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Kelley-Jones C, Scott SE, Waller J. Acceptability of de-intensified screening for women at low risk of breast cancer: a randomised online experimental survey. BMC Cancer 2024; 24:1111. [PMID: 39243000 PMCID: PMC11378402 DOI: 10.1186/s12885-024-12847-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 08/23/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND Risk-stratified approaches to breast screening show promise for increasing benefits and reducing harms. But the successful implementation of such an approach will rely on public acceptability. To date, research suggests that while increased screening for women at high risk will be acceptable, any de-intensification of screening for low-risk groups may be met with less enthusiasm. We report findings from a population-based survey of women in England, approaching the age of eligibility for breast screening, to compare the acceptability of current age-based screening with two hypothetical risk-adapted approaches for women at low risk of breast cancer. METHODS An online survey of 1,579 women aged 40-49 with no personal experience of breast cancer or mammography. Participants were recruited via a market research panel, using target quotas for educational attainment and ethnic group, and were randomised to view information about (1) standard NHS age-based screening; (2) a later screening start age for low-risk women; or (3) a longer screening interval for low-risk women. Primary outcomes were cognitive, emotional, and global acceptability. ANOVAs and multiple regression were used to compare acceptability between groups and explore demographic and psychosocial factors associated with acceptability. RESULTS All three screening approaches were judged to be acceptable on the single-item measure of global acceptability (mean score > 3 on a 5-point scale). Scores for all three measures of acceptability were significantly lower for the risk-adapted scenarios than for age-based screening. There were no differences between the two risk-adapted scenarios. In multivariable analysis, higher breast cancer knowledge was positively associated with cognitive and emotional acceptability of screening approach. Willingness to undergo personal risk assessment was not associated with experimental group. CONCLUSION We found no difference in the acceptability of later start age vs. longer screening intervals for women at low risk of breast cancer in a large sample of women who were screening naïve. Although acceptability of both risk-adapted scenarios was lower than for standard age-based screening, overall acceptability was reasonable. The positive associations between knowledge and both cognitive and emotional acceptability suggests clear and reassuring communication about the rationale for de-intensified screening may enhance acceptability.
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Affiliation(s)
- Charlotte Kelley-Jones
- Cancer Prevention Group, Faculty of Life Sciences & Medicine, King's College London, Guy's Campus, Great Maze Pond, London, SE1 1UL, UK.
- c/o Professor J. Waller, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.
| | - Suzanne E Scott
- Cancer Prevention Group, Faculty of Life Sciences & Medicine, King's College London, Guy's Campus, Great Maze Pond, London, SE1 1UL, UK
- Wolfson Institute of Population Health, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
| | - Jo Waller
- Cancer Prevention Group, Faculty of Life Sciences & Medicine, King's College London, Guy's Campus, Great Maze Pond, London, SE1 1UL, UK
- Wolfson Institute of Population Health, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
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Brown SL, Hope-Stone L, van der Voort N, Hussain R, Heimann H, Coventry WL, Cherry MG. Associations between empirically proportionate and disproportionate fears of cancer recurrence and anxiety and depression in uveal melanoma survivors: Five-year prospective study. Br J Health Psychol 2024; 29:662-675. [PMID: 38462481 DOI: 10.1111/bjhp.12719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 02/01/2024] [Accepted: 02/21/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVE Fear of cancer recurrence (FCR) may develop into elevated anxiety or depression symptoms, but few risk factors for this development are known. Objective recurrence risk estimation is possible in some cancers. Using theories of risk communication and phobias, we examined whether the proportionality of FCR to known objective recurrence risk influences the development of anxiety and depression symptoms. METHOD Uveal melanoma (UM) patients can opt for reliable prognostic testing. Patients experience either a 'good' or 'poor' prognostic outcome, whereby 10-year mortality due to metastatic disease is, respectively, low or high. In a five-year prospective study of a consecutive sample of 589 UM survivors, we used random intercept cross lagged panel analyses to examine whether proportionality differentially influences whether FCR progresses to anxiety and depression. RESULTS Positive cross paths predicting anxiety from FCR were stronger in the poor prognosis group than the good prognosis and not tested groups. Prognostic group differences were not evident for depression. CONCLUSIONS FCR was more likely to progress to elevated anxiety symptoms when proportionate to the known objective recurrence risk. Objective evidence may play a prominent role in the development and structure of fear because it assumes a high epistemic weight that activates a wide range of emotional and cognitive responses. Interventions that assist survivors to tolerate FCR in the presence of higher recurrence risks may be important in reducing anxiety symptoms.
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Affiliation(s)
| | - Laura Hope-Stone
- University of Liverpool, Liverpool, UK
- Liverpool Ocular Oncology Centre, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Nicola van der Voort
- Liverpool Ocular Oncology Centre, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Rumana Hussain
- University of Liverpool, Liverpool, UK
- Liverpool Ocular Oncology Centre, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Heinrich Heimann
- University of Liverpool, Liverpool, UK
- Liverpool Ocular Oncology Centre, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
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Ye JF, Zheng S, Ao SH, Yan CD, Lai Y, Lai Z, Zhao X. How does patient-centered communication work? Trend analysis of mediation through cancer worry and health self-efficacy, 2011-2020. J Health Psychol 2024; 29:1164-1178. [PMID: 38305168 DOI: 10.1177/13591053241228437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
Abstract
This study proposed and tested the cross-sectional effects of patient-centered communication (PCC) on cancer screening behaviors via an affective-cognitive sequential chain of mediation through cancer worry and health self-efficacy. Cross-sectional data were analyzed from four iterations of the Health Information National Trends Survey (2011, 2014, 2017, and 2020). The results found that lowered cancer worry following PCC does not show a cross-sectional positive effect in promoting cancer screening behaviors, while enhanced health self-efficacy as a subsequent state is a facilitator of screening behaviors. The findings further demonstrated increased PCC, a rise in cancer worry, and a sustained level of health self-efficacy. Also, our research has identified an upward trend in cancer screening behaviors from 2011 to 2017, followed by a notable decrease in 2020. These insights underscore the nuanced ways PCC can foster cancer screening behaviors, emphasizing the importance of emotional and cognitive aspects in clinical settings.
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Affiliation(s)
| | | | | | | | | | - Ze Lai
- University of Macau, China
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Beach WA. Formulating cancer worries: How doctors establish medical expertise and authority to facilitate patients' care choices. Soc Sci Med 2024; 354:117071. [PMID: 39013282 DOI: 10.1016/j.socscimed.2024.117071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 03/25/2024] [Accepted: 06/21/2024] [Indexed: 07/18/2024]
Abstract
Video recordings of oncology interviews reveal how doctors rely on worry to establish medical expertise, facilitate treatment decision-making, and construct worry parameters to help patients understand whether there is a reasonable need for worry or not. Doctors express worry as frequently as cancer patients during oncology interviews, but they face a dilemma: how to provide care for cancer patients without directly stating they are worried about them? Plausible explanations are offered for why doctors do not state personal worries. Conversation analytic methods were employed to identify how doctors rely on worry to achieve distinct social actions. Four worry formulations are examined: (1) variations of "we worry" (and at times, non-specific and second person "you"), (2) hypothetical worry scenarios, (3) dismissing worry and offering assurance, and (4) doctors claiming they are not worried, bothered, or alarmed. Doctors align with and speak for the professionals and institutions they represent, expressing collective worries and claiming the legitimate right to worry (or not). Doctors also avoid abandoning patients to their own decision-making, yet do not formulate worry to coerce deference or dictate patients' choices. In all cases patients agreed and displayed minimal resistance to doctors' worry formulations. These findings contribute to ongoing work across institutional settings where participants have been shown to construct objective, legitimate claims meriting worries about diverse problems. Work is underway to examine when and how patients explicitly raise and doctors respond to cancer worries. Clinical implications are raised for how doctors can use worry to legitimize best treatment options, help patients minimize their worries, rely on hypothetical scenarios allowing patients to compare how other patients managed their cancer, and not dismiss the importance of minimizing the need to worry as a resource for offering reassurance.
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Affiliation(s)
- Wayne A Beach
- School of Communication, Center for Communication, Health, & the Public Good, San Diego State University, USA; Department of Surgery, Moores Cancer Center, University of California, San Diego, USA; Social Science & Medicine, USA.
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Vincent C, Fenge L, Porter S, Holland S. Exploring Whether and How People Experiencing High Deprivation Access Diagnostic Services: A Qualitative Systematic Review. Health Expect 2024; 27:e14142. [PMID: 39010641 PMCID: PMC11250414 DOI: 10.1111/hex.14142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 06/03/2024] [Accepted: 06/16/2024] [Indexed: 07/17/2024] Open
Abstract
INTRODUCTION To contribute to addressing diagnostic health inequalities in the United Kingdom, this review aimed to investigate determinants of diagnostic service use amongst people experiencing high deprivation in the United Kingdom. METHODS A systematic review was conducted using three databases (EBSCO, Web of Science and SCOPUS) to search studies pertaining to diagnostic service use amongst people experiencing high deprivation. Search terms related to diagnostics, barriers and facilitators to access and deprivation. Articles were included if they discussed facilitators and/or barriers to diagnostic service access, contained participants' direct perspectives and focussed on individuals experiencing high deprivation in the United Kingdom. Articles were excluded if the full text was unretrievable, only abstracts were available, the research did not focus on adults experiencing high deprivation in the United Kingdom, those not including participants' direct perspectives (e.g., quantitative studies) and papers unavailable in English. RESULTS Of 14,717 initial papers, 18 were included in the final review. Determinants were grouped into three themes (Beliefs and Behaviours, Emotional and Psychological Factors and Practical Factors), made up of 15 sub-themes. These were mapped to a conceptual model, which illustrates that Beliefs and Behaviours interact with Emotional and Psychological Factors to influence Motivation to access diagnostic services. Motivation then influences and is influenced by Practical Factors, resulting in a Decision to Access or Not. This decision influences Beliefs and Behaviours and/or Emotional and Psychological Factors such that the cycle begins again. CONCLUSION Decision-making regarding diagnostic service use for people experiencing high deprivation in the United Kingdom is complex. The conceptual model illustrates this complexity, as well as the mediative, interactive and iterative nature of the process. The model should be applied in policy and practice to enable understanding of the factors influencing access to diagnostic services and to design interventions that address identified determinants. PATIENT OR PUBLIC CONTRIBUTION Consulting lived experience experts was imperative in understanding whether and how the existing literature captures the lived experience of those experiencing high deprivation in South England. The model was presented to lived experience experts, who corroborated findings, highlighted significant factors for them and introduced issues that were not identified in the review.
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Affiliation(s)
- Christine Vincent
- Department of Social Sciences and Social Work, Faculty of Health and Social SciencesBournemouth UniversityBournemouthUK
| | - Lee‐Ann Fenge
- Department of Social Sciences and Social Work, Faculty of Health and Social SciencesBournemouth UniversityBournemouthUK
| | - Sam Porter
- Department of Social Sciences and Social Work, Faculty of Health and Social SciencesBournemouth UniversityBournemouthUK
| | - Sharon Holland
- Department of Nursing Science, Faculty of Health and Social SciencesBournemouth UniversityBournemouthUK
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Peng W, McKinnon-Crowley J, Huang Q, Mao B. Assessing Fear, Embarrassment, and Disgust in Colonoscopy: The Development of Measurement Instruments and Psychometric Evidence. HEALTH EDUCATION & BEHAVIOR 2024; 51:601-612. [PMID: 37293778 DOI: 10.1177/10901981231177075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Avoidance of colonoscopy is often associated with fear, embarrassment, and disgust aroused in screening procedures. However, each emotion can be linked to different challenges faced by patients. More research is needed to evaluate and address the causes of these respective emotions. AIM The purpose of this study was to develop and assess the scales of three negative emotions (i.e., fear, embarrassment, and disgust) caused by specific issues in colonoscopy screening. METHOD The measurement items were developed based on multiple common barriers in colonoscopy screening procedures. An online sample of 232 adults aged 45-75 was recruited from Amazon Mechanical Turk to test the scales. Explorative and confirmatory factor analyses were conducted to validate the measurement models. RESULTS Psychometric evidence demonstrated the factor structures of three negative emotions. Each emotional factor was caused by unique combinations of barriers in the preparation, screening, and recovery stages of colonoscopy. Most of the emotional factors were associated with attitudes and screening intention. CONCLUSION This study showed different dimensions of negative emotions and their underlying causes in colonoscopy. These findings will help assess specific causes of negative emotions in colonoscopy and develop effective interventions to improve screening uptake.
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Affiliation(s)
- Wei Peng
- Washington State University, Pullman, WA, USA
| | | | | | - Bingjing Mao
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Costa-Requena G, Richart-Aznar P, Segura-Huerta Á. Cancer worry at higher-risk sample of hereditary cancer in Spain. Eur J Cancer Prev 2024; 33:293-298. [PMID: 37997907 DOI: 10.1097/cej.0000000000000862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
BACKGROUND Few studies have examined the prevalence of cancer worry in the general and at-risk population. The objective of this study was to describe the prevalence of cancer worry in a sample of individuals at increased risk of developing hereditary cancer, determine differences in cancer worry by socio-demographic characteristics and assess the relationship between cancer worry and psychological distress. METHODS A cross-sectional study was designed with 895 patients. The Cancer Worry Scale (CWS), Hospital Anxiety and Depression Scale (HADS) for psychological distress and sociodemographic characteristics were examined. The multiple linear regression model was developed to explore what variables were predicted for cancer worry. To identify variables associated with higher cancer worry scores, a logistic model was fitted. RESULTS In the at-higher-risk sample of hereditary cancer, the mean of CWS was 10.20 (SD: 3.70). The significant predictors for cancer worry were gender, age, previous psychiatric treatment, patients affected by cancer and having children. In the sample, 38% of patients had higher scores on cancer worry, the variables associated were patients affected by cancer compared, women, widow/divorced participants, less than secondary school, patients with previous psychiatric treatment and patients less than 55 years old. Using the HADS cutoff score 29% of the sample showed significant psychological distress, more anxiety (35%) than depressive (22%) symptomatology. Psychological distress showed a higher variability (36%) on cancer worry. CONCLUSION Findings highlighted distinctive profiles in socio-demographic characteristics according to the degree of cancer worry; therefore, genetic counseling should continue to be provided to address cancer worry and relieve psychological distress.
