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Wang X, He Y, Zhang H. How to Influence Behavioral Intention Toward Age-Friendly Home Modifications in Urban Older People Aged 70. Gerontol Geriatr Med 2023; 9:23337214231152697. [PMID: 36860701 PMCID: PMC9969473 DOI: 10.1177/23337214231152697] [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: 10/09/2022] [Revised: 12/12/2022] [Accepted: 01/07/2023] [Indexed: 02/27/2023] Open
Abstract
Aging in place with a suitable living environment is essential for the health and well-being of older adults. However, the willingness of older people to modify their housing to meet their needs is not strong. Using the Analytic Network Process (ANP) method, the study first explores the weights of factors, such as perceived behavioral control, policies, and market conditions that influence older adults' behavioral intention. Then, a structural equation modeling (SEM) approach was used to dissect the psychological factors which account for the largest proportion. Using data from 560 people aged 70 or older from Beijing, results suggest that effectiveness perception, cost perception, and subjective norms can influence older people's behavioral intention directly or indirectly through emotional attitudes. Risk perception can moderate the level of behavioral intention triggered by cost perceptions. This study provides new evidence for the impact of factors and interaction mechanism on older adults' behavioral intentions toward age-friendly home modifications.
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Affiliation(s)
- Xiaoyu Wang
- Guangdong University of Finance,
Guangzhou, China
| | - Yiming He
- Guangdong University of Finance,
Guangzhou, China
| | - Huan Zhang
- Beijing Normal University, China,Huan Zhang, School of Social Development
and Public Policy, Beijing Normal University, Room 2014 New Main Building, No.
19 Xinjiekou Wai Street, Beijing 100875, China.
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Taşhan ST, Derya YA, Uçar T, Nacar G, Erci B. Theory-based training to promote breast cancer screening among women with breast cancer worries: randomized controlled trial. SAO PAULO MED J 2020; 138:158-166. [PMID: 32491082 PMCID: PMC9662844 DOI: 10.1590/1516-3180.2019.033430092019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 09/30/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Breast cancer worries are important determinants in relation to behavior favoring breast cancer screening. OBJECTIVE To determine the effect of theory-based training to promote breast cancer screening among women with high and low levels of breast cancer worries. DESIGN AND SETTING Randomized controlled trial, conducted in two family health centers. METHODS In total, 285 women were recruited. Women with low levels of breast cancer worries were included in the first intervention group (112 women) and the first control group (112 women), while women with high levels of breast cancer worries were included in the second intervention group (37 women) and the second control group (43 women). Theory-based training to promote breast cancer screening was given to intervention groups. The women's willingness to undergo breast cancer screening and breast cancer worry scores were evaluated at 1, 3 and 6 months. RESULTS The women in the low cancer-worry intervention group performed breast self-examination more in months 1 and 6 following the training, and the women in the high cancer-worry control group performed breast self-examination more in month 3 (P < 0.05). No difference between the women who had low or high levels of breast cancer worries were observed in relation to breast self-examination, clinical breast examination or mammography (P > 0.05). CONCLUSION The level of worry did not affect the success of theory-based training, and the training was partially effective with regard to willingness to undergo breast cancer screening.
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Affiliation(s)
- Sermin Timur Taşhan
- PhD. Professor, Department of Birth, Women’s Health and Illness, Faculty of Nursing, Inönü Üniversitesi, Malatya, Turkey.
| | - Yeşim Aksoy Derya
- PhD. Associate Professor, Department of Midwifery, Faculty of Health Sciences, Inönü Üniversitesi, Malatya, Turkey.
| | - Tuba Uçar
- PhD. Associate Professor, Department of Midwifery, Faculty of Health Sciences, Inönü Üniversitesi, Malatya, Turkey.
| | - Gülçin Nacar
- PhD. Research Assistant, Department of Birth, Women’s Health and Illness, Faculty of Nursing, Inönü Üniversitesi, Malatya, Turkey.
| | - Behice Erci
- PhD. Professor, Department of Public Health, Faculty of Nursing, Inönü Üniversitesi, Malatya, Turkey.
