacheco C, Greiner KA, Geana M. A Prescription for Internet Access: Appealing to Middle-Aged and Older Racial and Ethnic Minorities Through Social Network Sites to Combat Colorectal Cancer. HEALTH COMMUNICATION 2017; 32:916-920. [PMID: 27435103 DOI: 10.1080/10410236.2016.1195679] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The popularity and usage of social media networks or SNS (social networking sites) among American Internet users age 50 and over doubled between 2009 and 2010 and has steadily climbed. Part of this increased access may be the result of older adults who are living with a chronic disease and are reaching out for online support. Colorectal cancer (CRC) risk is among those concerns, particularly among middle-age and older minority populations where disparities exist. This exploratory study investigates information seeking behavior related to cancer factors (e.g. testing for colon cancer, cancer fatalism) and current social media usage among racial and ethnic minority groups (African American and Latinos) and Whites age 50 and older. The secondary data from the 2012 Health Information National Trends Survey (HINTS) was analyzed to compare these populations. Results show that African Americans and Latinos were only slightly more likely to use social network sites to seek out cancer information compared to Whites. However, Whites were more likely to use the Internet to seek health information compared to African Americans and Latinos. In this sample, Whites were also more likely to be informed by a physician about CRC testing (p <.01). Whites were also more fatalistic about CRC (p<.001) and more likely to have self-reported receiving a positive diagnosis (p <.001). Implications of this study suggest that use of both traditional health information sources (physician) and the Internet (social media networks, Internet sites) have increased among older Americans and can serve as critical channels for cancer information and education.
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Affiliation(s)
- Crystal Y Lumpkins
- a Department of Family Medicine Research Division , University of Kansas Medical Center
| | - Natabhona Mabachi
- a Department of Family Medicine Research Division , University of Kansas Medical Center
| | - Jaehoon Lee
- b Institute for Measurement, Methodology, Analysis and Policy , Texas Tech University
| | | | - K Allen Greiner
- a Department of Family Medicine Research Division , University of Kansas Medical Center
| | - Mugur Geana
- d William Allen White School of Journalism and Mass Communications , University of Kansas
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80
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Kagan SH, Maloney KW. Cancer Screening and Early Detection in Older People: Considerations for Nursing Practice. Semin Oncol Nurs 2017; 33:199-207. [PMID: 28343838 DOI: 10.1016/j.soncn.2017.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To synthesize relevant issues in cancer screening for older people for nursing practice. DATA SOURCES Published scientific literature, clinical literature, and published cancer screening guidelines from the United States and Canada. CONCLUSION Nurses are caring for increasing numbers of older patients and, with this demographic shift, face increasing demands to address cancer screening and detection in both primary and specialty practice. IMPLICATIONS FOR NURSING PRACTICE Ageism, self-stereotyping, cancer fear and fatalism, and cancer survivorship experiences influence cancer screening and generate the need for improved awareness of these issues to advance nursing practice.
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81
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Jiang Y, West BT, Barton DL, Harris MR. Acceptance and Use of eHealth/mHealth Applications for Self-Management Among Cancer Survivors. Stud Health Technol Inform 2017; 245:131-135. [PMID: 29295067 PMCID: PMC6180909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Cancer survivors' acceptance and use of eHealth/mHealth applications for self-management can be unique and are not fully understood. We used data from the Health Information National Trends Survey 4 Cycle 4 to examine cancer survivors' acceptance and use of eHealth/mHea applications for key self-management processes, and conducted logistic regression and Rao-Scott design-adjusted Chi-square tests to assess bivariate associations between potential predictors and actual use. Potential factors were selected based on the Individual and Family Self-Management theory. High acceptance of eHealth applictions was identified, and adoption of mHealth was relatively low. Younger, higher educated, married, employed, and higher income survivors tended to use eHealth/mHealth applications for self-management. Survivors who were newly diagnosed or still on treatment were more likely to look for cancer information online or communicate with health providers electronically. BMI and rural residency were associated with use of mHealth apps to achieve a health-related goal and treatment decision-making.
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Affiliation(s)
- Yun Jiang
- School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Brady T. West
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Debra L. Barton
- School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
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Smith SG, McGregor LM, Raine R, Wardle J, von Wagner C, Robb KA. Inequalities in cancer screening participation: examining differences in perceived benefits and barriers. Psychooncology 2016; 25:1168-1174. [PMID: 27309861 PMCID: PMC5082500 DOI: 10.1002/pon.4195] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 06/09/2016] [Accepted: 06/10/2016] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Inequalities exist in colorectal cancer (CRC) screening uptake, with people from lower socioeconomic status backgrounds less likely to participate. Identifying the facilitators and barriers to screening uptake is important to addressing screening disparities. We pooled data from 2 trials to examine educational differences in psychological constructs related to guaiac fecal occult blood testing. METHODS Patients (n = 8576) registered at 7 general practices in England, within 15 years of the eligible age range for screening (45-59.5 years), were invited to complete a questionnaire. Measures included perceived barriers (emotional and practical) and benefits of screening, screening intentions, and participant characteristics including education. RESULTS After data pooling, 2181 responses were included. People with high school education or no formal education reported higher emotional and practical barriers and were less likely to definitely intend to participate in screening, compared with university graduates in analyses controlling for study arm and participant characteristics. The belief that one would worry more about CRC after screening and concerns about tempting fate were strongly negatively associated with education. In a model including education and participant characteristics, respondents with low emotional barriers, low practical barriers, and high perceived benefits were more likely to definitely intend to take part in screening. CONCLUSIONS In this analysis of adults approaching the CRC screening age, there was a consistent effect of education on perceived barriers toward guaiac fecal occult blood testing, which could affect screening decision making. Interventions should target specific barriers to reduce educational disparities in screening uptake and avoid exacerbating inequalities in CRC mortality.