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Affiliation(s)
- Gema Costa-Requena
- Department of Psychiatry and Clinical Psychology, Hospital Universitari i Politècnic La Fe
- Genetic Counselling Unit for Hereditary Cancer, Department of Oncology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Paula Richart-Aznar
- Genetic Counselling Unit for Hereditary Cancer, Department of Oncology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Ángel Segura-Huerta
- Genetic Counselling Unit for Hereditary Cancer, Department of Oncology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
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Zhang L, Ye JF, Zhao X. "I Saw it Incidentally but Frequently": Exploring the Effects of Online Health Information Scanning on Lung Cancer Screening Behaviors Among Chinese Smokers. HEALTH COMMUNICATION 2024:1-12. [PMID: 38683113 DOI: 10.1080/10410236.2024.2345948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
In China, lung cancer is the most common cancer with high mortality. While prior research suggests that health information scanning influences cancer screening within the general population, a deeper exploration of the underlying mechanisms is imperative. This study specifically targets smokers, aiming to investigate whether online health information scanning can effectively encourage lung cancer screening and elucidate the mechanisms driving this association. Data were extracted from a Chinese national survey conducted between January and September 2023, exclusively involving current smokers (N = 992). A moderated mediation model was employed to examine a cognitive-affective sequential chain of mediation through risk perceptions and cancer worry. Results showed that 99.1% of Chinese smokers reported online health information scanning, which possessed significant influence. Online health information scanning was positively associated with effective lung cancer screening among smokers directly (OR = 1.927, p < .01) and indirectly (OR = .065, p < .001). The perceived threat of smoking and cancer worry served as the cognitive and affective mediating mechanisms. Furthermore, a moderating effect of eHealth literacy was observed (OR = 6.292, p < .05). Smokers with higher eHealth literacy are more inclined to undergo effective lung cancer screening. Based on these findings, public health sectors should leverage online platforms to disseminate tailored cancer screening education and implement initiatives to enhance public eHealth literacy.
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Affiliation(s)
- Luxi Zhang
- Department of Communication/Institute of Collaborative Innovation, University of Macau
| | - Jizhou Francis Ye
- Department of Communication/Institute of Collaborative Innovation, University of Macau
| | - Xinshu Zhao
- Department of Communication/Institute of Collaborative Innovation/Center for Research in Greater Bay Area, University of Macau
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Fukuda S, Watanabe K, Takahashi S, Yoshida T, Fujimori S, Komatsu T, Shimodaira Y, Matsuhashi T, Iijima K. Disproportionate cancer worries in ultra-short-segment Barrett's esophagus in Japan. DEN OPEN 2024; 4:e329. [PMID: 38223912 PMCID: PMC10787273 DOI: 10.1002/deo2.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/16/2024]
Abstract
Objectives Although Barrett's esophagus (BE), especially ultra-short-segment BE (USSBE), is very frequently diagnosed in Japan, how subjects feel about receiving a diagnosis of BE is unclear. We therefore prospectively investigated cancer worry in subjects who received a BE diagnosis. Methods Self-administered questionnaires were sent to subjects who were diagnosed with BE at three health checkup institutes in Akita Prefecture, Japan. The cancer worry scale (CWS) was used to quantitatively assess the fear of developing cancer. The BE subjects were classified into USSBE <1 cm and non-USSBE ≥1 cm groups. Factors associated with the CWS were investigated using logistic regression analyses. Results A total of 325 (31%) subjects, comprising 229 USSBE and 96 non-USSBE patients were included in this study. Compared with the USSBE group, the non-USSBE group had a significantly higher frequency of a history of a BE diagnosis and perception of carcinogenesis. However, the CWS was similar between the USSBE and non-USSBE groups, with a median CWS of 12.5 (3.75) versus 12.7 (3.65). A multivariate logistic regression analysis revealed that while positive reflux symptoms were significantly associated with a positive CWS, the BE length was not significantly associated with it, with an odds ratio (95% confidence interval) of 1.3 (0.75-2.2). Conclusions A BE diagnosis promotes a similar level of worry about cancer among subjects, irrespective of the length of BE. In Japan, since USSBE poses a much lower cancer risk than non-USSBE, the former may frequently be associated with a disproportionate cancer worry relative to the latter. (UMIN000044010).
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Affiliation(s)
- Sho Fukuda
- Department of GastroenterologyAkita University Graduate School of MedicineAkitaJapan
| | - Kenta Watanabe
- Department of GastroenterologyAkita University Graduate School of MedicineAkitaJapan
| | - So Takahashi
- Department of GastroenterologyAkita University Graduate School of MedicineAkitaJapan
| | - Tatsuki Yoshida
- Department of GastroenterologyAkita University Graduate School of MedicineAkitaJapan
| | - Shusei Fujimori
- Department of GastroenterologyYokote Municipal HospitalAkitaJapan
| | - Taiga Komatsu
- Department of AnesthesiologyHonjo‐Daiichi HospitalAkitaJapan
| | - Yosuke Shimodaira
- Department of GastroenterologyAkita University Graduate School of MedicineAkitaJapan
| | - Tamotsu Matsuhashi
- Department of GastroenterologyAkita University Graduate School of MedicineAkitaJapan
| | - Katsunori Iijima
- Department of GastroenterologyAkita University Graduate School of MedicineAkitaJapan
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Mamudu L, Li J, McEligot AJ, Wood M, Rusmevichientong P, Tetteh-Bator E, Soale AN, Fortenberry JD, Williams F. Cancer worry and its impact on self-reported depressive symptoms among adult males and females in the US: a nationwide sample study. BMC Psychiatry 2024; 24:31. [PMID: 38191340 PMCID: PMC10773041 DOI: 10.1186/s12888-023-05405-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 11/25/2023] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVE With cancer the second deadliest disease in the world, worry about cancer can have mental health or psychiatric implications. This study examines the prevalence, differences, and influence of cancer worry (CW), its interaction effect with age, and other confounders on self-reported depressive symptoms (SRDS) among adult males and females in the US. METHODS We utilized a nationally representative sample data of 2,950 individuals (males = 1,276; females = 1,674) from Cycle 4 of the Health Information National Trends Survey 5 (HINTS 5) 2020. Using frequencies, bivariate chi-square test, and multivariate logistic regression, we examined the prevalence, difference, and association of CW with SRDS, adjusting for confounders. RESULTS The prevalence rate of SRDS was found to be 32% among females and 23.5% among males. Among individuals with CW, females had a higher prevalence of SRDS compared to males (40.5% vs. 35.1%). However, there was a significant difference in the likelihood of experiencing SRDS between males and females with CW, with males having 84% increased risk compared to females. Across all age groups, the multivariate analysis of the relationship between CW and SRDS revealed that both males and females showed a significantly decreased likelihood of SRDS compared to those aged 18-34 years. However, males aged 35 years or older exhibited an even more pronounced decrease in likelihood compared to females in the same age group. Nonetheless, when examining the interaction of age and CW, we observed a significantly increased likelihood of SRDS across all age groups. Males, in particular, had a higher increased likelihood of SRDS compared to females across all ages, except for those aged 75 years and older. CONCLUSION The findings of this study highlight the significant influence of CW on individuals' SRDS and the modifying effect of age, particularly among males. These results are important for a better understanding of the risk of CW on mental health, which can be a preventive strategy or control mechanism.
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Affiliation(s)
- Lohuwa Mamudu
- Department of Public Health, California State University, 800 N. State College Boulevard, Fullerton, Fullerton, CA, 92831, USA.
| | - Jinyi Li
- Department of Public Health, University of California Irvine, Irvine, CA, 92967, USA
| | - Archana J McEligot
- Department of Public Health, California State University, 800 N. State College Boulevard, Fullerton, Fullerton, CA, 92831, USA
| | - Michele Wood
- Department of Public Health, California State University, 800 N. State College Boulevard, Fullerton, Fullerton, CA, 92831, USA
| | - Pimbucha Rusmevichientong
- Department of Public Health, California State University, 800 N. State College Boulevard, Fullerton, Fullerton, CA, 92831, USA
| | - Erasmus Tetteh-Bator
- Department of Mathematics and Statistics, University of South Florida, 4202 E. Fowler Ave, Tampa, FL, 33620, USA
| | - Abdul-Nasah Soale
- Department of Mathematics and Statistics, Applied Mathematics and Statistics, Case Western Reserve University, Yost Hall, 2049 Martin Luther King Jr. Drive, 44106-7058, Cleaveland, OH, USA
| | - James D Fortenberry
- Division of Adolescent Medicine, Indiana University School of Medicine, 410 W 10th St., Room 1001, Indianapolis, IN, 46202, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, 11545 Rockville Pike, T-10 C12, Rockville, MD, 20852, USA.
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11
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Parsamand T, Zarani F, Panaghi L, Kwok C. Conceptualization of Breast Cancer and Attitudes toward Breast Cancer Screening: A Qualitative Study on Iranian and Australian Women. Cancer Invest 2024; 42:34-43. [PMID: 37982678 DOI: 10.1080/07357907.2023.2283866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 11/11/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVE Regular screening can lead to early diagnosis of breast cancer. Australia is one of the countries with a high rate of participation in breast cancer screening, while in Iran, most patients are diagnosed in advanced stages. This qualitative study used a thematic analysis method to examine the attitudes and beliefs of Iranian and Australian women toward breast cancer and breast cancer screening. METHOD In-depth interviews were conducted with eight Iranian and seven Australian women. Data were collected through semi-structured interviews and analyzed using thematic analysis with an inferential approach. RESULTS According to the results, four main themes were extracted for the perceptions of breast cancer, including "the meaning of breast cancer", "causes of breast cancer", "prevention of breast cancer" and "effects of significant people in life". Considering the perceptions of breast cancer screening, three themes were identified, including "beliefs about breast cancer screening," "sources of information about breast cancer screening," and "barriers to breast cancer screening." CONCLUSION Cultural and social factors influence women's perceptions of breast cancer and screening. Therefore, investigating the cultural meaning of breast cancer and breast cancer screening for women can be useful for screening and prevention purposes.
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Affiliation(s)
- Tina Parsamand
- Ph.D. Department of Educational Science and Psychology, Shahid Beheshti University, Tehran, Iran
| | - Fariba Zarani
- Ph.D. Department of Educational Science and Psychology, Shahid Beheshti University, Tehran, Iran
| | - Leili Panaghi
- Family Research Institute, Shahid Beheshti University, Tehran, Iran
| | - Cannas Kwok
- Faculty of Nursing and Midwifery, University of Sydney, Camperdown, Australia
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12
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Goodwin B, Anderson L, Collins K, Sanjida S, Riba M, Singh GK, Campbell KM, Green H, Ishaque S, Kwok A, Opozda MJ, Pearn A, Shaw J, Sansom-Daly UM, Tsirgiotis JM, Janda M, Grech L. Anticipatory anxiety and participation in cancer screening. A systematic review. Psychooncology 2023; 32:1773-1786. [PMID: 37929985 DOI: 10.1002/pon.6238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/20/2023] [Accepted: 10/21/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVES To synthesize current evidence on the association between anticipatory anxiety, defined as apprehension-specific negative affect that may be experienced when exposed to potential threat or uncertainty, and cancer screening to better inform strategies to maximize participation rates. METHODS Searches related to cancer screening and anxiety were conducted in seven electronic databases (APA PsycINFO, Scopus, Web of Science, Embase, Cochrane Library, PubMed, CINAHL), with potentially eligible papers screened in Covidence. Data extraction was conducted independently by multiple authors. Barriers to cancer screening for any type of cancer and relationships tested between anticipatory anxiety and cancer screening and intention were categorized and compared according to the form and target of anxiety and cancer types. RESULTS A total of 74 articles (nparticipants = 119,990) were included, reporting 103 relationships tested between anticipatory anxiety and cancer screening and 13 instances where anticipatory anxiety was reported as a barrier to screening. Anticipatory anxiety related to a possible cancer diagnosis was often associated with increased screening, while general anxiety showed no consistent relationship. Negative relationships were often found between anxiety about the screening procedure and cancer screening. CONCLUSION Anticipatory anxiety about a cancer diagnosis may promote screening participation, whereas a fear of the screening procedure could be a barrier. Public health messaging and primary prevention practitioners should acknowledge the appropriate risk of cancer, while engendering screening confidence and highlighting the safety and comfort of screening tests.