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Waisbren SE, Weipert CM, Walsh RC, Petty CR, Green RC. Psychosocial Factors Influencing Parental Interest in Genomic Sequencing of Newborns. Pediatrics 2016; 137 Suppl 1:S30-5. [PMID: 26729701 PMCID: PMC9923974 DOI: 10.1542/peds.2015-3731g] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND When parents of newborns are presented with the hypothetical possibility of obtaining genomic sequencing (GS) for their newborn infants immediately after birth, they express substantial interest. This study examined associations between expressed interest in GS and demographic and psychosocial variables some months after birth. METHODS A total of 1096 parents were enrolled in a study on GS of newborns shortly after the birth of their infants, before discharge from the postpartum floor. Of these parents, 663 (60.5%) completed a follow-up survey 2 to 28 months later that queried their interest in GS for their infant and whether they received worrisome health information during pregnancy, labor, and delivery. They were also administered the Parenting Stress Index. Multivariate logistic regression was used to examine factors associated with interest in GS of newborns. RESULTS Of parents, 76.1% indicated at least some interest in GS. A 10-point increase on the Parenting Stress Index was associated with an increase in the odds of having some interest in GS (odds ratio: 1.15; 95% confidence interval: 1.01-1.32). Age, gender, race, ethnicity, marital status, education, anxiety, and whether this was the first biological child were not significantly associated with interest in GS. Receiving worrisome health information was associated with greater interest in GS but this did not reach significance (odds ratio: 1.42; 95% confidence interval: 0.95-2.12). CONCLUSIONS This hypothetical survey study suggests that previous experiences leading to worrisome health information and parenting stress need to be considered when GS is offered. Additional research, currently underway, is exploring factors associated with real-life parental choices around whether to obtain GS of their newborns.
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Affiliation(s)
- Susan E. Waisbren
- Boston Children’s Hospital;,Harvard Medical School; and,Address correspondence to Susan E. Waisbren, PhD, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115. E-mail:
| | - Caroline M. Weipert
- Division of Genetics, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Rebecca C. Walsh
- Division of Genetics, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | | | - Robert C. Green
- Harvard Medical School; and,Division of Genetics, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
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Making the Decision to Participate in Predictive Genetic Testing for Arrhythmogenic Right Ventricular Cardiomyopathy. J Genet Couns 2014; 23:1045-55. [DOI: 10.1007/s10897-014-9733-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 05/28/2014] [Indexed: 10/25/2022]
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Bellcross CA, Peipins LA, McCarty FA, Rodriguez JL, Hawkins NA, Hensley Alford S, Leadbetter S. Characteristics associated with genetic counseling referral and BRCA1/2 testing among women in a large integrated health system. Genet Med 2014; 17:43-50. [PMID: 24946155 DOI: 10.1038/gim.2014.68] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Accepted: 05/08/2014] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Evidence shows underutilization of cancer genetics services. To explore the reasons behind this underutilization, this study evaluated characteristics of women who were referred for genetic counseling and/or had undergone BRCA1/2 testing. METHODS An ovarian cancer risk perception study stratified 16,720 eligible women from the Henry Ford Health System into average-, elevated-, and high-risk groups based on family history. We randomly selected 3,307 subjects and interviewed 2,524 of them (76.3% response rate). RESULTS Among the average-, elevated-, and high-risk groups, 2.3, 10.1, and 20.2%, respectively, reported genetic counseling referrals, and 0.8, 3.3, and 9.5%, respectively, reported having undergone BRCA testing. Personal breast cancer history, high risk, and perceived ovarian cancer risk were associated with both referral and testing. Discussion of family history with a doctor predicted counseling referral, whereas belief that family history influenced risk was the strongest BRCA testing predictor. Women perceiving their cancer risk as much higher than other women their age were twice as likely (95% confidence interval: 2.0-9.6) to report genetic counseling referral. CONCLUSION In a health system with ready access to cancer genetic counseling and BRCA testing, women who were at high risk underutilized these services. There were strong associations between perceived ovarian cancer risk and genetic counseling referral, and between a belief that family history influenced risk and BRCA testing.
