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Scaglioni G, Chiereghin A, Bazzani C, Mezzetti F, Cavazza N. Psychosocial Predictors of Colorectal Cancer Screening Intention: An Experiment on the Invitation Letter. Int J Behav Med 2023; 30:867-877. [PMID: 36515798 DOI: 10.1007/s12529-022-10142-1] [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] [Accepted: 11/28/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND In Italy, attendance rates for colorectal cancer (CRC) screening are suboptimal. The present work analysed cognitive and emotional predictors of CRC screening intention and tested an intervention on a real invitation letter to improve CRC screening intention, both directly and in interaction with the predictors of our model. METHODS Our model included variables from the theory of planned behaviour and the emotional barriers to bowel screening scale. We applied six changes to an invitation letter used in Italy to avoid the repetition of words like 'faeces', 'blood', or 'occult' and reduce the prompting of disgust. The 228 participants were randomly assigned to a between-participants design (original letter vs. manipulated letter). RESULTS Disgust hindered CRC screening intention, while embarrassment, fear, and subjective norms (i.e., perception of the social pressures to attend CRC screening) were not associated with intention to screen. More positive attitudes towards CRC screening were associated with a higher intention to screen. The positive association between perceived behavioural control and CRC screening intention was stronger for participants who read the letter with fewer (vs. more) references to bodily waste. Letter manipulation did not affect intention to screen. CONCLUSIONS The disgust associated with faecal matter is a critical factor in determining CRC screening attendance, and it should be acknowledged as such in public policies. Until new screening tests avoiding the activation of this emotional reaction are concretely available, public campaigns should improve CRC screening participation by boosting both positive attitudes towards screening and patients' perceived behavioural control.
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Affiliation(s)
- Giulia Scaglioni
- Department of Humanities, Social Sciences, and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121, Parma, Italy.
| | - Angela Chiereghin
- Governance of Screening Programs Unit, Local Health Authority of Bologna, Via Montebello 6, 40121, Bologna, Italy
| | - Carmen Bazzani
- Governance of Screening Programs Unit, Local Health Authority of Bologna, Via Montebello 6, 40121, Bologna, Italy
| | - Francesca Mezzetti
- Governance of Screening Programs Unit, Local Health Authority of Bologna, Via Montebello 6, 40121, Bologna, Italy
| | - Nicoletta Cavazza
- Department of Communication and Economics, University of Modena and Reggio Emilia, Viale Antonio Allegri 9, 42121, Reggio Emilia, Italy
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Scaglioni G, Guidetti M, Cavazza N. The role of disgust as an emotional barrier to colorectal cancer screening participation: a systematic review and meta-analysis. Psychol Health 2023; 38:389-408. [PMID: 34433347 DOI: 10.1080/08870446.2021.1967351] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Worldwide colorectal cancer (CRC) screening rates are suboptimal. This systematic review and meta-analysis examine the role of disgust in CRC screening avoidance. DESIGN A systematic literature search was conducted. In all, 46 studies were included in the review. Among these, 16 studies were compared with a meta-analytical approach in order to 1) estimate the effect size of state disgust on screening intention and attendance; 2) examine whether methodological characteristics moderate the effect of state disgust on screening behaviour; 3) estimate the effect sizes of trait disgust and type of exam kit on state disgust. RESULTS In the reviewed studies, state disgust was often associated with CRC screening and especially with CRC screening avoidance. The meta-analysis confirmed low-to-moderate negative effects of state disgust on screening intention and attendance. Population sampling strategy was the only significant moderator of the effect of state disgust on screening attendance, i.e. studies that used convenience (versus random/representative) samples found a significantly lower effect size. Trait disgust and type of exam kit exerted a large and a moderate-to-large positive effect, respectively, on state disgust. CONCLUSIONS Disgust can boost CRC screening avoidance. Further studies and interventions must be designed to help patients in overcoming this emotional barrier.