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Affiliation(s)
- Belinda Goodwin
- Viertel Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Queensland, Australia
- Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Laura Anderson
- Viertel Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Queensland, Australia
- National Centre for Youth Substance Use Research, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Katelyn Collins
- Viertel Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Queensland, Australia
- School of Psychology and Wellbeing, University of Southern Queensland, Springfield, Queensland, Australia
| | - Saira Sanjida
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Marcos Riba
- The University of Queensland, Saint Lucia, Queensland, Australia
| | - Gursharan K Singh
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
- Cancer and Palliative Outcomes Centre, School of Nursing, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Kimberley M Campbell
- IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Heather Green
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Sana Ishaque
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Alastair Kwok
- Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
- Department of Oncology, Monash Health, Clayton, Victoria, Australia
| | - Melissa J Opozda
- Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute and University of Adelaide, Adelaide, South Australia, Australia
- College of Medicine and Public Health, Flinders University, Darwin, Northern Territory, Australia
| | - Amy Pearn
- The Gene Council, North Perth, Washington, Australia
| | - Joanne Shaw
- Psycho-oncology Co-operative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Camperdown, New South Wales, Australia
| | - Ursula M Sansom-Daly
- Psycho-oncology Co-operative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Camperdown, New South Wales, Australia
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Discipline of Paediatrics, UNSW Sydney, Kensington, New South Wales, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Joanna M Tsirgiotis
- Sydney Youth Cancer Centre, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Monika Janda
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Lisa Grech
- Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
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13
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Day AT, Sood A, Emmet TR, Eary RL, Prestwood CA, Salley J, Huffman A, Doenges J, Mayfield Arnold E, Tiro JA, Lee SC. Supportive Care Needs Among Head and Neck Cancer Patients Prior to Oncologic Treatment: A Prospective, Nested Cross-Sectional Qualitative Analysis. Ann Otol Rhinol Laryngol 2023; 132:1443-1452. [PMID: 37005576 DOI: 10.1177/00034894231162686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
OBJECTIVES To qualitatively characterize pretreatment head and neck cancer (HNC) patients' supportive care (SC) needs, attitudes toward SC, and barriers to SC utilization. MATERIALS AND METHODS A prospective, nested, bi-institutional, cross-sectional pilot study design was employed. Participants were sub-selected from a representative sample of 50 patients newly diagnosed with mucosal or salivary gland HNC or sarcoma of the head and neck. Eligibility criteria included reporting ≥2 unmet needs (according to the Supportive Care Needs Survey-Short Form 34) or clinically-significant distress (National Comprehensive Cancer Network Distress Thermometer score ≥4). Semi-structured interviews were performed prior to initiation of oncologic treatment. Audio-recorded interviews were transcribed and thematically analyzed using NVivo 12.0 (QSR Australia). Thematic findings and representative quotes were interpreted by the entire research team. RESULTS Twenty-seven patients were interviewed. One-third were treated at the county safety-net hospital and the remainder were treated at the university health system. An equal proportion of patients presented with oral cavity, oropharyngeal, and laryngeal or other tumors. Two significant findings were identified on semi-structured interviews. First, patients did not perceive the relevance of SC prior to treatment. Second, anxiety surrounding the HNC diagnosis and impending treatment dominated in the pretreatment phase. CONCLUSION Improved HNC patient education about the relevance and importance of SC in the pretreatment setting is needed. Integration of social work or psychological services in HNC clinics is warranted to address patients' cancer-related worry-a discrete, dominant pretreatment SC need.
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Affiliation(s)
- Andrew T Day
- Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Anubha Sood
- Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX, USA
| | - Thomas R Emmet
- Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Rebecca L Eary
- Department of Family and Community Medicine, UT Southwestern Medical Center, Dallas, TX, USA
| | - Courtney A Prestwood
- Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Jordan Salley
- Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Alexandra Huffman
- Support Services, Simmons Comprehensive Cancer Center, Dallas, TX, USA
| | - Jacquelyn Doenges
- Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | | | - Jasmin A Tiro
- Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX, USA
| | - Simon Craddock Lee
- Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX, USA
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Alenezi AM, Alshariyah MMH, Alanazi MN, Abdel-Salam DM, Al-Hazmi AH, Thirunavukkarasu A, Alhuwaydi AM, Alsabilah RH, Mohamed RA. Assessment of Psychosocial Correlates and Associated Factors of Colorectal Cancer Screening among Southwestern Saudi Population: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:2791. [PMID: 37893864 PMCID: PMC10606086 DOI: 10.3390/healthcare11202791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/09/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
Psychosocial correlates are one of the crucial determinants for the uptake of colorectal cancer (CRC) screening by the pre-eligible population. The present study aimed to identify the psychosocial correlates of colorectal cancer screening and determine their associated factors among the Saudi population in the Najran region, Saudi Arabia. Using a validated questionnaire, we assessed five constructs of psychosocial correlates of CRC screening among 790 participants aged 45 years and above. The five constructs were salience and coherence, cancer worries, perceived susceptibility, response efficacy, and social influence. Of the studied population, less than 50% agreed with most of the five constructs' statements, and 27.5% preferred to follow their family members' advice. Significantly higher mean scores (±SD) were identified for the male gender (7.38 ± 2.15, p = 0.027) and participants working in government sectors (7.60 ± 2.03, p = 0.027) in the cancer worries construct, while the mean (±SD) scores of perceived susceptibility were significantly higher among married participants (14.38 ± 4.10, p = 0.023) and smokers (14.95 ± 3.92, p = 0.041). Our survey results could help policymakers to implement focused health education programs for the pre-eligible population on the importance of the uptake of CRC screening. Furthermore, it is recommended to carry out exploratory mixed-method surveys in other regions of Saudi Arabia to understand the region's specific psychosocial correlates towards CRC screening.
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Affiliation(s)
| | | | - Maryam Nazal Alanazi
- Department of Psychological Counseling, College of Sciences and Arts, Qurrayat Campus, Jouf University, Qurrayat 77425, Saudi Arabia;
| | - Doaa Mazen Abdel-Salam
- Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Assiut 71515, Egypt;
| | - Ahmad Homoud Al-Hazmi
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (A.H.A.-H.); (A.T.)
| | - Ashokkumar Thirunavukkarasu
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (A.H.A.-H.); (A.T.)
| | - Ahmed M. Alhuwaydi
- Department of Internal Medicine, Division of Psychiatry, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia;
| | | | - Rehab A. Mohamed
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt;
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15
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Azizoddin DR, Wilson JM, Flowers KM, Beck M, Chai P, Enzinger AC, Edwards R, Miaskowski C, Tulsky JA, Schreiber KL. Daily pain and opioid administration in hospitalized patients with cancer: the importance of psychological factors, recent surgery, and current opioid use. Pain 2023; 164:1820-1827. [PMID: 36893325 PMCID: PMC10363176 DOI: 10.1097/j.pain.0000000000002880] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/26/2023] [Indexed: 03/11/2023]
Abstract
ABSTRACT Pain is common and variable in its severity among hospitalized patients with cancer. Although biopsychosocial factors are well established as modulators of chronic pain, less is known about what patient-level factors are associated with worse pain outcomes among hospitalized cancer patients. This prospective cohort study included patients with active cancer presenting to the emergency department (ED) with pain severity of ≥4/10 and followed pain outcomes longitudinally throughout hospital admission. Baseline demographic, clinical, and psychological factors were assessed on ED presentation, and daily average clinical pain ratings and opioid consumption during hospitalization were abstracted. Univariable and multivariable generalized estimating equation analyses examined associations of candidate biopsychosocial, demographic, and clinical predictors with average daily pain and opioid administration. Among 113 hospitalized patients, 73% reported pain as the primary reason for presenting to the ED, 43% took outpatient opioids, and 27% had chronic pain that predated their cancer. Higher pain catastrophizing ( B = 0.1, P ≤ 0.001), more recent surgery ( B = -0.2, P ≤ 0.05), outpatient opioid use ( B = 1.4, P ≤ 0.001), and history of chronic pain before cancer diagnosis ( B = 0.8, P ≤ 0.05) were independently associated with greater average daily pain while admitted to the hospital. Higher pain catastrophizing ( B = 1.6, P ≤ 0.05), higher anxiety ( B = 3.7, P ≤ 0.05), lower depression ( B = -4.9, P ≤ 0.05), metastatic disease ( B = 16.2, P ≤ 0.05), and outpatient opioid use ( B = 32.8, P ≤ 0.001) were independently associated with higher daily opioid administration. Greater psychological distress, especially pain catastrophizing, as well as pain and opioid use history, predicted greater difficulty with pain management among hospitalized cancer patients, suggesting that early assessment of patient-level characteristics may help direct consultation for more intensive pharmacologic and nonpharmacologic interventions.
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Affiliation(s)
- Desiree R. Azizoddin
- Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Jenna M. Wilson
- Department of Anesthesiology, Perioperative and Pain medicine, Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Kelsey Mikayla Flowers
- Department of Anesthesiology, Perioperative and Pain medicine, Brigham and Women’s Hospital, Boston, MA
| | - Meghan Beck
- Department of Anesthesiology, Perioperative and Pain medicine, Brigham and Women’s Hospital, Boston, MA
| | - Peter Chai
- Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA
- Fenway Health, Boston, MA
| | - Andrea C. Enzinger
- Harvard Medical School, Boston, MA
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA
| | - Robert Edwards
- Department of Anesthesiology, Perioperative and Pain medicine, Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Christine Miaskowski
- Schools of Nursing and Medicine, University of California San Francisco, San Francisco, CA
| | - James A. Tulsky
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Kristin L. Schreiber
- Department of Anesthesiology, Perioperative and Pain medicine, Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
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16
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Lin L, Zhang X, Yu M, Bernardo B, Adeyanju T, Paskett ED. The relationship between family history of cancer and cancer attitudes & beliefs within the Community Initiative Towards Improving Equity and Health Status (CITIES) cohort. PLoS One 2023; 18:e0287629. [PMID: 37368880 PMCID: PMC10298770 DOI: 10.1371/journal.pone.0287629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/11/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE To determine the relationship between family history of cancer with cancer attitudes and beliefs (CABs) and cancer screening knowledge. METHODS This study used data collected for the Community Initiative Towards Improving Equity and Health Status (CITIES) project which surveyed Ohioans ages 21-74. In the current analysis, we included data on age, gender, race, marital status, education, income, financial security, health insurance, CABs, knowledge about the correct age to begin cancer screenings, and presence of a first-degree relative with cancer. Multivariable logistic regression was used to examine the association of family history of cancer with CABs and knowledge about the correct age to begin cancer screening. RESULTS Participants were predominantly over the age of 41, female, and white. Out of 603 participants, 295 (48.92%) reported not having a first-degree relative with cancer and 308 (51.08%) reported having a first-degree relative with cancer. Overall, 109 (18.08%) participants reported negative CABs, 378 (62.69%) reported moderate CABs, and 116 (19.24%) reported positive CABs. Participants who reported a first-degree relative with cancer were more likely to report positive CABs, but the association was not significant (p = .11). We observed that older, more educated, and married participants were more likely to have positive CABs (all p < 0.05). Family history of cancer was not associated with differences in knowledge about the correct age for beginning colorectal cancer screening (p = .85) and mammography (p = .88). CONCLUSIONS Having a first-degree relative with cancer was not found to be associated with CABs or knowledge about cancer screening. However, age and socioeconomic status were associated with more positive CABs and increased knowledge about cancer screening. Future research should focus on standardizing a CABs scale and expanding the generalizability of our findings.
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Affiliation(s)
- Li Lin
- College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
| | - Xiaochen Zhang
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, United States of America
| | - Mengda Yu
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, United States of America
| | - Brittany Bernardo
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, United States of America
| | - Toyin Adeyanju
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, United States of America
| | - Electra D. Paskett
- College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, United States of America
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17
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Mittal A, Neibart SS, Kulkarni A, Anderson T, Hudson SV, Beer NL, Einstein MH, Kohler RE. Barriers and facilitators to effective cervical cancer screening in Belize: a qualitative analysis. Cancer Causes Control 2023:10.1007/s10552-023-01703-0. [PMID: 37165111 DOI: 10.1007/s10552-023-01703-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 04/13/2023] [Indexed: 05/12/2023]
Abstract
PURPOSE Belize has among the highest cervical cancer incidence and mortality rates of Latin American and Caribbean countries. This study evaluates the perspectives of key stakeholders for cervical cancer screening in Belize and identifies the barriers and facilitators for providing equitable access to prevention services. METHODS Semi-structured interviews discussing cervical cancer screening were conducted with key stakeholders across the six districts of Belize in 2018. Interviews were transcribed, coded, and analyzed thematically; themes were organized by levels of the social-ecological model. RESULTS We conducted 47 interviews with health care providers (45%), administrators (17%), government officials (25%), and other stakeholders (13%). Majority (78%) of interviews were from the public sector. Perceived barriers to cervical cancer screening were identified across multiple levels: (1) Individual Patient: potential delays in Pap smear results and fear of a cancer diagnosis; (2) Provider: competing clinician responsibilities; (3) Organizational: insufficient space and training; (4) Community: reduced accessibility in rural areas; and (5) Policy: equipment and staffing budget limitations. The main facilitators we identified included the following: (1) at the Community level: resource-sharing between public and private sectors and dedicated rural outreach personnel; (2) at the Policy level: free public screening services and the establishment of population-based screening. CONCLUSION Despite free, publicly available cervical cancer screening in Belize, complex barriers affect access and completion of management when abnormal screening tests are identified. Provider workload, education outreach, and additional funding for training and facilities are potential areas for strengthening this program and increasing detection and management for cervical cancer control.