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Affiliation(s)
- Cecelia A Bellcross
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Lucy A Peipins
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Frances A McCarty
- National Center for Health Statistics, Office of Public Health Science Services, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA
| | - Juan L Rodriguez
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nikki A Hawkins
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Steven Leadbetter
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Predictive genetic testing experience for myocilin primary open-angle glaucoma using the Australian and New Zealand Registry of Advanced Glaucoma. Genet Med 2014; 16:558-63. [DOI: 10.1038/gim.2013.196] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 11/12/2013] [Indexed: 11/09/2022] Open
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Flander L, Speirs-Bridge A, Rutstein A, Niven H, Win AK, Ait Ouakrim D, Hopper JL, Macrae F, Keogh L, Gaff C, Jenkins M. Perceived versus predicted risks of colorectal cancer and self-reported colonoscopies by members of mismatch repair gene mutation-carrying families who have declined genetic testing. J Genet Couns 2013; 23:79-88. [PMID: 23748873 DOI: 10.1007/s10897-013-9614-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 05/22/2013] [Indexed: 01/13/2023]
Abstract
People carrying germline mutations in mismatch repair genes are at high risk of colorectal cancer (CRC), yet about half of people from mutation-carrying families decline genetic counselling and/or testing to identify mutation status. We studied the association of quantitative measures of risk perception, risk prediction and self-reported screening colonoscopy in this elusive yet high-risk group. The sample of 26 participants (mean age 43.1 years, 14 women) in the Australasian Colorectal Cancer Family Registry were relatives of mutation carriers; had not been diagnosed with any cancer at the time of recruitment and had declined an invitation to attend genetic counselling and/or testing. A structured elicitation protocol captured perceived CRC risk over the next 10 years. Self-reported colonoscopy screening was elicited during a 45-minute semi-structured interview. Predicted 10-year CRC risk based on age, gender, known mutation status and family history was calculated using "MMRpro." Mean perceived 10-year risk of CRC was 31 % [95 % CI 21, 40], compared with mean predicted risk of 4 % [2, 7] (p < 0.001); this was independent of age and sex (p = 0.9). Among those reporting any medical advice and any screening colonoscopy (n = 18), those with higher risk perception had less frequent colonoscopy (Pearson's r = 0.49 [0.02, 0.79]). People who decline genetic testing for CRC susceptibility mutations perceive themselves to be at substantially higher risk than they really are. Those with high perceived risk do not undertake screening colonoscopy more often than those who perceive themselves to be at average risk.
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Affiliation(s)
- Louisa Flander
- Centre for Molecular, Environmental, Genetic & Analytic Epidemiology, The University of Melbourne, Melbourne, VIC, 3010, Australia,
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Milhabet I, Duprez C, Krzeminski A, Christophe V. Cancer risk comparative perception and overscreening behaviours of non-carriers from BRCA1/2 families. Eur J Cancer Care (Engl) 2013; 22:540-8. [PMID: 23731020 DOI: 10.1111/ecc.12060] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2013] [Indexed: 01/12/2023]
Abstract
Cancer-free women who are from families with an inherited form of breast and/or ovarian cancer (BRCA1/2) are referred to as 'unaffected non-carriers' when the results of genetic testing for the inherited gene are negative. Recent studies have identified overscreening behaviours (undergoing more screening tests for cancer than are medically warranted) among these women, even though they do not require specific cancer monitoring. Overscreening behaviours deserve particular attention due to their potential psychological drivers and implications. The principal objective of this study was to examine the factors, including state anxiety, feelings of self-vulnerability, and the comparative perception of cancer risk that might explain these overscreening behaviours. Unaffected non-carriers women (n = 77) were asked about these different variables. Overscreening was associated with and determined by feelings of self-vulnerability and the comparative perception of cancer risk, but was not associated with anxiety. An increase in feelings of self-vulnerability or elevated comparative pessimism (CP) was related to the participants' decision to be frequently screened. Patients' perceptions of the risk should be considered in measures or information aimed at preventing inappropriate overscreening behaviours.