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Affiliation(s)
- S G Smith
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.
- Department of Epidemiology and Public Health, University College London, London, UK.
| | - L M McGregor
- Department of Epidemiology and Public Health, University College London, London, UK
| | - R Raine
- Department of Applied Health Research, University College London, London, UK
| | - J Wardle
- Department of Epidemiology and Public Health, University College London, London, UK
| | - C von Wagner
- Department of Epidemiology and Public Health, University College London, London, UK
| | - K A Robb
- Department of Epidemiology and Public Health, University College London, London, UK
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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83
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Foley NM, O'Connell EP, Lehane EA, Livingstone V, Maher B, Kaimkhani S, Cil T, Relihan N, Bennett MW, Redmond HP, Corrigan MA. PATI: Patient accessed tailored information: A pilot study to evaluate the effect on preoperative breast cancer patients of information delivered via a mobile application. Breast 2016; 30:54-58. [PMID: 27611236 DOI: 10.1016/j.breast.2016.08.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 08/01/2016] [Accepted: 08/18/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The information needs of cancer patients are highly variable. Literature suggests an improved ability to modulate personalised stress, increased patient involvement with decision making, greater satisfaction with treatment choices and reduced anxiety levels in cancer patients who have access to information. The aim of this project was to evaluate the effects of a mobile information application on anxiety levels of patients undergoing surgery for breast cancer. MATERIALS AND METHODS An application was developed for use with Apple iPad containing information on basic breast cancer biology, different treatments used and surgical techniques. Content and face validity studies were performed. A randomized control trial was designed, with a 1:2 allocation. Data collected include basic demographics and type of surgery. Questionnaires used included: the HADS, Mini-MAC, information technology familiarity and information satisfaction. RESULTS A total of 39 women participated. 13 women had access to an iPad containing additional information and 26 women acted as controls. The mean age was 54 and technology familiarity was similar among both groups. Anxiety and depression scores at seven days were significantly lower in control patients without access to the additional information provided by the mobile application (p = 0.022 and 0.029 respectively). CONCLUSION Anxiety and depression in breast cancer patients is both multifactorial and significant, with anxiety levels directly correlating with reduced quality of life. Intuitively, information should improve anxiety levels, however, we have demonstrated that surgical patients with less information reported significantly lower anxiety. We advise the thorough testing and auditing of information initiatives before deployment.
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Affiliation(s)
- N M Foley
- Breast Research Centre, Cork University Hospital, Wilton, Cork, Ireland.
| | - E P O'Connell
- Breast Research Centre, Cork University Hospital, Wilton, Cork, Ireland
| | - E A Lehane
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - V Livingstone
- Breast Research Centre, Cork University Hospital, Wilton, Cork, Ireland
| | - B Maher
- School of Medicine, University College Cork, Cork, Ireland
| | - S Kaimkhani
- Breast Research Centre, Cork University Hospital, Wilton, Cork, Ireland
| | - T Cil
- Division of General Surgery, University of Toronto, Toronto, Ontario, Canada
| | - N Relihan
- Breast Research Centre, Cork University Hospital, Wilton, Cork, Ireland
| | - M W Bennett
- Breast Research Centre, Cork University Hospital, Wilton, Cork, Ireland
| | - H P Redmond
- Breast Research Centre, Cork University Hospital, Wilton, Cork, Ireland
| | - M A Corrigan
- Breast Research Centre, Cork University Hospital, Wilton, Cork, Ireland; Royal College of Surgeons, Dublin, Ireland
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84
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Abstract
Objective: The present paper investigates on lay people's beliefs regarding cancer risk factors' and their correlates, especially people's socioeconomic status (SES), as they may heavily contribute to social health inequalities. Methods: We used data from the 2010 Baromètre Cancer, a national representative telephone survey conducted in France (N = 3359, age 15–75, participation rate 52%). Results: Respondents differentiate behavioral factors (smoking, drinking, unprotected sun exposure, etc.), environmental risk factors (air pollution, chemicals in food, etc.) and psychosocial risk factors (stress, painful experiences, etc.) for cancer. Those with a higher SES were more likely to emphasize behavioral and psychosocial factors, while those with an intermediate SES were more likely to do so for environmental ones. Perceived financial vulnerability was associated to higher perceptions for both environmental and psychosocial factors. After adjustment on socio-demographic background and SES, respondents who emphasized behavioral risk factors were less prone to endorse fatalistic attitudes (considering that nothing can be done to avoid cancer), while those who emphasized environmental risk factors were more prone to do so, and were also more frequently daily smokers. Conclusion: These results suggest that lay people's beliefs regarding cancer risk factors are shaped by their conceptions regarding one's body and health, and especially their health locus of control, as the tendency to either emphasize behavioral or environmental factors was correlated to fatalistic attitudes. Prevention campaigns designed to tackle lay people's perceptions regarding cancer risk factors should not consider they simply reflect ignorance or misinformation, as they are embedded in social and cultural contexts. Lay perceptions of cancer risk factors are embedded in social and cultural contexts. These perceptions reflect people's conceptions of one's body, health & illness. These perceptions are correlated to fatalistic attitudes and risk behaviors. SES disparities in such perceptions are predictive of health inequalities.
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