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Affiliation(s)
- Avni Mittal
- Department of Obstetrics and Reproductive Health and Gynecology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Shane S Neibart
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
| | - Abha Kulkarni
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Taylor Anderson
- University of Queensland Ochsner Clinical School, Brisbane, QLD, Australia
| | - Shawna V Hudson
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Department of Cancer Prevention and Control, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | | | - Mark H Einstein
- Department of Obstetrics and Reproductive Health and Gynecology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Racquel E Kohler
- Department of Cancer Prevention and Control, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health , Piscataway, NJ, USA
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18
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Bae PhD BJ, Heald PhD G. Non-linear effects of absolute risk information on individuals'self-evaluation, affective responses, and behavioral intentionsof precautionary actions against skin cancer. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1259-1269. [PMID: 34242548 DOI: 10.1080/07448481.2021.1926266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 03/01/2021] [Accepted: 04/25/2021] [Indexed: 05/31/2023]
Abstract
OBJECTIVE The current study explores non-linear effects of absolute risk and effects of comparative risk information about skin cancer on individuals' safety ratings, affective responses and behavioral intentions. METHOD An experimental survey was conducted among college students (N = 563) to test the effects of absolute and comparative risk information across a range of risk levels from 3.7% to 60%. RESULTS The non-linear model of absolute risk effect was confirmed by the data. Absolute risk information had detectable effects at low levels of risk, but the effects did not change appreciably at the highest absolute risk levels. Regarding comparative risk, the data did not support its effects on individuals' safety ratings, affective responses and behavioral intentions. CONCLUSION The study found the non-linear model fits well to the skin cancer related feelings and behavioral intentions. It suggests future research apply non-linear models to a variety of health communication areas.
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Affiliation(s)
- Beom Jun Bae PhD
- Communication Arts Department, Georgia Southern University, Statesboro, Georgia, USA
| | - Gary Heald PhD
- School of Communication, Florida State University, Tallahassee, Florida, USA
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19
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Gummersbach E, Fuchs A, Lubisch D, in der Schmitten J, Pentzek M, Leve V. Was motiviert Frauen zur Teilnahme am Mammographiescreening? Ergebnisse einer qualitativen Analyse von Interviews. PRÄVENTION UND GESUNDHEITSFÖRDERUNG 2023. [DOI: 10.1007/s11553-023-01024-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Zusammenfassung
Einleitung
Die Teilnahmerate am Mammographiescreening beträgt derzeit ca. 49 %. Über die Gründe für Frauen, am Screening teilzunehmen, ist bisher zu wenig bekannt.
Material und Methoden
Für eine qualitative Studie wurden aus den Teilnehmerinnen einer Fragebogenstudie zum Einfluss verschiedener Informationsbroschüren auf die Teilnahmebereitschaft 8 Frauen für Interviews ausgewählt. Die Frauen wurden nach den Kriterien Teilnahmebereitschaft (6 ja, 2 nein), Bildung (6 hoch, 2 niedrig) und Entscheidungssicherheit (6 hoch, 2 niedrig) ausgewählt und im Jahr 2014 in problemzentrierten Einzelinterviews befragt. Sequenzen der Interviewtranskripte wurden in multidisziplinären Teams inhaltsanalytisch ausgewertet.
Ergebnisse
Alle interviewten Frauen hatten Mammographieerfahrung. Es wurden übergreifende Themen in sechs Kategorien identifiziert: Pflichtgefühl, Autonomie, Zweifel, Unsicherheit, Arzt/Ärztin, Institution. Die Frauen sahen in der Screeningteilnahme die Chance, einer möglichen Bedrohung durch Brustkrebs zu entgehen. Erfahrungen mit Brustkrebs im Umfeld beeinflussten ihre Entscheidung. Einer selbstverantwortlichen Entscheidungsbildung wurde ein hoher Stellenwert zugesprochen, andererseits folgten sie dem Rat ihres Arztes/ihrer Ärztin. Bei der Durchführung des Screenings fühlten sie sich einer unpersönlichen und schmerzhaften Maschinerie ausgesetzt.
Schlussfolgerungen
Frauen treffen ihre Entscheidung, am Screening teilzunehmen oder nicht, eher auf der emotionalen Ebene. Um ihnen eine informierte Entscheidung zu ermöglichen, sollten in einem ärztlichen Gespräch neben sachlichen Informationen ihre Vorstellungen und Erfahrungen in Bezug auf das Mammographiescreening ergebnisoffen besprochen werden.
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20
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Liu PL, Ye JF, Ao HS, Sun S, Zheng Y, Li Q, Feng GC, Wang H, Zhao X. Effects of electronic personal health information technology on American women's cancer screening behaviors mediated through cancer worry: Differences and similarities between 2017 and 2020. Digit Health 2023; 9:20552076231185271. [PMID: 37434732 PMCID: PMC10331072 DOI: 10.1177/20552076231185271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 06/08/2023] [Indexed: 07/13/2023] Open
Abstract
Backgrounds Thanks to their accessibility and low cost, electronic personal health information (ePHI) technologies have been widely used to facilitate patient-physician communication and promote health prevention behaviors (e.g. cancer screening). Despite that empirical evidence has supported the association between ePHI technology use and cancer screening behaviors, the underlying mechanism through which ePHI technology use influences cancer screening behaviors remains a topic of discussion. Objective This study investigates the relationship between ePHI technology uses and cancer screening behaviors of American women and examines the mediating role of cancer worry. Methods Data for this study were from the Health Information National Trends Survey (HINTS) collected in 2017 (HINTS 5 Cycle 1) and 2020 (HINTS 5 Cycle 4). The final sample included 1914 female respondents in HINTS 5 Cycle 1 and 2204 in HINTS 5 Cycle 4. Mann-Whitney U test, two-sample t-test, and mediation analysis were performed. We also referred to the regression coefficients generated by min-max normalization as percentage coefficients (bp) for the comparison. Results This study reports increased usage of ePHI technologies (from 1.41 in 2017 to 2.19 to 2020), increased cancer worry (from 2.60 in 2017 to 2.84 in 2020), and a stable level of cancer screening behaviors (from 1.44 in 2017 to 1.34 in 2020) among American women. Cancer worry was found to mediate the ePHI effect on cancer screening behaviors (bp = 0.005, 95% confidence interval [0.001, 0.010]) in a positive complementary mediation in 2020. Conclusions The research findings support a positive association between ePHI technology use and cancer screening behaviors, and cancer worry has been identified as a salient mediator. An understanding of the mechanism that prompts US women's cancer screening practices provides practical implications for health campaign practitioners.
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Affiliation(s)
- Piper Liping Liu
- Department of Communication, University of Macau, Taipa, Macau, China
| | - Jizhou Francis Ye
- Department of Communication, University of Macau, Taipa, Macau, China
| | - Harris Song Ao
- Department of Communication, University of Macau, Taipa, Macau, China
| | | | - Yu Zheng
- Faculty of Humanities and Arts, Macau University of Science and Technology, Taipa, Macau, China
| | - Qingrui Li
- Faculty of Humanities and Arts, Macau University of Science and Technology, Taipa, Macau, China
| | | | - Haiyan Wang
- Department of Communication, University of Macau, Taipa, Macau, China
| | - Xinshu Zhao
- Department of Communication, University of Macau, Taipa, Macau, China
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21
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Nichol BAB, Hurlbert AC, Read JCA. Predicting attitudes towards screening for neurodegenerative diseases using OCT and artificial intelligence: Findings from a literature review. J Public Health Res 2022; 11:22799036221127627. [PMID: 36310821 PMCID: PMC9597051 DOI: 10.1177/22799036221127627] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/02/2022] [Indexed: 11/25/2022] Open
Abstract
Recent developments in artificial intelligence (AI) and machine learning raise the possibility of screening and early diagnosis for neurodegenerative diseases, using 3D scans of the retina. The eventual value of such screening will depend not only on scientific metrics such as specificity and sensitivity but, critically, also on public attitudes and uptake. Differential screening rates for various screening programmes in England indicate that multiple factors influence uptake. In this narrative literature review, some of these potential factors are explored in relation to predicting uptake of an early screening tool for neurodegenerative diseases using AI. These include: awareness of the disease, perceived risk, social influence, the use of AI, previous screening experience, socioeconomic status, health literacy, uncontrollable mortality risk, and demographic factors. The review finds the strongest and most consistent predictors to be ethnicity, social influence, the use of AI, and previous screening experience. Furthermore, it is likely that factors also interact to predict the uptake of such a tool. However, further experimental work is needed both to validate these predictions and explore interactions between the significant predictors.
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Affiliation(s)
- Beth AB Nichol
- Department of Social Work, Education,
and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | - Anya C Hurlbert
- Biosciences Institute, Newcastle
University, Newcastle upon Tyne, UK
| | - Jenny CA Read
- Biosciences Institute, Newcastle
University, Newcastle upon Tyne, UK
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22
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Zaveri S, Nevid D, Ru M, Moshier E, Pisapati K, Reyes SA, Port E, Romanoff A. Racial Disparities in Time to Treatment Persist in the Setting of a Comprehensive Breast Center. Ann Surg Oncol 2022; 29:6692-6703. [PMID: 35697955 DOI: 10.1245/s10434-022-11971-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 05/16/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND Racial disparities in breast cancer care have been linked to treatment delays. We explored whether receiving care at a comprehensive breast center could mitigate disparities in time to treatment. METHODS Retrospective chart review identified breast cancer patients who underwent surgery from 2012 to 2018 at a comprehensive breast center. Time-to-treatment intervals were compared among self-identified racial and ethnic groups by negative binomial regression models. RESULTS Overall, 2094 women met the inclusion criteria: 1242 (59%) White, 262 (13%) Black, 302 (14%) Hispanic, 105 (5%) Asian, and 183 (9%) other race or ethnicity. Black and Hispanic patients more often had Medicaid insurance, higher American Society of Anesthesiologists (ASA) scores, advanced-stage breast cancer, mastectomy, and additional imaging after breast center presentation (p < 0.05). After controlling for other variables, racial or ethnic minority groups had consistently longer intervals to treatment, with Black women experiencing the greatest disparity (incidence rate ratio 1.42). Time from initial comprehensive breast center visit to treatment was also significantly shorter in White patients versus non-White patients (p < 0.0001). Black race, Medicaid insurance/being uninsured, older age, earlier stage, higher ASA score, undergoing mastectomy, having reconstruction, and requiring additional pretreatment work-up were associated with a longer time from initial visit at the comprehensive breast center to treatment on multivariable analysis (p < 0.05). CONCLUSION Racial or ethnic minority groups have significant delays in treatment even when receiving care at a comprehensive breast center. Influential factors include insurance delays and necessity of additional pretreatment work-up. Specific policies are needed to address system barriers in treatment access.
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Affiliation(s)
- Shruti Zaveri
- Department of Surgery, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Daniella Nevid
- Dubin Breast Center, Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Meng Ru
- Department of Population Health Science and Policy, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Erin Moshier
- Department of Population Health Science and Policy, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kereeti Pisapati
- Dubin Breast Center, Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sylvia A Reyes
- Dubin Breast Center, Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Elisa Port
- Dubin Breast Center, Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Anya Romanoff
- Department of Global Health and Health System Design, The Icahn School of Medicine at Mount Sinai, New York, NY, USA. .,The New York Academy of Medicine, 1216 Fifth Avenue, Room 556C, New York, NY, 10029, USA.
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Merten JW, Hamadi HY, King JL. Cancer Risk Perceptions Among People Who Check Their Skin for Skin Cancer: Results from the 2017 U.S. Health Information National Trends Survey (HINTS). JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:770-778. [PMID: 32968953 DOI: 10.1007/s13187-020-01880-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/16/2020] [Indexed: 06/11/2023]
Abstract
When detected early, melanoma is highly treatable and rarely fatal. Self-skin checks can identify changes in moles that could be an indicator of melanoma. Cancer risk perceptions may influence the uptake of important preventive health behaviors such as self-skin checks. The purpose of this study is to examine cancer risk perception factors associated with those who have checked their skin for signs of skin cancer using the 2017 HINTS data. Retrospective cross-sectional analysis of a nationally representative sample of U.S. adults using the Health Information National Trends Survey (HINTS). Logistic regressions were performed to identify associations between having checked skin for signs of skin cancer, risk perceptions, and demographic variables. White women over the age of 45 with a college degree and annual incomes greater than $75,000 were more likely to check their skin for signs of skin cancer. More than a third reported they would rather not know if they had cancer and more than 60% had some level of worry about having cancer. Those with a personal or family history of cancer were more likely to check. HINTS is a cross-sectional survey which provides only a glimpse of behavioral predictors. Self-skin checks are simple and cost-effective to detect melanoma early and improve outcomes. Fear and worry about cancer were significant factors in the likelihood of checking skin for signs of skin cancer. Population-based strategies could be developed to reduce concerns about early detection.