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Affiliation(s)
- Giulia Scaglioni
- Department of Humanities, Social Sciences, and Cultural Industries, University of Parma, Parma, Italy
| | - Margherita Guidetti
- Department of Communication and Economics, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Nicoletta Cavazza
- Department of Communication and Economics, University of Modena and Reggio Emilia, Reggio Emilia, Italy
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Cai W, Zhang X, Luo Y, Ye M, Guo Y, Ruan W. Quality indicators of colonoscopy care: a qualitative study from the perspectives of colonoscopy participants and nurses. BMC Health Serv Res 2022; 22:1064. [PMID: 35986267 PMCID: PMC9390113 DOI: 10.1186/s12913-022-08466-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/16/2022] [Indexed: 12/05/2022] Open
Abstract
Background Quality of care in colonoscopy is closely related to colonoscopy participants and the nursing workforce in endoscopy-related settings. However, limited data are available on the evaluations and recommendations regarding quality indicators for nursing care by these two groups. Therefore, the aim of this study was to explore the standards and requirements of quality of care in colonoscopy from the perspectives of patients and nurses. Method With a descriptive qualitative study, semi-structured interviews were conducted between November 2021 and January 2022 with colonoscopy participants (P = 11) and nursing workforce (N = 7) in the endoscopy unit in a tertiary hospital. The interviews were analyzed using a thematic analysis. Results Nine major themes emerged according to the structure, process, and outcome care quality model: workforce structure, quality requirements, unit facilities, nursing tools, nursing quality control systems, dynamic assessment and intervention, pre-examination care, strengthening education, and colonoscopy outcomes. Conclusion The indicator of quality of colonoscopy care should be used to assess and improve current practices to ensure a more direct and sustained impact of colonoscopy care. This study highlights the importance of nurse managers valuing the opinions and reflections of people involved in colonoscopy to improve the quality of colonoscopy care. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08466-5.
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Kimpel CC, Bonnet K, Schlundt D. The Patient Experience of an Inadequate-Quality Bowel Preparation During the Colonoscopy Process: A Qualitative Study. Gastroenterol Nurs 2022; 45:244-253. [PMID: 35758928 PMCID: PMC9338919 DOI: 10.1097/sga.0000000000000654] [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: 06/04/2021] [Accepted: 10/13/2021] [Indexed: 11/26/2022] Open
Abstract
As many as 35% of patients may experience an inadequate-quality bowel preparation for colonoscopy, which may then require a repeated colonoscopy without insurance coverage. To our knowledge, there have been no qualitative studies with an in-depth exploration of patient experiences of this outcome. This study aimed to explore patients' perceptions of experiencing an inadequate preparation compared to those with only an adequate-quality bowel preparation history. Quantitative analyses were conducted for three one-item questions (e.g., anxiety rating) with ordinal scales. Qualitative data were collected from audio-recorded and transcribed telephone interviews ( N = 20) and anonymous online surveys ( N = 59). An inductive/deductive coding system was constructed, and themes were generated to form a conceptual framework. Brief quantitative results are provided. Themes of the colonoscopy process include context, prepreparation, implementation, outcomes, response, and decision to repeat. This novel study underscored the emotional experience of patients with inadequate preparation and subsequent influence on decisions to repeat the procedure. Recommendations are given for research, policy, and practice.