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Affiliation(s)
- I Milhabet
- Laboratoire d'Anthropologie et de Psychologie Cognitives et Sociales, Université de Nice-Sophia Antipolis, Nice Cedex 4, France.
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Braverman J, Frost JH. Matching the Graphical Display of Data to Avoidance Versus Approach Motivation Increases Outcome Expectancies. The Journal of Social Psychology 2012; 152:228-45. [DOI: 10.1080/00224545.2011.598583] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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10
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Jones DL, Clayton EW. The role of distress in uptake and response to predisposition genetic testing: the BMPR2 experience. Genet Test Mol Biomarkers 2011; 16:203-9. [PMID: 22085393 DOI: 10.1089/gtmb.2011.0059] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
This study examines psychological determinants and effects of participating in genetic testing among persons diagnosed with or at risk for developing primary pulmonary arterial hypertension. Longitudinal data were drawn from orally administered surveys with 70 affected or at-risk individuals concerning their thoughts, feelings, and decision making about testing for mutations in BMPR2. Distress was measured by use of the Impact of Events Scale. Variations in tolerance for ambiguity were also examined. Although uptake of testing was low, as is common for incompletely penetrant mutations that lack clear therapeutic interventions, we found that those who participated in testing evidenced greater reduction in distress compared to those who had not participated in testing, irrespective of test result. No differences in tolerance for ambiguity by testing status were found. Participation in genetic testing, irrespective of test results, may be particularly beneficial to individuals who may have genetic mutations and who are experiencing high levels of distress.
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Affiliation(s)
- Diana L Jones
- Department of Human Services and Rehabilitation, Western Washington University, Bellingham, Washington 98225, USA.
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11
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Perez GK, Cruess DG, Cruess S, Brewer M, Stroop J, Schwartz R, Greenstein R. Attitudes toward direct-to-consumer advertisements and online genetic testing among high-risk women participating in a hereditary cancer clinic. JOURNAL OF HEALTH COMMUNICATION 2011; 16:607-628. [PMID: 21432710 DOI: 10.1080/10810730.2011.551993] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Genetic testing for the breast cancer genes 1/2 (BRCA 1/2) has helped women determine their risk of developing breast and ovarian cancer. As interest in genetic testing has grown, companies have created strategies to disseminate information about testing, including direct-to-consumer advertising (DTCA) and online genetic testing. This study examined attitudes toward DTCA and online testing for BRCA among 84 women at a high-risk clinic as well as additional factors that may be associated with these attitudes, such as personal and familial cancer history, cancer worry and risk perception, and history with genetic testing/counseling. Results showed that the majority of the women held favorable attitudes toward DTCA for BRCA testing but did not support online testing. Factors such as familial ovarian cancer, cancer worry, and satisfaction with genetic counseling/testing were associated with positive attitudes toward DTCA, whereas personal breast cancer history was related to negative attitudes. The findings suggest that women may view DTCA as informational but rely on physicians for help in their decision to undergo testing, and also suggest that cancer history may affect women's acceptance of DTCA and genetic testing.
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Affiliation(s)
- Giselle K Perez
- Department of Psychology, University of Connecticut, Storrs, Connecticut 06269-1020, USA.