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Affiliation(s)
- Julie Williams Merten
- Department of Public Health, Brooks College of Health, University of North Florida, 1 UNF Drive, Jacksonville, FL, 32224, USA.
| | - Hanadi Y Hamadi
- Department of Health Administration, University of North Florida, Jacksonville, FL, USA
| | - Jessica L King
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
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Hawranek C, Maxon J, Andersson A, Van Guelpen B, Hajdarevic S, Numan Hellquist B, Rosén A. Cancer Worry Distribution and Willingness to Undergo Colonoscopy at Three Levels of Hypothetical Cancer Risk—A Population-Based Survey in Sweden. Cancers (Basel) 2022; 14:cancers14040918. [PMID: 35205668 PMCID: PMC8870195 DOI: 10.3390/cancers14040918] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 12/03/2022] Open
Abstract
Simple Summary Cancer worry is a known health concern in cancer patients and people with a genetic predisposition to cancer. We measured how worried people, in general, are about developing cancer to describe levels in non-affected individuals. In total, 943 respondents completed a survey containing the Cancer Worry Scale (CWS) and hypothetical questions asking if they would attend a colonoscopy screening at a 5, 10, or 70 percent lifetime risk of developing bowel cancer. Unaffected individuals scored a mean of 9.46 on the six-item CWS. Women scored significantly higher than men (9.91 vs. 9.06). Women and parents had higher cancer worry than men and people without children when ruling out differences in education, age, and country of birth. People who worried more were also more inclined to undergo a colonoscopy screening, and intention increased with higher levels of hypothetical risk. These data may be helpful in future work on cancer worry and cancer prevention. Abstract Purpose: We describe levels of cancer worry in the general population as measured with the Cancer Worry Scale (CWS) and investigate the association with colonoscopy screening intentions in three colorectal cancer risk scenarios. Methods: The data were sourced through a population-based survey. Respondents (n = 943) completed an eight-item CWS and questions on colonoscopy screening interest at three hypothetical risk levels. Results: Respondents without a personal cancer history (n = 853) scored 9.46 on the six-item CWS (mean, SD 2.72). Mean scores were significantly higher in women (9.91, SD 2.89) as compared to men (9.06, SD 2.49, p < 0.001). Linear regression showed higher cancer worry in women and those with children when controlling for education, age group, and country of birth. High cancer worry (six-item CWS mean >12) was identified in 25% of women and in 17% of men. Among those, 71% would attend a colonoscopy screening compared to 52% of those with low cancer worry (p < 0.001, 5% CRC-risk). Conclusions: The distribution of cancer worry in a general population sample showed higher mean scores in women, and levels overlapped with earlier findings in cancer-affected samples. Respondents with high cancer worry were more inclined to undergo a colonoscopy screening, and intention increased with higher levels of hypothetical risk.
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Affiliation(s)
- Carolina Hawranek
- Department of Radiation Sciences, Oncology, Umeå University, SE-901 87 Umeå, Sweden; (J.M.); (A.A.); (B.V.G.); (B.N.H.); (A.R.)
- Correspondence: ; Tel.: +46-76-69-60-648
| | - Johan Maxon
- Department of Radiation Sciences, Oncology, Umeå University, SE-901 87 Umeå, Sweden; (J.M.); (A.A.); (B.V.G.); (B.N.H.); (A.R.)
| | - Andreas Andersson
- Department of Radiation Sciences, Oncology, Umeå University, SE-901 87 Umeå, Sweden; (J.M.); (A.A.); (B.V.G.); (B.N.H.); (A.R.)
| | - Bethany Van Guelpen
- Department of Radiation Sciences, Oncology, Umeå University, SE-901 87 Umeå, Sweden; (J.M.); (A.A.); (B.V.G.); (B.N.H.); (A.R.)
- Wallenberg Centre for Molecular Medicine, Umeå University, SE-901 87 Umeå, Sweden
| | - Senada Hajdarevic
- Department of Nursing, Umeå University, SE-901 87 Umeå, Sweden;
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, SE-901 87 Umeå, Sweden
| | - Barbro Numan Hellquist
- Department of Radiation Sciences, Oncology, Umeå University, SE-901 87 Umeå, Sweden; (J.M.); (A.A.); (B.V.G.); (B.N.H.); (A.R.)
| | - Anna Rosén
- Department of Radiation Sciences, Oncology, Umeå University, SE-901 87 Umeå, Sweden; (J.M.); (A.A.); (B.V.G.); (B.N.H.); (A.R.)
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Affect regulation as a moderator of intentions for breast cancer chemoprevention. J Behav Med 2022; 45:490-496. [PMID: 35113300 DOI: 10.1007/s10865-022-00289-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 01/14/2022] [Indexed: 10/19/2022]
Abstract
Women at high risk for breast cancer (BC) may consider chemoprevention for risk reduction, but uptake is low. This study examined the role of affect regulation (the attempt to alter or control one's emotions) in decision-making about BC chemoprevention. A cross-sectional, single group design was used. High-risk women (N = 81) were surveyed. Moderation analyses specified cancer-specific distress as the independent variable, affect regulation (cognitive reappraisal or expressive suppression) as the moderator, and chemoprevention intentions (yes = 1, unsure = 0, no = -1) as the dependent variable. Cognitive reappraisal significantly moderated the relationship between cancer-specific distress and chemoprevention intentions (p = 0.03), but expressive suppression did not (p = 0.31). For the 44% of participants who were highest on reappraisal, higher cancer-specific distress was associated with greater intentions for chemoprevention. For the remaining 56%, there was no relationship between cancer-specific distress and chemoprevention intentions. Cognitive reappraisal may play an important role in decisions regarding uptake of chemoprevention.
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Francis DB, Zelaya CM. Cancer Fatalism and Cancer Information Seeking Among Black Women: Examining the Impact of Aretha Franklin's Death on Cancer Communication Outcomes. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:763-768. [PMID: 32020521 DOI: 10.1007/s13187-020-01701-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Information seeking is often heightened following news coverage of cancer announcements from prominent celebrities or public figures. While scholars have sought to explicate the mechanisms influencing cancer information seeking following celebrity health announcements, the focus has primarily been on cognitive and emotional factors. Other influences such as sociocultural constructs have largely been ignored in this domain. Additionally, few studies have examined the health communication behaviors of minority individuals. The purpose of this study was to examine Black women's information seeking behaviors as a response to the death of the singer Aretha Franklin from pancreatic cancer and the role of fatalistic beliefs about cancer in the information seeking process. Using a survey conducted a few weeks after Franklin's death (N = 164), we found moderate amounts of pancreatic cancer information seeking, with almost 30% of women looking for information. Younger Black women were much more likely to search for information after Franklin's death than older women. Moreover, while we found fatalistic beliefs to be associated with pancreatic cancer information seeking, the findings were driven by younger women. In particular, younger women were more likely to seek pancreatic cancer information regardless of their beliefs about cancer. This study advances the understanding of cancer information seeking among Black women. Implications for cancer communication with Black women are discussed.
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Affiliation(s)
- Diane B Francis
- Department of Communication, University of Kentucky, Lexington, KY, 40506, USA.
| | - Carina M Zelaya
- College of Communication and Information, University of Kentucky, Lexington, KY, USA
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Makhnoon S, Tran G, Levin B, Mattie KD, Dreyer B, Volk RJ, Grana G, Arun BK, Peterson SK. Uptake of cancer risk management strategies among women who undergo cascade genetic testing for breast cancer susceptibility genes. Cancer 2021; 127:3605-3613. [PMID: 34157779 DOI: 10.1002/cncr.33668] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/21/2021] [Accepted: 04/27/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Uptake of cancer risk management based on inherited predispositions, which encompasses bilateral mastectomy (BLM), bilateral salpingo-oophorectomy (BSO), and intensified screening, is the primary motivation for cascade testing for hereditary breast and ovarian cancer (HBOC). However, long-term outcome data for cascade testers are lacking. METHODS Medical records were abstracted for all unaffected women with pathogenic variants in HBOC genes from 2 cancer hospitals (2013-2019) with at least 1 year of follow-up to compare the uptake of surgery and screening between cascade and noncascade testers. RESULTS Cascade testers (79.8%) were younger than noncascade testers (mean age, 37.6 vs 43.5 years; P = .002). Among women aged ≥40 years, 43% underwent BLM, and 71.6% underwent BSO, with no significant difference in uptake between cascade and noncascade testers. The mean time to BSO among cascade testers was shorter among women aged ≥40 years versus those aged <40 years (11.8 vs 31.9 months; P = .04); no such difference was observed among noncascade testers. Mammography and breast magnetic resonance imaging rates were low in the recorded 6 years for both groups after genetic counseling. CONCLUSIONS Management uptake among cascade testers is high with rates comparable to those for unaffected BRCA-positive women. A large proportion of women act on cascade test results, and this represents a novel report of utilization of cancer management strategies.
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Affiliation(s)
- Sukh Makhnoon
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Grace Tran
- Clinical Cancer Genetics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Brooke Levin
- William G. Rohrer Cancer Genetics Program, Division of Hematology and Medical Oncology, MD Anderson Cancer Center at Cooper University Health Care, Camden, New Jersey
| | - Kristin D Mattie
- William G. Rohrer Cancer Genetics Program, Division of Hematology and Medical Oncology, MD Anderson Cancer Center at Cooper University Health Care, Camden, New Jersey
| | | | - Robert J Volk
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Generosa Grana
- William G. Rohrer Cancer Genetics Program, Division of Hematology and Medical Oncology, MD Anderson Cancer Center at Cooper University Health Care, Camden, New Jersey
| | - Banu K Arun
- Clinical Cancer Genetics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Susan K Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Mizota Y, Yamamoto S. Rainbow of KIBOU project: Effectiveness of invitation materials for improving cancer screening rate using social marketing and behavioral economics approaches. Soc Sci Med 2021; 279:113961. [PMID: 34000582 DOI: 10.1016/j.socscimed.2021.113961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 01/27/2023]
Abstract
Studies to date have shown that individual invitation (call) and re-invitation (recall) are effective in improving cancer screening rate. Also, by dividing subjects into segments and sending unique messages to each segment, the cancer screening rate is further improved. However, this approach is not realistic in the local governments due to limited resources, so we used social marketing and nudge techniques to develop cancer screening recommendation materials that do not need to send separately. This study therefore aimed to verify the effect of these materials in the real world. We compared the cancer screening rates in municipalities within Japan that used the invitation materials we developed (colorectal, breast, lung, cervical and stomach cancer), with those from the previous year. In addition, the usefulness of the materials in the real world was examined multilaterally using RE-AIM framework (Reach, Effectiveness, Adaption, Implementation, Maintenance). From 2015 to 2018, 4.3 million residents (Reach) from 787 municipalities (Adaption) were sent invitation materials for cancer screening. Of 167 municipalities that were compared, 141 (83%) showed an increase in screening rate when our materials were used. Overall, the screening rate improved by 2.6% or 1.44 fold (p < 0.001) (Effectiveness). However, the screening rate varied greatly depending on how screening is provided. Of the four years studied, 75 municipalities used the same materials for two or more years (Implementation). The material developed in this study improved the cancer screening rate in the real world, and it may be possible to further improve the screening rate if the number of opportunities for screening and its capacity is increased at the timing of sending materials. The materials can be found on the website (http://rokproject.jp/kenshin/) and free electronic files are available to municipalities wishing to use them.
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Affiliation(s)
- Yuri Mizota
- Center for Cancer Information and Control Services, National Cancer Center, 5-1-1, Tsukij, Chuo-ku, Tokyo, 104-0045, Japan; Health Service Division, Health Service Bureau, Ministry of Health, Labour, and Welfare, 1-2-2, Kasumigaseki, Chiyoda-ku, Tokyo, 100-8916, Japan; Shizuoka Graduate University of Public Health, 4-27-2, Kitaando, Aoiku, Shizuoka, 420-0881, Japan.
| | - Seiichiro Yamamoto
- Center for Cancer Information and Control Services, National Cancer Center, 5-1-1, Tsukij, Chuo-ku, Tokyo, 104-0045, Japan; Shizuoka Graduate University of Public Health, 4-27-2, Kitaando, Aoiku, Shizuoka, 420-0881, Japan; Centre for the Fourth Industrial Revolution Japan, World Economic Forum, ARK Mori Building, 37th Floor 1-12-32, Akasaka, Minato-ku, Tokyo, 107-6037, Japan.
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Wolbert T, Barry R, Gress T, Arrington A, Thompson E. Assessing Colorectal Cancer Screening Barriers in Rural Appalachia. South Med J 2021; 114:293-298. [PMID: 33942114 DOI: 10.14423/smj.0000000000001252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The age-appropriate colorectal cancer (CRC) screening rate in the rural Appalachian area is low compared with the national rate, which may account for the overall higher incidence of CRC in this area. The purpose of this study was to explore potential barriers to CRC screening in the West Virginia Appalachian area. METHODS A cross-sectional survey was designed to identify patient-reported barriers to CRC screening using the health belief model to assess their attitudes and behaviors. Autonomous paper-based surveys were randomly handed to individuals older than 50 years at various locations, including healthcare and nonhealthcare facilities. All of the responses were then categorized into two groups: the screened group and the unscreened group. Differences among both groups were statistically analyzed. RESULTS There were three main areas that significantly accounted for the discrepancies between the screened and unscreened groups: perceptions of discomfort from screening tests, psychological and behavior deterrents in CRC screening and diagnosis, and limited resources for accessing care, especially transportation. In particular, psychological and behavioral deterrents in CRC screening appeared to play a role in promoting aversion to CRC screening. CONCLUSIONS Lack of CRC screening awareness and knowledge may be responsible for fatalism regarding CRC and aversion to screening. Thus, multidisciplinary interventions that provide education about CRC screening, early intervention prognosis, and treatment options, as well as addressing systemic barriers to screening, such as assistance with scheduling, prep instructions, and transportation, can improve the screening rate in Appalachia and eventually lead to better outcomes through the early diagnosis of CRC.