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Affiliation(s)
- Christine Cleary Kimpel
- Christine Cleary Kimpel, MA, BSN, RN, is PhD Candidate, Vanderbilt University School of Nursing, Nashville, Tennessee
- Kemberlee Bonnet, MA, is Research Coordinator, Vanderbilt University (Psychology), Nashville, Tennessee
- David Schlundt, PhD, is Associate Professor, Vanderbilt University (Psychology), Nashville, Tennessee
| | - Kemberlee Bonnet
- Christine Cleary Kimpel, MA, BSN, RN, is PhD Candidate, Vanderbilt University School of Nursing, Nashville, Tennessee
- Kemberlee Bonnet, MA, is Research Coordinator, Vanderbilt University (Psychology), Nashville, Tennessee
- David Schlundt, PhD, is Associate Professor, Vanderbilt University (Psychology), Nashville, Tennessee
| | - David Schlundt
- Christine Cleary Kimpel, MA, BSN, RN, is PhD Candidate, Vanderbilt University School of Nursing, Nashville, Tennessee
- Kemberlee Bonnet, MA, is Research Coordinator, Vanderbilt University (Psychology), Nashville, Tennessee
- David Schlundt, PhD, is Associate Professor, Vanderbilt University (Psychology), Nashville, Tennessee
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5
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The effects of social-media based social comparison information and similarity mindsets on COVID-19 vaccination uptake cognitions. J Behav Med 2022; 46:276-289. [PMID: 35522398 PMCID: PMC9073443 DOI: 10.1007/s10865-022-00321-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 03/26/2022] [Indexed: 11/24/2022]
Abstract
Vaccine hesitancy—delays in vaccine uptake when one is readily available—is an important public health issue. During the COVID-19 pandemic, the role of psychosocial factors in influencing cognitions and behaviors related to vaccine uptake have been examined. Using an online sample of unvaccinated U.S. adults (N = 300), we examined the influence of COVID-19-related social media-based comparison information (e.g., others’ attitudes about taking the vaccine)—as well as the moderating impact of (dis)similarity mindsets and indirect influence of affective associations, norm perceptions, and self-evaluations of efficacy—on vaccination uptake intentions. Participants reported higher intentions for vaccine uptake following exposure to cautious comparison models (e.g., those that engaged in health prevention behaviors, intended to get vaccinated) versus risky comparison models (e.g., those who did not engage in health prevention behaviors, did not intend to get vaccinated) and neutral comparison models and this effect was indirect through positive affective associations about taking the vaccine. There were no main or interactive effects of (dis)similarity mindsets. Understanding the psychosocial factors that influence health cognitions and behaviors in the context of an infectious disease pandemic will advance theoretical development and aid in creating interventions targeting vaccine uptake.
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Seva RR, Tan ALS, Tejero LMS, Salvacion MLDS. Multi-dimensional readiness assessment of medical devices. THEORETICAL ISSUES IN ERGONOMICS SCIENCE 2022. [DOI: 10.1080/1463922x.2022.2064934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Rosemary Ruiz Seva
- Industrial and Systems Engineering, De La Salle University, Manila, Philippines
| | - Angela Li Sin Tan
- Defence Medical and Environmental Research Institute - DSO National Laboratories, Singapore, Singapore
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Okuhara T, Okada H, Goto E, Tsunezumi A, Kagawa Y, Kiuchi T. Types of anticipated affect that encourage and discourage vaccination: a scoping review protocol. BMJ Open 2022; 12:e057859. [PMID: 35428641 PMCID: PMC9014101 DOI: 10.1136/bmjopen-2021-057859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Various cognitive behavioural models and theories have been used to address vaccine hesitancy. However, those models and theories have been criticised for focusing on cognitive influences on health behaviours at the expense of affective influences. Recent studies have highlighted the importance of affective elements as complementary predictors of health behaviours. Anticipated affect (ie, an expectation of one's affective response to the target behaviour) has received the most scrutiny. This scoping review will analyse studies of anticipated affect that aimed to encourage vaccination and organise implications for future research and practice in vaccine communication. Our report will focus on exploring the usefulness of affective influence in terms of a comparison with the cognitive influence on vaccination. METHODS AND ANALYSIS We will search several databases (MEDLINE, CINAHL, PsycINFO, PsycARTICLES, Academic Search Complete, Embase, Scopus, Web of Science and Google Scholar) and identify additional literature by searching the reference lists of eligible studies. Eligible studies are those that quantitatively or qualitatively examined anticipated affect and aimed to encourage vaccination. Only papers written in English will be included. We will include all eligible publications from database inception up to the date of the final database search. Two independent reviewers will screen the titles, abstracts and full texts of all identified studies. Two independent reviewers will share responsibility for data extraction and verification. Discrepancies will be resolved through discussion to reach consensus. We will extract data such as study characteristics, type of vaccine, type of anticipated affect, participant characteristics, methodology and main results. Data will be extracted using a customised extraction template on Covidence. The findings will be synthesised in a descriptive, narrative review. ETHICS AND DISSEMINATION This work does not warrant any ethical or safety review. This scoping review will be presented at a relevant conference and published in a peer-reviewed journal.