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12
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Andersen J, Sandberg S, Raaheim M, Gjengedal E. Psychosocial aspects of predictive genetic testing for acute intermittent porphyria in norwegian minors. JIMD Rep 2011; 1:1-7. [PMID: 23430820 PMCID: PMC3509828 DOI: 10.1007/8904_2011_8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2010] [Revised: 12/16/2010] [Accepted: 12/22/2010] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE The Norwegian Porphyria Centre routinely offers genetic counselling and predictive genetic testing in families diagnosed with porphyria. The aim of this study was to investigate the subjective experiences of adolescents and young adults who were genetically tested for acute intermittent porphyria (AIP) as minors. What were the psychosocial consequences and how were these handled? METHODS Qualitative interviews of ten Norwegians aged 16-21 years were performed and analysed based on interpretive description. All participants were initially predictively tested for AIP as minors, but three had subsequently developed manifest disease. RESULTS The participants considered early diagnosis and lifestyle moderation advantageous, but finding motivation for precaution was difficult. AIP inflicted few psychosocial challenges and was a small part of the participants' identity, but risk of manifest disease was, nevertheless, a cause for concern for two participants with latent AIP. The participants were content with their present level of knowledge and they felt capable of obtaining relevant information when needed. AIP was experienced as a vague condition, and participants and their relatives attributed a variety of symptoms to the disease. CONCLUSION AND IMPLICATIONS Being genetically tested as a minor was experienced as useful and entailed relatively few adverse psychosocial consequences, although there was a potential for concern. Appropriate and individually tailored genetic counselling and written consent is subsequently advised. What constitutes a suitable age for testing will differ from individual to individual, but these results suggest that parents in collaboration with their children may be suited to decide what age is appropriate.
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Affiliation(s)
- Janice Andersen
- The Norwegian Porphyria Centre (NAPOS), Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, 5021, Norway,
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Botoseneanu A, Alexander JA, Banaszak-Holl J. To test or not to test? The role of attitudes, knowledge, and religious involvement among U.S. adults on intent-to-obtain adult genetic testing. HEALTH EDUCATION & BEHAVIOR 2011; 38:617-28. [PMID: 21482703 DOI: 10.1177/1090198110389711] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Genetic testing can advance cancer prevention if current screening behaviors improve. Increased prevalence of high-risk genotypes within specific religious groups, use of religious venues for recruiting to genetic screening, and ethical-religious considerations argue for exploring the role of religiosity in forming genetic testing decisions. This study uses the theory of reasoned action and structural equation modeling to test the effects of religious involvement, attitudes, knowledge, and previous experience on intent-to-obtain genetic testing within a representative sample of 1,824 U.S. adults. A majority of respondents indicate willingness to test, especially for curable disorders. Attitudes, knowledge, and previous experience have significant direct effects, and religious involvement has an indirect effect, through its negative effect on attitudes, on intent-to-test. High religious involvement is associated with more negative attitudes toward genetic testing. The findings underscore the need to refine genetic testing outreach efforts to account for multiple influences on consumer intent-to-test.
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Sweeny K, Melnyk D, Miller W, Shepperd JA. Information Avoidance: Who, What, When, and Why. REVIEW OF GENERAL PSYCHOLOGY 2010. [DOI: 10.1037/a0021288] [Citation(s) in RCA: 262] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although acquiring information can provide numerous benefits, people often opt to remain ignorant. We define information avoidance as any behavior designed to prevent or delay the acquisition of available but potentially unwanted information. We review the various literatures that examine information avoidance and provide a unique framework to integrate the contributions of these disparate areas of research. We first define information avoidance and distinguish it from related phenomena. We then discuss the motivations that prompt information avoidance and the factors that moderate the likelihood of avoidance. Finally, we discuss individual differences that predict preferences for information avoidance. We conclude by evaluating the current state of research on information avoidance and discussing directions for future research.