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Affiliation(s)
- Thao Wolbert
- From the Department of Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia, the Department of Plastic Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, the Department of Translational Research, Hershel "Woody" Williams Veterans Affairs Medical Center, Huntington, West Virginia, and the Department of Surgery, University of Arizona College of Medicine, Tucson
| | - Rahman Barry
- From the Department of Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia, the Department of Plastic Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, the Department of Translational Research, Hershel "Woody" Williams Veterans Affairs Medical Center, Huntington, West Virginia, and the Department of Surgery, University of Arizona College of Medicine, Tucson
| | - Todd Gress
- From the Department of Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia, the Department of Plastic Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, the Department of Translational Research, Hershel "Woody" Williams Veterans Affairs Medical Center, Huntington, West Virginia, and the Department of Surgery, University of Arizona College of Medicine, Tucson
| | - Amanda Arrington
- From the Department of Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia, the Department of Plastic Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, the Department of Translational Research, Hershel "Woody" Williams Veterans Affairs Medical Center, Huntington, West Virginia, and the Department of Surgery, University of Arizona College of Medicine, Tucson
| | - Errington Thompson
- From the Department of Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia, the Department of Plastic Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, the Department of Translational Research, Hershel "Woody" Williams Veterans Affairs Medical Center, Huntington, West Virginia, and the Department of Surgery, University of Arizona College of Medicine, Tucson
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Isaka Y, Hori A, Tanaka R, Ichikawa M. Alleviating psychological distress associated with a positive cervical cancer screening result: a randomized control trial. BMC WOMENS HEALTH 2021; 21:64. [PMID: 33579257 PMCID: PMC7881683 DOI: 10.1186/s12905-021-01207-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 02/02/2021] [Indexed: 01/22/2023]
Abstract
Background The method of communicating a positive cancer screening result should seek to alleviate psychological distress associated with a positive result. We evaluated whether the provision of information through a leaflet would help reduce psychological distress in a randomized controlled trial. Methods The participants were women aged 20–69 years who were about to undergo cervical cancer screening at health centers. Before the screening, they received hypothetical screening results, with a leaflet (intervention group, n = 493) or without it (control group, n = 479), randomly. Their psychological distress and intention to undergo further examination were then compared between the intervention and control groups. Results After the intervention (providing a leaflet with hypothetical screening results), psychological distress appeared to be higher in the control group than in the intervention group among those who received a hypothetical positive screening result (odds ratio: 2.57, 95% confidence interval: 1.87–3.54), while 95% and 97% of those in the intervention and control groups, respectively, reported that they would undergo further examination. Conclusions Information provision might help reduce psychological distress but not hinder further examination among women who screen positive for cervical cancer. Trial registration: UMIN Clinical Trials Registry UMIN000029894. Date of Registration: November 2017.
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Affiliation(s)
- Yukari Isaka
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan.
| | - Ai Hori
- Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan
| | - Rie Tanaka
- Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan
| | - Masao Ichikawa
- Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan
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Labisso WL, Leka Y, Leka Y, Haileselassie W. A Descriptive Cross-Sectional Study on Awareness and Belief of People About Cancer in Southern Ethiopia: Special Focus on Breast and Cervical Cancers. Risk Manag Healthc Policy 2020; 13:2655-2668. [PMID: 33239927 PMCID: PMC7682616 DOI: 10.2147/rmhp.s267207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 10/14/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The general population's lack of awareness, limited knowledge, myths and misconceptions about breast and cervical cancers (CCs) is considered as a serious public health problem. OBJECTIVE This study was intended to assess the status of awareness and beliefs of people about cancer and breast and CCs in particular. METHODS A descriptive community-based cross-sectional survey was conducted on 345 study participants in Southern Ethiopia. A pretested, structured questionnaire that contained demographics and questions on the variables of exposure to biological and chemical carcinogenic agents, lifestyle and personal behavior was administered. Frequency distribution and proportions were used to describe the study population in relation to major variables. RESULTS The mean age of study participants was 25.19 (Range 15-58). More than a third of the study participants heard about cancer from Mass Media followed by schools (28.5%) and treating physicians (6.7%). The proportion of study participants that knew about the association between smoking, alcohol intake and cancer development was 38.6% and 51.5%, respectively. Only 48% and 24.2% of the study participants heard about breast and CCs, respectively. The fact that 69.4% of the study participants had limited knowledge about the mode of transmission of the causative agents of CCs indicates that the study groups are at risk of acquiring the agent. Additionally, only 4.7% of the study participants were screened for CC and have poor breast self-examination experiences, indicating poor awareness and knowledge about the importance of screening programs. CONCLUSION Comprehensive awareness and knowledge about cancer in general and breast and CCs in particular is lacking in southern Ethiopia. Early sexual debut, limited knowledge about the diseases and unfavorable lifestyle are the risk factors to be addressed in public health education.
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Affiliation(s)
- Wajana Lako Labisso
- Department of Pathology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yishak Leka
- Department of Pathology, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Yohannes Leka
- Department of Medical Microbiology, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Werissaw Haileselassie
- Department of Reproductive Health and Health Service Management, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Caycho-Rodríguez T, Rojas-Jara C, Ventura-León J, Noe-Grijalva M, Cabrera-Orosco I, Reyes-Bossio M. Single item to assess for worry for cancer: Initial evidence of validity and reliability. ENFERMERÍA CLÍNICA (ENGLISH EDITION) 2020; 31:203-210. [PMID: 34243909 DOI: 10.1016/j.enfcle.2019.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 11/04/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To translate into Spanish and evaluate the evidence of content validity, construct validity and reliability of the Cancer Worry Chart as a single item measure of worry for cancer. METHOD The Spanish translation of the Cancer Worry Chart was done with the back-translation procedure. The participants were 165 healthy people with a family history of cancer who responded to the Cancer Worry Chart and the Cancer Worry Scale (CWS). RESULTS Translation back-translation allows a Spanish version of the Cancer Worry Chart whose content is clear, coherent and relevant (V>.70). Evidence of construct validity is reported based on 3 criteria: (a) an adequate adjustment of the one-dimensional model formed by the Cancer Worry Chart and the items of the CWS performed with the structural equations method (χ2S-B=23.38; df=14; χ2S-B/df=1.67; CFI=.988; RMSEA=.064); (b) a significant correlation between the Cancer Worry Chart and the CWS (r=.76 [IC95%: .68-.90]); (c) ascending averages in the CWS score as the groups formed by each response option of the Cancer Worry Chart express a greater degree of worry (F=55.72; p=.000; ω2=.57). The reliability of the Cancer Worry Chart is above what is recommended (αsingle item=.84). CONCLUSION The Spanish version of the Cancer Worry Chart showed satisfactory evidence of content validity, construct validity and reliability to measure, briefly, quickly and generally, the worry for cancer in healthy people with a family history of cancer.
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Werner P, AboJabel H, Maxfield M. Conceptualization, measurement and correlates of dementia worry: A scoping review. Arch Gerontol Geriatr 2020; 92:104246. [PMID: 32980573 DOI: 10.1016/j.archger.2020.104246] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE The combination of a growing population of older adults and increasing prevalence and awareness of dementia diagnoses suggests that dementia worry may also intensify. As a relatively new area of investigation, the dementia worry literature is growing, but variability in definitions and measurement continue. A scoping review was conducted to gather and examine existing research, as well as assist in guiding future studies in this area. The review focused on characterizing the conceptualization, measurement, and correlates of dementia worry. METHODS Using PubMed, CINAHL, AgeLine, and PsycINFO, a search of literature concerning dementia worry was completed. RESULTS A total of 45 articles examining dementia worry fulfilled the inclusion criteria. Most studies were cross-sectional (n = 39), quantitative (n = 38), and conducted in the United States (n = 22). Inconsistencies in the conceptualization, measurement, and correlates examined make it difficult to determine the meaning and true levels of dementia worry. CONCLUSIONS Recent attention to dementia worry has increased awareness of the basic concept and its correlates. However, the lack of unity in the definition and measurement of dementia worry impedes advancement in this research area, as well as in establishing its clinical significance.
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Affiliation(s)
- Perla Werner
- Department of Community Mental Health, University of Haifa, Israel.
| | - Hanan AboJabel
- Department of Community Mental Health, University of Haifa, Israel.
| | - Molly Maxfield
- Edson College of Nursing and Health Innovation, Arizona State University, USA.
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Park T, Ju I, Ohs JE, Hinsley A. Optimistic bias and preventive behavioral engagement in the context of COVID-19. Res Social Adm Pharm 2020; 17:1859-1866. [PMID: 33317765 PMCID: PMC7836537 DOI: 10.1016/j.sapharm.2020.06.004] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 06/02/2020] [Indexed: 12/23/2022]
Abstract
Background The coronavirus (COVID-19) pandemic presents a global crisis. To remain safe, individuals must take preventive measures. Health behavior theories suggest that perceived risk is a key determinant of engagement in preventive behavior. People often underestimate their risk for disease compared with similar others’, a phenomenon known as optimistic bias (OB). Objective This study aimed to explore how OB affected individuals' engagement in COVID-19 preventive behavior/intentions. Based on health behavior theories, this study considered risk perception and risk response as mediators of the relationship between OB and individuals’ preventive health behaviors and intentions. Methods This study used a cross-sectional survey design. Online survey platforms were used to recruit U.S. adults. A total of 293 valid responses were included in the analyses. Multivariate regression analyses were conducted to determine the relationship of OB to the respondents’ health information seeking intention and related behavioral outcomes. Results Results from the first regression model showed that OB was negatively related to risk perception. In other words, optimistically biased respondents perceived their risk of COVID-19 to be low. The second model demonstrated that perceived risk was related positively to affective responses to risk (e.g., worry and fear). That is, the lower their perceived risk of COVID-19, the less likely respondents were to feel anxiety and fear about this disease. Models 3 and 4 revealed positive relationships between risk response and respondents’ intentions and behaviors. Finally, the results supported a fully mediated pathway: OB → risk perception → risk response → information seeking intention and behavioral outcomes. Conclusions The study findings suggest that by decreasing their perceived risk and subsequent responses, optimistic bias can undermine individuals’ motivation to take precautions. To reduce this bias, the actual risk of COVID-19 should be reinforced.
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Affiliation(s)
- Taehwan Park
- Pharmacy Administration and Public Health, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, 11439, USA.
| | - Ilwoo Ju
- Brian Lamb School of Communication, College of Liberal Arts, Purdue University, West Lafayette, IN, 47907, USA
| | - Jennifer E Ohs
- Department of Communication, College of Arts and Sciences, Saint Louis University, St. Louis, MO, 63108, USA
| | - Amber Hinsley
- Department of Communication, College of Arts and Sciences, Saint Louis University, St. Louis, MO, 63108, USA
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Paiella S, Marinelli V, Secchettin E, Mazzi MA, Ferretto F, Casolino R, Bassi C, Salvia R. The emotional impact of surveillance programs for pancreatic cancer on high-risk individuals: A prospective analysis. Psychooncology 2020; 29:1004-1011. [PMID: 32108397 DOI: 10.1002/pon.5370] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 02/21/2020] [Accepted: 02/23/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Literature shows that emotional status can influence participation in screening/surveillance programs, and that screening/surveillance programs may alter the psychological well-being of subjects examined. This study aims to assess if participating in a surveillance program for pancreatic cancer early detection is associated with abnormal levels of psychological distress in high-risk individuals (HRIs), compared to the general population. METHODS Fifty-four HRIs participating in a magnetic resonance cholangiopancreatography (MRCP)-based surveillance program completed several psychological assessment questionnaires, investigating global functioning, self-efficacy, perceived stress, coping abilities, and social support. The questionnaires were administered by a clinical psychologist after the MRCP but before the subjects were informed about the results of the scans. The HRIs were subjects with strong familiarity of pancreatic cancer and/or carriers of known genetic mutations related to cancer susceptibility. The psychological assessment was made at the time of the first examination. RESULTS The population was characterized by an overall good psychological status. Scoring of our sample was comparable to the general population norms. The HRIs showed decent global functioning, high self-efficacy levels, low perceived stress in the last month prior to examination, efficient emotion-focused coping strategies, and an adequate social support system. The younger subjects' subpopulation only revealed higher levels of stress. CONCLUSIONS From a psychological point of view, an MRCP-based pancreatic cancer annual surveillance seemed not to influence the HRIs' psychological well-being, unless in young people. Further studies are needed to better establish if there are any changes in distress levels over time and how emotional status influences participation in surveillance programs.
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Affiliation(s)
- Salvatore Paiella
- General and Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Verona, Italy
| | - Veronica Marinelli
- General and Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Verona, Italy
| | - Erica Secchettin
- General and Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Verona, Italy
| | - Maria Angela Mazzi
- Clinical Psychology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Francesca Ferretto
- General and Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Verona, Italy
| | | | - Claudio Bassi
- General and Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Verona, Italy
| | - Roberto Salvia
- General and Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Verona, Italy
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Horshauge PM, Gabel P, Larsen MB, Kirkegaard P, Edwards A, Andersen B. The association between health literacy and colorectal cancer screening uptake in a publicly funded screening program in Denmark: Cross-sectional study. Prev Med Rep 2020; 19:101132. [PMID: 32551215 PMCID: PMC7287294 DOI: 10.1016/j.pmedr.2020.101132] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 05/13/2020] [Accepted: 05/23/2020] [Indexed: 02/07/2023] Open
Abstract
There are multiple reasons for not participating in colorectal cancer screening, but the role of health literacy in screening uptake is not well understood. The aims of this study were to determine the association between health literacy and colorectal cancer screening uptake and to explore whether socioeconomic and -demographic characteristics and worry and attitude variables modify this association. In a cross-sectional study, 10,030 53-74-year-old randomly selected citizens resident in Central Denmark Region received a questionnaire assessing health literacy using the European Health Literacy Survey Short Scale 16-item. Data on colorectal cancer screening uptake were obtained from the Danish Colorectal Cancer Screening database, and socioeconomic and -demographic data were linked from Statistics Denmark. The response rate was 71% (n = 7142). Odds ratio (OR) for uptake was 1.06 (95% confidence interval (CI): 0.96, 1.19) for problematic health literacy and 1.00 (95% CI: 0.87, 1.16) for inadequate health literacy, when using adequate health literacy as the reference value. The association was not modified by socioeconomic or -demographic characteristics, worry or attitude. No association was found between health literacy and colorectal cancer screening uptake. Future research needs to clarify which dimensions of health literacy may predict screening uptake and how it is best measured.