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Affiliation(s)
- Tsuyoshi Okuhara
- Department of Health Communication, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiroko Okada
- Department of Health Communication, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Eiko Goto
- Department of Health Communication, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Aiko Tsunezumi
- Department of Health Communication, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yumi Kagawa
- Department of Health Communication, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Takahiro Kiuchi
- Department of Health Communication, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Peng W, Huang Q, Lun D, Carcioppolo N. The Development and Validation of the Colonoscopy Joking Scale. HEALTH COMMUNICATION 2022; 37:409-417. [PMID: 33198530 DOI: 10.1080/10410236.2020.1846274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Joking is an important communication behavior that helps people cope with colorectal cancer and colonoscopy screening. However, whether joking serves a beneficial or maladaptive function in the context of colorectal cancer screening remains unknown. The lack of a valid scale impedes our understanding of how joking influences colonoscopy uptake. This study aims to develop and validate the Colonoscopy Joking Scale, a scale of joking behaviors in colonoscopy screening. A sample of Mturk participants aged 50-75 (N = 105) who were not compliant with colonoscopy screening recommendations was recruited to rate items for three joking factors and a measure of colonoscopy screening intentions. Two joking factors (i.e., screening-related and sexual connotation) related to colonoscopy screening and one related to general health were identified in the analysis. The psychometric analysis demonstrated strong convergent, predictive, and discriminant validity. The Colonoscopy Joking Scale will be helpful to understand what joking factor is associated with specific barriers to colonoscopy for different patients so that effective educational and interventional programs can be implemented.
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Affiliation(s)
- Wei Peng
- The Edward R. Murrow College of Communication, Washington State University
| | - Qian Huang
- School of Communication, University of Miami
| | - Di Lun
- School of Communication, University of Miami
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9
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Could a Behavioral Model Explain Adherence to Second-Level Colonoscopy for Colon Cancer Screening? Results of a Cross-Sectional Study of the Palermo Province Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052782. [PMID: 35270473 PMCID: PMC8910366 DOI: 10.3390/ijerph19052782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 12/04/2022]
Abstract
According to Italian Essential Levels of Assistance (ELA), a colonoscopy is strongly recommended after a positive fecal occult blood test (FOBT) due to its effectiveness in early colorectal cancer detection. Despite the evidence, the Palermo province population (Italy), after a positive FOBT, have a lower colonoscopy adherence compared to Italian standards. This cross-sectional study analyzed patients’ perceptions of colonoscopy procedures to understand the reasons for non-adherence. Patients with a positive FOBT who did not undergo a colonoscopy within the national organized screening program were administered a telephone interview based on the Health Belief Model (HBM) questionnaire. The number of non-compliant patients with a colonoscopy after a positive FOBT were 182, of which 45 (25.7%) patients had undergone a colonoscopy in another healthcare setting. Among the HBM items, in a multivariate analysis only perceived benefits were significantly associated with colonoscopy adherence (aOR = 6.7, p = 0.03). Health promotion interventions should focus on the importance of the benefits of colorectal screening adherence to prevent colorectal cancer, implementing health communication by healthcare workers that have closer contacts with people, as general practitioners.
