Correlates and geographic patterns of knowledge that physical activity decreases cancer risk

Compliance with public health recommendations of cancer-free female research volunteers: the French Seintinelles study

PURPOSE

Acting on modifiable risk factors can prevent approximately 40% of cancers. Knowing the factors that lead people to adopt healthy behaviors is crucial for designing effective primary prevention campaigns. Our study attempts to provide knowledge in this direction.

METHODS

This cross-sectional study was conducted via the Seintinelles collaborative research platform in a community of women without a personal cancer history, and volunteering to take online questionnaires. We collected data on sociodemographic and health factors, knowledge of cancer risk factors, behaviors, and possible behavior changes (tobacco/alcohol use, diet, body weight, and physical activity) in the last 10 years.

RESULTS

The study involved 1465 women aged between 18 and 84 years. Factors such as young age, living alone, and obesity were associated with some positive or negative behavior changes. Being professionally active and having comorbidities favored certain positive behavior changes, while having dependent children, living in a rural area, and being hospitalized were associated with negative or no change in behaviors. Lack of knowledge about modifiable risk factors for cancer was associated with the non-adoption of various healthy behaviors (consumptions of fruit and vegetables, processed and red meat; physical activity). Only 5.5% of participants currently reported to be compliant with seven public health recommendations (smoking; alcohol, fruit/vegetables, and red/processed meat intakes; body mass index; and physical activity).

CONCLUSIONS

This study allowed to identify the need to increase the level of knowledge on modifiable risk factors for cancer among the general population and to better clarify the content of prevention messages.

Physical activity: the relative associations with cognitive and affective risk beliefs

Objective: The role of affectively oriented risk beliefs in explaining health behaviors has not been examined in the context of physical activity or in diverse study populations. We evaluated whether affective risk beliefs account for unique variance in physical activity intentions and behavior above and beyond that accounted for by cognitive risk beliefs. Design: A cross-sectional survey of socio-demographically diverse US residents (N = 835; 46.4% no college training; 46.7% minority racial/ethnic ancestry; 42.6% men). Main outcome measures: Physical activity intentions and behavior. Results: Hierarchical linear regressions showed that affective risk beliefs accounted for variance in physical activity intentions beyond that predicted by socio-demographics and cognitive risk beliefs (F-change ps<.001). Specifically, intentions were higher among people with higher anticipated regret (ps<.001) and with higher absolute feelings of risk (ps<.05) or worry (ps<.05). There was an indirect relationship between perceived absolute likelihood and intentions through anticipated regret and feelings of risk. Neither cognitive nor affective risk beliefs accounted for variance in physical activity behavior (F-change ps>.05), but unsurprisingly, behavior was positively associated with physical activity intentions (p<.001). Conclusion: Future interventions could target affective risk beliefs-particularly anticipated regret-to increase intentions, and then add other intervention components to bridge the intention-behavior gap.

Awareness of Health Outcomes Associated with Insufficient Physical Activity and Associations with Physical Activity Intentions and Behavior

INTRODUCTION

Little is known about people's awareness of the link between insufficient physical activity and increased risk for multiple health outcomes.

METHODS

Of 1161 respondents to an online cross-sectional survey of the US population, we randomly selected 361 and used content analysis to code up to three responses to an open-ended question asking what illnesses are caused by insufficient physical activity. Chi-square and Fisher's exact tests examined relations between disease codes and socio-demographics; t-tests and Mann-Whitney U tests examined relations between codes and physical activity intentions and behavior.

RESULTS

Ten codes emerged: cardiovascular (63.5% of participants), metabolic (65.8%), musculoskeletal (10.5%), fatigue (2.0%), psychiatric (8.0%), respiratory (3.4%), gastrointestinal (0.9%), cancer (3.4%), other (2.8%), unexpected interpretation (1.4%). 55.6% of participants named < 3 diseases. Code frequencies were generally similar across demographic groups, ps > .05. Physical activity intentions and behavior were higher among people who either mentioned cardiovascular (p_intentions = .001, p_behavior = .001) or metabolic (p_intentions = .01, p_behavior = .005) conditions, or who named < 3 diseases (p_intentions = .006, p_behavior = .001).