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Affiliation(s)
- Kate Sweeny
- Department of Psychology, University of California, Riverside, Riverside, California
| | - Darya Melnyk
- Department of Psychology, University of Florida, Gainseville, Florida
| | - Wendi Miller
- Department of Psychology, University of Florida, Gainseville, Florida
| | - James A. Shepperd
- Department of Psychology, University of Florida, Gainseville, Florida
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Dancyger C, Smith JA, Jacobs C, Wallace M, Michie S. Comparing family members' motivations and attitudes towards genetic testing for hereditary breast and ovarian cancer: a qualitative analysis. Eur J Hum Genet 2010; 18:1289-95. [PMID: 20648056 PMCID: PMC3002862 DOI: 10.1038/ejhg.2010.114] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2009] [Revised: 05/14/2010] [Accepted: 06/04/2010] [Indexed: 11/09/2022] Open
Abstract
Genetic testing for hereditary breast and ovarian cancer reveals significant risk information regarding one's chances of developing cancer that has potential implications for patients and their families. This study reports on the motivations and attitudes of index patients and their relatives towards genetic testing for hereditary breast and ovarian cancer. In total, 10 female index patients and 20 of their relatives were interviewed regarding their experiences of communicating genetic information within their families, and their motivations and attitudes towards genetic testing. The analysis found two types of 'family groups': groups strongly committed to genetic testing and groups uncertain about testing. Within committed family groups, index patients and their relatives felt obliged to be tested for others, leading some relatives to be tested without having fully thought through their decision or the implications of knowing their mutation status. These family groups also described considerations in relation to the value of testing for themselves. In family groups uncertain about testing, relatives had not attended for predictive testing, had postponed decision making until some point in the future or had expressed ambivalence about the value of testing for themselves. Results suggest the value of explicitly acknowledging motivations for genetic testing within the context of family obligations, relationships and communication, and the possible value of involving family members in genetic counselling and decision making from a family's first contact with genetic services.
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Affiliation(s)
- Caroline Dancyger
- BPS Centre for Outcome Research and Effectiveness (CORE), Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
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Shiloh S. An Experimental Investigation of the Effects of Acknowledging False Negative and False Positive Errors on Clients' Cancer Screening Intentions: The Lesser of Two Evils? Appl Psychol Health Well Being 2010. [DOI: 10.1111/j.1758-0854.2010.01030.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Ashida S, Wilkinson AV, Koehly LM. Motivation for health screening: evaluation of social influence among Mexican-American adults. Am J Prev Med 2010; 38:396-402. [PMID: 20307808 PMCID: PMC2844878 DOI: 10.1016/j.amepre.2009.12.028] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Revised: 10/20/2009] [Accepted: 12/07/2009] [Indexed: 10/19/2022]
Abstract
BACKGROUND Americans of Mexican origin are at high risk for developing cardiovascular disease. PURPOSE This study aimed to evaluate the associations between the presence of social network members who encourage screening and individuals' motivation to undergo three types of health screening: blood cholesterol, blood pressure, and blood glucose. The distinct roles of encouragers from different generations (older, same, and younger) were evaluated. METHODS Adults of Mexican origin (N=452) aged 20-75 years from 162 households in Houston TX were included in this cross-sectional study by completing surveys in 2008 regarding their intentions to screen, health behaviors, illness beliefs, social networks, and family health history in either English or Spanish. Data were analyzed in 2009. RESULTS About one third of the participants reported having at least one same-generation network member who encouraged screening; smaller proportions reported having at least one older- (17% to 19%) and one younger-generation (11% to 12%) encourager. The presence of at least one older-generation encourager was associated with higher levels of intention to screen for all three screenings controlling for sociodemographic characteristics and illness beliefs. Having at least one same-generation encourager was associated with higher levels of intention to screen for blood cholesterol. CONCLUSIONS Social influence may play an important role in motivating individuals to engage in screenings. Network-based intervention involving older individuals to provide encouragement to younger network members should be explored as a means to increase motivation to screen among this population.
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Affiliation(s)
- Sato Ashida
- Social and Behavioral Research Branch, National Human Genome Research Institute, Bethesda, Maryland 20892, USA.