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Wainwright JV, Mehta SJ, Clifton A, Bocage C, Ogden SN, Cohen S, Rendle KA. Persistent Barriers to Colorectal Cancer Screening Completion Amid Centralized Outreach: A Mixed Methods Study. Am J Health Promot 2021; 36:697-705. [PMID: 34970929 PMCID: PMC9109679 DOI: 10.1177/08901171211064492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To understand patient experiences and persistent barriers to colorectal cancer (CRC) screening amid centralized outreach at urban family medicine practices. APPROACH Following a pragmatic trial assessing mailed fecal immunochemical test (FIT) outreach, we invited a subset of participants to complete a semi-structured qualitative interview and structured questionnaire. SETTING Single urban academic healthcare system. PARTICIPANTS Sixty patients who were eligible and overdue for CRC screening at the time of trial enrollment. METHOD Using Andersen's Behavioral Model, we developed an interview guide to systematically assess factors shaping screening decisions and FIT uptake. Close-ended responses were analyzed using descriptive statistics. Qualitative data were analyzed using the constant comparative method. RESULTS Most participants (82%) self-reported that they had ever completed any modality of CRC screening, and nearly half (43%) completed the mailed FIT during the trial. Most patients (60%) preferred FIT to colonoscopy due to its private, convenient, and non-invasive nature; however, persistent barriers related to screening beliefs including fear of test results and cancer treatment still prevented some patients from completing any form of CRC screening. CONCLUSIONS Mailed FIT can overcome many structural barriers to CRC screening, yet clear communication and follow-up amid centralized outreach are essential. For some patients, tailored outreach or navigation to address screening-related fears or other screening beliefs may be needed to ensure timely completion of CRC screening.
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Affiliation(s)
- Jocelyn V Wainwright
- Department of Family Medicine and Community Health, Perelman School of Medicine, 14640University of Pennsylvania, Philadelphia, PA, USA
| | - Shivan J Mehta
- Department of Medicine, Perelman School of Medicine, 14640University of Pennsylvania, Philadelphia, PA, USA.,Penn Center for Cancer Care Innovation, Abramson Cancer Center, 14640University of Pennsylvania, Philadelphia, PA, USA
| | - Alicia Clifton
- Penn Center for Cancer Care Innovation, Abramson Cancer Center, 14640University of Pennsylvania, Philadelphia, PA, USA
| | - Claire Bocage
- Department of Family Medicine and Community Health, Perelman School of Medicine, 14640University of Pennsylvania, Philadelphia, PA, USA
| | - Shannon N Ogden
- Department of Health Law, Policy and Management, 27118Boston University School of Public Health, Boston, MA, USA
| | - Sarah Cohen
- Department of Family Medicine and Community Health, Perelman School of Medicine, 14640University of Pennsylvania, Philadelphia, PA, USA
| | - Katharine A Rendle
- Department of Family Medicine and Community Health, Perelman School of Medicine, 14640University of Pennsylvania, Philadelphia, PA, USA.,Penn Center for Cancer Care Innovation, Abramson Cancer Center, 14640University of Pennsylvania, Philadelphia, PA, USA
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Coifman KG, Disabato DJ, Aurora P, Seah THS, Mitchell B, Simonovic N, Foust JL, Sidney PG, Thompson CA, Taber JM. What Drives Preventive Health Behavior During a Global Pandemic? Emotion and Worry. Ann Behav Med 2021; 55:791-804. [PMID: 34165145 PMCID: PMC8344868 DOI: 10.1093/abm/kaab048] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background & Purpose Primary prevention of COVID-19 has focused on encouraging compliance with specific behaviors that restrict contagion. This investigation sought to characterize engagement in these behaviors in U.S. adults early during the pandemic and to build explanatory models of the psychological processes that drive them. Methods US adults were recruited through Qualtrics Research Panels (N = 324; 55% female; Mage = 50.91, SD = 15.98) and completed 10 days of online reports of emotion, COVID-19 perceived susceptibility and worry, and recommended behaviors (social distancing, hand washing, etc.). Factor analysis revealed behaviors loaded on two factors suggesting distinct motivational orientations: approach and avoidance. Results Changes in approach and avoidance behaviors over the 10 days indicated large individual differences consistent with three types of participants. Discrete emotions, including fear, guilt/shame, and happiness were associated with more recommended behaviors. Fear and COVID-19 worry indirectly influenced each other to facilitate more behavioral engagement. While emotions and worry strongly predicted individual differences in behavior across the 10 days, they did not predict as well why behaviors occurred on one day versus another. Conclusions These findings suggest how daily affective processes motivate behavior, improving the understanding of compliance and efforts to target behaviors as primary prevention of disease.