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Affiliation(s)
- Petricia Marie Horshauge
- Department of Public Health Programmes, Randers Regional Hospital, Denmark.,Department of Clinical Medicine, Aarhus University, Denmark
| | - Pernille Gabel
- Department of Public Health Programmes, Randers Regional Hospital, Denmark
| | - Mette Bach Larsen
- Department of Public Health Programmes, Randers Regional Hospital, Denmark
| | - Pia Kirkegaard
- Department of Public Health Programmes, Randers Regional Hospital, Denmark
| | - Adrian Edwards
- Department of Public Health Programmes, Randers Regional Hospital, Denmark.,Division of Population Medicine, School of Medicine, Cardiff University, UK
| | - Berit Andersen
- Department of Public Health Programmes, Randers Regional Hospital, Denmark.,Department of Clinical Medicine, Aarhus University, Denmark
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Merten JW, Hamadi H, Wheeler M. Cancer risk perception predictors for total body skin examinations: a cross-sectional study using Health Information National Trends Survey (HINTS) 2017 data. Int J Dermatol 2020; 59:829-836. [PMID: 32459047 DOI: 10.1111/ijd.14935] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 04/15/2020] [Accepted: 04/18/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Despite the lack of national skin cancer screening recommendations, a total body skin examination by a healthcare provider may detect skin cancer earlier, allowing for more effective treatment and better outcomes. OBJECTIVE Examine prevalence, demographic, and cancer risk perceptions of adults who have had a skin examination performed by a healthcare provider. METHODS Retrospective, cross-sectional analysis of a nationally representative sample of U.S. adults using the Health Information National Trends Survey (HINTS). Logistic regressions were performed to identify associations between having a skin examination, risk perceptions, and demographic variables. RESULTS Approximately 46% of the sample reported having a skin examination. Females, college graduates, those with a history of skin cancer, people who check their skin for signs of skin cancer, and adults over the age of 45 were more likely to have a skin examination. The people least likely to be screened were those not wanting to know their chances of getting cancer. LIMITATIONS HINTS is a cross-sectional survey which provides only a glimpse of predictors. CONCLUSIONS The findings are consistent with other studies that people sometimes avoid cancer risk information. An educational intervention focused on the benefits of early cancer detection would benefit people who report not wanting to know their chances of getting cancer.
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Affiliation(s)
- Julie W Merten
- Department of Public Health, University of North Florida, Jacksonville, FL, USA
| | - Hanadi Hamadi
- Department of Health Administration, University of North Florida, Jacksonville, FL, USA
| | - Meghann Wheeler
- Department of Public Health, University of North Florida, Jacksonville, FL, USA
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McBride E, Tatar O, Rosberger Z, Rockliffe L, Marlow LAV, Moss-Morris R, Kaur N, Wade K, Waller J. Emotional response to testing positive for human papillomavirus at cervical cancer screening: a mixed method systematic review with meta-analysis. Health Psychol Rev 2020; 15:395-429. [PMID: 32449477 DOI: 10.1080/17437199.2020.1762106] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Tens-of-millions of women every year test positive for human papillomavirus (HPV) at routine cervical screening. We performed a mixed-methods systematic review using a results-based convergent design to provide the first comprehensive overview of emotional response to testing positive for HPV (HPV+). We mapped our findings using the cognitive behavioural framework. Six electronic databases were searched from inception to 09-Nov-2019 and 33 papers were included. Random-effects meta-analyses revealed that HPV+ women with abnormal or normal cytology displayed higher short-term anxiety than those with normal results (MD on State-Trait Anxiety Inventory = 7.6, 95% CI: 4.59-10.60 and MD = 6.33, CI: 1.31-11.35, respectively); there were no long-term differences. Psychological distress (general/sexual/test-specific) was higher in HPV+ women with abnormal cytology in the short-term and long-term (SMD = 0.68, CI: 0.32-1.03 and SMD = 0.42, CI: 0.05-0.80, respectively). Testing HPV+ was also related to disgust/shame, surprise and fear about cancer. Broadly, adverse response related to eight cognitive constructs (low control, confusion, cancer-related concerns, relationship concerns, sexual concerns, uncertainty, stigma, low trust) and six behavioural constructs (relationship problems, social impact, non-disclosure of results, idiosyncratic prevention, indirect clinical interaction, changes to sexual practice). Almost exclusive use of observational and qualitative designs limited inferences of causality and conclusions regarding clinical significance.
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Affiliation(s)
- Emily McBride
- Department of Behavioural Science and Health, University College London (UCL), London, UK
| | - Ovidiu Tatar
- Research Center-Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, QC, Canada
| | - Zeev Rosberger
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Department of Psychology, Psychiatry and Oncology, McGill University, Montreal, Canada
| | - Lauren Rockliffe
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Laura A V Marlow
- School of Cancer and Pharmaceutical Sciences, King's College London (KCL), London, UK
| | - Rona Moss-Morris
- Department of Psychology, King's College London (KCL), London, UK
| | - Navdeep Kaur
- Research Center-Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada
| | - Kristina Wade
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Faculty of Medicine, McGill University, Montreal, Canada
| | - Jo Waller
- School of Cancer and Pharmaceutical Sciences, King's College London (KCL), London, UK
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Draucker CB, Rawl SM, Vode E, Carter-Harris L. Integration Through Connecting in Explanatory Sequential Mixed Method Studies. West J Nurs Res 2020; 42:1137-1147. [PMID: 32389099 DOI: 10.1177/0193945920914647] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purposes of this methods article are to (a) discuss how integration can occur through a connecting approach in explanatory sequential mixed methods studies, (b) describe a connecting strategy developed for a study testing a conceptual model to predict lung cancer screening, and (c) describe three analytic products developed by subsequent integration procedures enabled by the connecting strategy. Connecting occurs when numeric data from a quantitative strand of a study are used to select a sample to be interviewed for a subsequent qualitative strand. Because researchers often do not fully exploit numeric data for this purpose, we developed a multi-step systematic sampling strategy that produced an interview sample of eight subgroups of five persons (n = 40) whose profiles converged with or diverged from the conceptual model in specified ways. The subgroups facilitated the development of tailored interview guides, in-depth narrative summaries, and exemplar case studies to expand the quantitative findings.
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Affiliation(s)
| | - Susan M Rawl
- Indiana University School of Nursing, Indianapolis, Indiana, USA.,Indiana University Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA
| | - Emilee Vode
- Indiana University School of Nursing, Indianapolis, Indiana, USA
| | - Lisa Carter-Harris
- Memorial Sloan Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences, New York, USA
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40
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Kovar A, Bronsert M, Jaiswal K, Murphy C, Wolverton D, Ahrendt G, Tevis S. The Waiting Game: How Long Are Breast Cancer Patients Waiting for Definitive Diagnosis? Ann Surg Oncol 2020; 27:3641-3649. [PMID: 32314153 DOI: 10.1245/s10434-020-08484-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Receiving a new breast cancer (BC) diagnosis can cause significant patient anxiety, which is amplified by delays in diagnosis. There is a lack of defined time periods for delays in the workup of BC. This study aims to evaluate national variations in timing from first abnormal mammogram to first biopsy and to determine independent predictors of delay in diagnosis. PATIENTS AND METHODS Data were derived from SEER-Medicare linked claims database from 2007 to 2013. Time intervals from abnormal mammogram, either screening or diagnostic, to biopsy were assessed. The fourth quartile for timing from first mammogram to first biopsy was utilized to define delay in diagnosis. Multivariate analyses were used to evaluate the association between clinicopathologic variables and delays in diagnosis. RESULTS We analyzed 53,758 patients with stage 0-II BC who underwent upfront surgery. Significant variations in timing of care were identified, with mean times from mammogram to biopsy, surgeon visit, and breast surgery of 23.3, 31.6, and 52.6 days, respectively. Over the study period, there was a decrease in delays from mammogram to biopsy. Non-White race, Northeast location, and earlier stage disease were found to be independent predictors of delays in the diagnosis of BC (p < 0.0001). CONCLUSIONS The study demonstrates significant variations in time to diagnostic biopsy. More efficient processes of care to address these delays should be implemented, and further studies are needed to determine whether improved efficiency decreases patient anxiety. The large variations in time to diagnosis speak to the need for consensus guidelines to establish a standard of care.
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Affiliation(s)
- Alexandra Kovar
- Department of Surgery, University of Colorado, Aurora, CO, USA
| | - Michael Bronsert
- University of Colorado School of Medicine, Surgical Outcomes and Applied Research (SOAR) Program and Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), Aurora, CO, USA
| | - Kshama Jaiswal
- Division of Breast Surgery, Denver Health Medical Center, Denver, CO, USA
| | - Colleen Murphy
- Department of Surgery, University of Colorado, Aurora, CO, USA
| | - Dulcy Wolverton
- Department of Radiology, University of Colorado, Aurora, CO, USA
| | | | - Sarah Tevis
- Department of Surgery, University of Colorado, Aurora, CO, USA.
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Parker AM, Finucane ML, Ayer L, Ramchand R, Parks V, Clancy N. Persistent Risk-Related Worry as a Function of Recalled Exposure to the Deepwater Horizon Oil Spill and Prior Trauma. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2020; 40:624-637. [PMID: 31858633 DOI: 10.1111/risa.13437] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Large oil spills are disasters associated with psychological effects for exposed communities. The amount of worry that individuals experience after a disaster may be influenced by many factors, such as the type and extent of exposure to disaster impacts, prior trauma, and sociodemographic characteristics. This study examined the nature and predictors of worry about ongoing impacts of the 2010 Deepwater Horizon (DH) oil spill reported by Gulf of Mexico coastal residents. A random sample of 2,520 adult residents of Gulf of Mexico coastal counties were administered a telephone survey in 2016, including items about persistent worry and exposure to DH impacts, prior trauma, residence at the time of the spill, and sociodemographic characteristics. Respondents varied in the amount of worry they reported about ongoing health, social, and economic impacts. Controlling for sociodemographic characteristics, higher exposure to the DH oil spill was related to higher levels of worry about ongoing impacts, with past traumatic events related specifically to worry about health impacts. Unexpectedly, those who moved into the region after the spill showed similar levels of worry to residents exposed to the spill, and higher levels than residents who did not recall being exposed to the DH oil spill. This study highlights the impact of the DH oil spill on coastal residents many years after the DH disaster. The findings underscore the need to examine multiple pathways by which individuals experience disasters and for risk researchers to close knowledge gaps about long-term impacts of oil spills within a multi-dimensional framework.
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Gabel P, Edwards A, Kirkegaard P, Larsen MB, 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: A randomised controlled trial. PATIENT EDUCATION AND COUNSELING 2020; 103:359-368. [PMID: 31451360 DOI: 10.1016/j.pec.2019.08.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/21/2019] [Accepted: 08/18/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES This trial tested the effectiveness of a self-administered web-based decision aid, targeted at citizens with lower educational attainment, on informed choice about colorectal cancer screening participation as assessed by group levels of knowledge, attitudes and uptake. METHODS The randomised controlled trial was conducted among 2702 screening-naïve Danish citizens, 53-74 years old, with lower educational attainment. Baseline questionnaire respondents (62%) were allocated to intervention and control groups. Intervention group citizens received the decision aid. Outcomes were informed choice, worries and decisional conflict. RESULTS Analyses were conducted among 339 eligible citizens. The mean difference in knowledge score change between intervention and control group was 0.00 (95% confidence interval (CI): -0.38;0.38). Trends towards more positive screening attitudes (mean difference in score change: 0.72, 95% CI: -0.38;1.81) and higher screening uptake (7.6%, 95% CI:-2.2;17.4%) were observed. Worries (-0.33, 95% CI: -0.97;0.32) and decisional conflict (mean difference: -3.5, 95%CI: -7.0;-0.1) were slightly reduced. CONCLUSIONS The decision aid did not affect informed choice or knowledge. However, there were trends towards increased screening uptake and more positive screening attitudes. PRACTICE IMPLICATIONS Being a simple intervention and easily administered, the decision aid could represent a cost-effective way of enhancing screening uptake, and some elements of informed decision-making.
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Affiliation(s)
- Pernille Gabel
- Department of Public Health Programmes, Randers Regional Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark.
| | - Adrian Edwards
- Department of Public Health Programmes, Randers Regional Hospital, Denmark; Division of Population Medicine, School of Medicine, Cardiff University, UK.
| | - Pia Kirkegaard
- Department of Public Health Programmes, Randers Regional Hospital, Denmark.
| | - Mette Bach Larsen
- Department of Public Health Programmes, Randers Regional Hospital, Denmark.
| | - Berit Andersen
- Department of Public Health Programmes, Randers Regional Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark.