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Pilarski R. Risk Perception Among Women at Risk for Hereditary Breast and Ovarian Cancer. J Genet Couns 2009; 18:303-12. [DOI: 10.1007/s10897-009-9227-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2008] [Accepted: 02/18/2009] [Indexed: 01/28/2023]
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Preconceptional ancestry-based carrier couple screening for cystic fibrosis and haemoglobinopathies: what determines the intention to participate or not and actual participation? Eur J Hum Genet 2009; 17:999-1009. [PMID: 19223934 DOI: 10.1038/ejhg.2009.1] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
This paper explores determinants of the intention to participate or not and of actual participation in preconceptional ancestry-based carrier couple screening for cystic fibrosis (CF) and haemoglobinopathies (HbPs). In total, 9453 individuals from a multi-ethnic population were invited. Invitees who had a partner and who were planning a pregnancy were the target population (33-36%). Test participation was conditional on survey participation. Those who refrained from test participation were asked to participate in the survey only. The questionnaire was based on the Theory of Planned Behaviour, which explains behaviour through intention. It was completed by 418 survey participants: 171 who intended to participate in the testing, and 247 who refrained from test participation. Both test intenders and offer decliners generally had a positive attitude towards test participation, and perceived high behavioural control. This applied to Western and non-Western survey participants equally. Offer decliners, however, perceived less control in terms of the time and effort needed for participation. Still, 68% of them intended to participate in the future if the screening would be offered routinely. Test intenders more often would draw reproductive consequences from test results, perceived a higher risk of being a carrier, more benefits and less adverse psychological outcomes. Feelings of stigmatisation were not an important issue, but 14% thought that there would be discrimination against carriers: among them more were non-Western survey participants. Preconceptional ancestry-based CF and HbPs carrier screening was evaluated as positive and desirable among Western and non-Western survey participants. The effort and time needed for participation were important reasons for declining participation, which might be overcome by improving access to the screening.
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Koehly LM, Peters JA, Kuhn N, Hoskins L, Letocha A, Kenen R, Loud J, Greene MH. Sisters in hereditary breast and ovarian cancer families: communal coping, social integration, and psychological well-being. Psychooncology 2008; 17:812-21. [PMID: 18688790 PMCID: PMC3125979 DOI: 10.1002/pon.1373] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE We investigated the association between psychological distress and indices of social integration and communal coping among sisters from hereditary breast and ovarian cancer (HBOC) families. SAMPLE AND METHODS Sixty-five sisters from 31 HBOC families completed the Brief Symptom Inventory-18 and the Colored Eco-Genetic Relationship Map, which identified members of participants' social support networks. Hierarchical linear models were used for all analyses to account for the clustering of sisters within families. RESULTS Intra-family correlation coefficients suggested that sisters shared perceptions of breast cancer risk and worry, but not ovarian cancer risk and worry. Further, sisters demonstrated shared levels of anxiety and somatization, but not depressive symptoms. Communal coping indices quantifying shared support resources were negatively related to anxiety and somatization. The number of persons with whom cancer risk information was shared exhibited a positive trend with somatization. Social integration, as measured by the size of participants' emotional support network, was negatively associated with anxiety. Lower depression scores were observed among participants with more persons playing multiple support roles and fewer persons providing tangible assistance. CONCLUSION Understanding how support relationships impact well-being among persons adjusting to HBOC risk, and the particular role of family in that process, will facilitate developing appropriate management approaches to help cancer-prone families adjust to their cancer risk.
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Affiliation(s)
- Laura M Koehly
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.
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Abstracts. Health Psychol Rev 2007. [DOI: 10.1080/17437190701472504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wang C, Gonzalez R, Janz NK, Milliron KJ, Merajver SD. The role of cognitive appraisal and worry in BRCA1/2 testing decisions among a clinic population. Psychol Health 2007. [DOI: 10.1080/14768320600976216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
In this article the Self Regulatory Theory (Leventhal, 1970; Leventhan H., Benyamini, Brownlee, Diefenbach, Leventhal E.A., Patrick-Miller, & Robitaille, 1997) is presented as a framework for conceptualizing genetic counseling. Findings published in the genetic counseling literature are re-interpreted from the perspective of the theory. Clients are seen as active information processors rather than passive receivers of information. Research related to clients' representations of genetic causality of disease and specific genetic conditions is reviewed. Associations of genetic illness representations to self representations, coping and health behaviors are examined, and suggestions are made for applications of the theory in research and clinical practice.
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Affiliation(s)
- Shoshana Shiloh
- Department of Psychology, Tel Aviv University, Tel Aviv, 69978, Israel.
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