CONCLUSION

In our socio-demographically diverse sample, awareness of diseases that are associated with insufficient physical activity was largely related to cardiovascular and metabolic problems. Future health communication efforts should raise awareness of the harms of insufficient physical activity for cancer and other diseases.

Perceptions of Cancer Risk/Efficacy and Cancer-Related Risk Behaviors: Results From the HCHS/SOL Sociocultural Ancillary Study

This study evaluated the associations among perceived risk, perceived efficacy, and engagement in six cancer-related risk behaviors in a population-based Hispanic/Latino sample. Interviews were conducted with 5,313 Hispanic/Latino adults as part of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study. Participants were recruited from the study's four field centers (Bronx, NY; Chicago, IL; Miami, FL; San Diego, CA) between February 2010 and June 2011. Perceived risk and perceived efficacy were assessed with questions drawn from the Health Interview National Trends Survey. More than half of the sample endorsed perceived risk of cancer associated with the six evaluated behaviors, as well as general perceived efficacy for preventing cancer. Adjusted logistic regression analyses demonstrated significant differences across Hispanic/Latino background groups for perceived risk associated with high consumption of alcohol and saturated fat, low consumption of fruits and vegetables, and insufficient exercise but not with smoking or low consumption of fiber. Differences were also found for the belief, "It seems like everything causes cancer" but not for other perceived efficacy items. Perceived cancer risk and perceived efficacy for preventing cancer were neither independently nor interactively associated with engagement in cancer-related risk behaviors after controlling for sociodemographic covariates. Results suggest that perceptions of risk and efficacy with regard to cancer vary across Hispanic/Latino background groups, and therefore background group differences should be considered in prevention efforts. Perceived risk and perceived efficacy were not related to cancer-related risk behaviors among Hispanics/Latinos. Further work is needed to evaluate determinants of cancer-related risk in this population.

Cancer beliefs and prevention policies: comparing Canadian decision-maker and general population views

PURPOSE

The knowledge, attitudes, and beliefs of key policy influencers and the general public can support or hinder the development of public policies that support cancer prevention. To address gaps in knowledge concerning healthy public policy development, views on cancer causation and endorsement of policy alternatives for cancer prevention among government influencers (elected members of legislative assemblies and senior ministry bureaucrats), non-governmental influencers (school board chairs and superintendents, print media editors and reporters, and workplace presidents and senior human resource managers), and the general public were compared.

METHODS

Two structured surveys, one administered to a convenience sample of policy influencers (government and non-governmental) and the other to a randomly selected sample of the general public, were used. The aim of these surveys was to understand knowledge, attitudes, and beliefs regarding health promotion principles and the priority and acceptability of policy actions to prevent four behavioral risk factors for cancer (tobacco use, alcohol misuse, unhealthy eating, and physical inactivity). Surveys were administered in Alberta and Manitoba, two comparable Canadian provinces.

RESULTS

Although all groups demonstrated higher levels of support for individualistic policies (e.g., health education campaigns) than for fiscal and legislative measures, the general public expressed consistently greater support than policy influencers for using evidence-based policies (e.g., tax incentives or subsidies for healthy behaviors).

CONCLUSIONS

These results suggest that Canadian policy influencers may be less open that the general public to adopt healthy public policies for cancer prevention, with potential detriment to cancer rates.

Fatalism and cancer risk knowledge among a sample of highly acculturated Latinas

Fatalistic beliefs about cancer are associated with decreased likelihood of knowing about cancer risk factors and engaging in cancer prevention and screening behaviors. Research suggests that Latinas are especially likely to hold fatalistic beliefs. However, this research has been in less-acculturated, high-poverty convenience samples. This study examined cancer knowledge, cancer fatalism, and the association between fatalism and knowledge in a national sample of highly acculturated, middle-income Latinas (N = 715). Results indicate that cancer fatalism is pervasive, and knowledge about cancer risk factors is lacking among this population. Fatalistic beliefs are paradoxically associated with cancer knowledge. Opportunities for tailored communications to improve health behaviors and additional research to understand causes/effects of these findings are discussed in the context of a growing body of research about how to communicate health information to more-acculturated Latinos.