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Takeuchi E, Kim Y, Shaffer KM, Cannady RS, Carver CS. Fear of cancer recurrence promotes cancer screening behaviors among family caregivers of cancer survivors. Cancer 2020; 126:1784-1792. [PMID: 31913499 DOI: 10.1002/cncr.32701] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 11/25/2019] [Accepted: 11/25/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Fear of cancer recurrence (FCR) has been associated with cancer screening behaviors among cancer survivors, but to the authors' knowledge, the question of whether the same is true for caregivers is unknown. The current study investigated the extent to which FCR among caregivers predicted their cancer screening behaviors years after their relatives' cancer diagnosis. METHODS A total of 813 caregivers (67% of whom were female, mean age of 56 years, and 92% non-Hispanic white) completed surveys 2 years (T1) and 8 years (T2) after their patients' cancer diagnosis. FCR, anxiety (Profile of Mood States-Short Form [POMS-SF]), and general mental health (Medical Outcomes Study 36-Item Short-Form Health Survey [MOS SF-36]) were reported at T1; caregivers' engagement in screening for colorectal, breast, and prostate cancers because of the patients' diagnoses were reported at T2. RESULTS Caregivers were found to engage in cancer screening at rates similar to those of the national average. Controlling for covariates, hierarchical logistic regression modeling for each type of cancer screening demonstrated that greater FCR was linearly related to a higher likelihood of undergoing colorectal cancer screening (odds ratio [OR], 1.15) and maintaining prostate cancer screening (OR, 1.34), but a lower likelihood of maintaining breast cancer screening in an age-appropriate manner (OR, 0.27). Examining curvilinear effects demonstrated that moderate levels of FCR were associated with a higher likelihood of maintaining age-appropriate colorectal cancer screening (OR, 1.48). CONCLUSIONS The overall FCR among caregivers uniquely promotes their engagement in cancer screening behaviors. The role of caregivers' FCR in other types of cancer preventive behaviors and ways to channel FCR concerns into promoting healthy lifestyle behaviors should be investigated.
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Affiliation(s)
- Emi Takeuchi
- Department of Psychology, University of Miami, Coral Gables, Florida.,Graduate School of Medicine, Keio University, Tokyo, Japan.,Center for Cancer Control and Information Service, National Cancer Center Japan, Tokyo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Youngmee Kim
- Department of Psychology, University of Miami, Coral Gables, Florida
| | - Kelly M Shaffer
- Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Rachel S Cannady
- Cancer Caregiver Support, American Cancer Society, Atlanta, Georgia
| | - Charles S Carver
- Department of Psychology, University of Miami, Coral Gables, Florida
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Caycho-Rodríguez T, Rojas-Jara C, Ventura-León J, Noe-Grijalva M, Cabrera-Orosco I, Reyes-Bossio M. Single item to assess for worry for cancer: Initial evidence of validity and reliability. ENFERMERIA CLINICA 2019; 31:S1130-8621(19)30521-2. [PMID: 31879252 DOI: 10.1016/j.enfcli.2019.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 07/22/2019] [Accepted: 11/04/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To translate into Spanish and evaluate the evidence of content validity, construct validity and reliability of the Cancer Worry Chart as a single item measure of worry for cancer. METHOD The Spanish translation of the Cancer Worry Chart was done with the back-translation procedure. The participants were 165 healthy people with a family history of cancer who responded to the Cancer Worry Chart and the Cancer Worry Scale (CWS). RESULTS Translation back-translation allows a Spanish version of the Cancer Worry Chart whose content is clear, coherent and relevant (V˃.70). Evidence of construct validity is reported based on 3 criteria: a) an adequate adjustment of the one-dimensional model formed by the Cancer Worry Chart and the items of the CWS performed with the structural equations method (χ2S-B=23.38; df=14; χ2S-B/df=1.67; CFI=.988; RMSEA=.064); b) a significant correlation between the Cancer Worry Chart and the CWS (r= .76 [IC95%: .68-.90]); c) ascending averages in the CWS score as the groups formed by each response option of the Cancer Worry Chart express a greater degree of worry (F=55.72; P=.000; ω2=.57). The reliability of the Cancer Worry Chart is above what is recommended (αsingle item=.84). CONCLUSION The Spanish version of the Cancer Worry Chart showed satisfactory evidence of content validity, construct validity and reliability to measure, briefly, quickly and generally, the worry for cancer in healthy people with a family history of cancer.
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Brown SL, Hughes M, Campbell S, Cherry MG. Could worry and rumination mediate relationships between self‐compassion and psychological distress in breast cancer survivors? Clin Psychol Psychother 2019; 27:1-10. [DOI: 10.1002/cpp.2399] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 09/06/2019] [Accepted: 09/06/2019] [Indexed: 11/07/2022]
Affiliation(s)
- Stephen L. Brown
- Department of Psychological Sciences University of Liverpool Liverpool UK
| | - Maria Hughes
- Department of Psychological Sciences University of Liverpool Liverpool UK
| | - Sophie Campbell
- Department of Psychological Sciences University of Liverpool Liverpool UK
| | - M. Gemma Cherry
- Department of Psychological Sciences University of Liverpool Liverpool UK
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Vrinten C, Stoffel S, Dodd RH, Waller J, Lyratzopoulos Y, von Wagner C. Cancer worry frequency vs. intensity and self-reported colorectal cancer screening uptake: A population-based study. J Med Screen 2019; 26:169-178. [PMID: 31042098 PMCID: PMC6854611 DOI: 10.1177/0969141319842331] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 03/15/2019] [Indexed: 12/31/2022]
Abstract
Objectives Many studies of cancer worry use items measuring frequency or intensity. Little is known about how each of these relate to cancer screening uptake. This study compared the association between worry frequency vs. intensity and colorectal cancer screening intention/uptake. Methods Across four surveys (2014–2016), we collected data from 2878 screening-eligible men and women (aged 60–70) in England. Measures included single-items assessing cancer worry frequency and intensity, and a derived combination of both. We also assessed self-reported past faecal occult blood testing uptake (ever vs. never), intention to participate when next invited (yes vs. no), and demographics. Using logistic regression, we compared a model containing sociodemographic characteristics (Model 1), with four models adding cancer worry frequency (Model 2), intensity (Model 3), both (Model 4), or the combined measure (Model 5). Results A model with cancer worry intensity and demographics (Model 3) explained significantly more variance in uptake and intention (R 2 = 0.068 and 0.062, respectively) than demographics alone (Model 1: R 2 = 0.058 and 0.042; p < 0.001), or a model with demographics and cancer worry frequency (Model 2: R 2 = 0.059 and 0.052; p < 0.001). The model was also equally as effective as models including both the frequency and intensity items (Model 4: R 2 = 0.070 n.s. and 0.062 n.s.), or using the derived combination of both (Model 5: R 2 = 0.063 n.s. and 0.053 n.s.). Conclusion A single item measure of cancer worry intensity appeared to be most parsimonious for explaining variance in colorectal cancer screening intention and uptake.
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Affiliation(s)
- Charlotte Vrinten
- Department of Behavioural Science and Health, University College London, London, UK
| | - Sandro Stoffel
- Department of Behavioural Science and Health, University College London, London, UK
| | - Rachael H Dodd
- Department of Behavioural Science and Health, University College London, London, UK
| | - Jo Waller
- Department of Behavioural Science and Health, University College London, London, UK
| | - Yoryos Lyratzopoulos
- Department of Behavioural Science and Health, University College London, London, UK
| | - Christian von Wagner
- Department of Behavioural Science and Health, University College London, London, UK
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Ferrer RA, Ellis EM. Moving beyond categorization to understand affective influences on real world health decisions. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2019; 13. [PMID: 33912229 DOI: 10.1111/spc3.12502] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This paper provides an overview of affect and health decision-making research, with a focus on identifying gaps, opportunities, and challenges to guide future research. We begin by defining common categorical distinctions of affective processes that influence health decisions: integral (i.e., related to the decision) and incidental (i.e., normatively unrelated to the decision) influences, and current (experienced in the moment) and anticipated ("cognitive representations" of future affect) affect. We then summarize key discoveries within the most common categories of affective influences on health decision making: current integral affect, current incidental affect, and anticipated integral affect. Finally, we highlight research gaps, challenges, and opportunities for future directions for research aimed at translating affective and decision science theory to improve our understanding of, and ability to intervene upon, health decision making.
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Affiliation(s)
- Rebecca A Ferrer
- Basic Biobehavioral and Psychological Sciences Branch, National Cancer Institute
| | - Erin M Ellis
- Office of Disease Prevention, National Institutes of Health
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Xie Z, Wenger N, Stanton A, Sepucha K, Kaplan C, Madlensky L, Elashoff D, Trent J, Petruse A, Johansen L, Layton T, Naeim A. Risk estimation, anxiety, and breast cancer worry in women at risk for breast cancer: A single-arm trial of personalized risk communication. Psychooncology 2019; 28:2226-2232. [PMID: 31461546 PMCID: PMC6858926 DOI: 10.1002/pon.5211] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/17/2019] [Accepted: 08/21/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Elevated anxiety and breast cancer worry can impede mammographic screening and early breast cancer detection. Genetic advances and risk models make personalized breast cancer risk assessment and communication feasible, but it is unknown whether such communication of risk affects anxiety and disease-specific worry. We studied the effect of a personalized breast cancer screening intervention on risk perception, anxiety, and breast cancer worry. METHODS Women with a normal mammogram but elevated risk for breast cancer (N = 122) enrolled in the Athena Breast Health risk communication program were surveyed before and after receiving a letter conveying their breast cancer risk and a breast health genetic counselor consultation. We compared breast cancer risk estimation, anxiety, and breast cancer worry before and after risk communication and evaluated the relationship of anxiety and breast cancer worry to risk estimation accuracy. RESULTS Women substantially overestimated their lifetime breast cancer risk, and risk communication somewhat mitigated this overestimation (49% pre-intervention, 42% post-intervention, 13% Gail model risk estimate, P < .001). Both general anxiety and breast cancer worry declined significantly after risk communication in women with high baseline anxiety. Baseline anxiety and breast cancer worry were essentially unrelated to risk estimation accuracy, but risk communication increased alignment of worry with accuracy of risk assessment. CONCLUSIONS Personalized communication about breast cancer risk was associated with modestly improved risk estimation accuracy in women with relatively low anxiety and less anxiety and breast cancer worry in women with higher anxiety. We detected no negative consequences of informing women about elevated breast cancer risk.
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Affiliation(s)
- Zhuoer Xie
- Department of Hematology and Oncology, David Geffen School of Medicine at University of California, Los Angeles, California, USA
| | - Neil Wenger
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at University of California, Los Angeles, California, USA
| | - Annette Stanton
- Department of Psychology, University of California, Los Angeles, California, USA
| | - Karen Sepucha
- Health Decision Sciences Center, Massachusetts General Hospital, Boston, MA, USA
| | - Celia Kaplan
- General Internal medicine, University of California, San Francisco, California, USA
| | - Lisa Madlensky
- Division of Medical Genetics, University of California, San Diego, California, USA
| | - David Elashoff
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, California, USA
| | - Jacqueline Trent
- Department of Hematology and Oncology, David Geffen School of Medicine at University of California, Los Angeles, California, USA
| | - Antonia Petruse
- Department of Hematology and Oncology, David Geffen School of Medicine at University of California, Los Angeles, California, USA
| | - Liliana Johansen
- Department of Hematology and Oncology, David Geffen School of Medicine at University of California, Los Angeles, California, USA
| | - Tracy Layton
- Department of Biomedical Informatics, University of California, San Diego, California, USA
| | - Arash Naeim
- UCLA Center for SMART Health, David Geffen School of Medicine at University of California, Los Angeles, California, USA
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Ruthig JC, Poltavski DP, Petros T. Examining Positivity Effect and Working Memory in Young-Old and Very Old Adults Using EEG-Derived Cognitive State Metrics. Res Aging 2019; 41:1014-1035. [PMID: 31409210 DOI: 10.1177/0164027519865310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The positivity effect among older adults is a tendency to process more positive and/or less negative emotional stimuli compared to younger adults, with unknown upper age boundaries. Cognitive and emotional working memory were assessed in young-old adults (60-75) and very old adults (VOAs; 80+) to determine whether emotional working memory declines similar to the age-related decline of cognitive working memory. The moderating role of valence on the link between age and emotional working memory was examined to identify change in positivity effect with advanced age. Electroencephalography (EEG) markers of cognitive workload and engagement were obtained to test the theory of cognitive resource allocation in older adults' emotional stimuli processing. EEG recordings were collected during cognitive memory task and emotional working memory tasks that required rating emotional intensity of images pairs. Results indicate a positivity effect among VOAs that does not require additional cognitive effort and is not likely to diminish with age.
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Knowledge, attitudes, and worries among different health literacy groups before receiving first invitation to colorectal cancer screening: Cross-sectional study. Prev Med Rep 2019; 14:100876. [PMID: 31080706 PMCID: PMC6506556 DOI: 10.1016/j.pmedr.2019.100876] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 03/20/2019] [Accepted: 04/22/2019] [Indexed: 01/27/2023] Open
Abstract
Background Colorectal cancer screening uptake is associated with knowledge, attitudes and worries about screening. People with higher levels of health literacy usually have higher screening-related knowledge, but its association with attitudes and worries is sparsely described.The aim of this study was to describe knowledge, attitudes, and worries about colorectal cancer screening among unscreened citizens, and to estimate the association between these and health literacy. Methods In a cross-sectional study 10,030 53-74 year-old Central Denmark Region citizens received a questionnaire assessing knowledge, attitudes, worry and health literacy. Socioeconomic and -demographic data were linked from Statistics Denmark after data collection. Results In total, 7142 (71.2%) questionnaires were completed. A good general level of knowledge was observed (4.91 and 5.13 out of 7 for men and women, respectively). Citizens tended to be positive towards screening (21.4 and 21.3 on a 4-28 range scale for men and women respectively), and showed low levels of worries (8.8 and 9.09 on a 3-15 range scale for men and women respectively). Knowledge decreased and worries increased with lower levels of health literacy. Further, attitudes tended to be more positive with higher levels of health literacy. Conclusions In general, citizens tend to have good knowledge, positive attitudes and few worries about colorectal cancer screening. People with lower health literacy could benefit from targeted interventions that address knowledge and worries about screening to support informed decision making.
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