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Affiliation(s)
- Karin G Coifman
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - David J Disabato
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Pallavi Aurora
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - T H Stanley Seah
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Benjamin Mitchell
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Nicolle Simonovic
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Jeremy L Foust
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Pooja Gupta Sidney
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - Clarissa A Thompson
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
| | - Jennifer M Taber
- Department of Psychological Sciences, Kent State University, Kent, Ohio, USA
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Waters EA, Maki J, Liu Y, Ackermann N, Carter CR, Dart H, Bowen DJ, Cameron LD, Colditz GA. Risk Ladder, Table, or Bulleted List? Identifying Formats That Effectively Communicate Personalized Risk and Risk Reduction Information for Multiple Diseases. Med Decis Making 2020; 41:74-88. [PMID: 33106087 DOI: 10.1177/0272989x20968070] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Personalized medicine may increase the amount of probabilistic information patients encounter. Little guidance exists about communicating risk for multiple diseases simultaneously or about communicating how changes in risk factors affect risk (hereafter "risk reduction"). PURPOSE To determine how to communicate personalized risk and risk reduction information for up to 5 diseases associated with insufficient physical activity in a way laypeople can understand and that increases intentions. METHODS We recruited 500 participants with <150 min weekly of physical activity from community settings. Participants completed risk assessments for diabetes, heart disease, stroke, colon cancer, and breast cancer (women only) on a smartphone. Then, they were randomly assigned to view personalized risk and risk reduction information organized as a bulleted list, a simplified table, or a specialized vertical bar graph ("risk ladder"). Last, they completed a questionnaire assessing outcomes. Personalized risk and risk reduction information was presented as categories (e.g., "very low"). Our analytic sample (N = 372) included 41.3% individuals from underrepresented racial/ethnic backgrounds, 15.9% with vocational-technical training or less, 84.7% women, 43.8% aged 50 to 64 y, and 71.8% who were overweight/obese. RESULTS Analyses of covariance with post hoc comparisons showed that the risk ladder elicited higher gist comprehension than the bulleted list (P = 0.01). There were no significant main effects on verbatim comprehension or physical activity intentions and no moderation by sex, race/ethnicity, education, numeracy, or graph literacy (P > 0.05). Sequential mediation analyses revealed a small beneficial indirect effect of risk ladder versus list on intentions through gist comprehension and then through perceived risk (bIndirectEffect = 0.02, 95% confidence interval: 0.00, 0.04). CONCLUSION Risk ladders can communicate the gist meaning of multiple pieces of risk information to individuals from many sociodemographic backgrounds and with varying levels of facility with numbers and graphs.
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Affiliation(s)
- Erika A Waters
- Department of Surgery, Division of Public Health Sciences, Washington University in St. Louis, Saint Louis, MO, USA
| | - Julia Maki
- Department of Surgery, Division of Public Health Sciences, Washington University in St. Louis, Saint Louis, MO, USA
| | - Ying Liu
- Department of Surgery, Division of Public Health Sciences, Washington University in St. Louis, Saint Louis, MO, USA
| | - Nicole Ackermann
- Department of Surgery, Division of Public Health Sciences, Washington University in St. Louis, Saint Louis, MO, USA
| | - Chelsey R Carter
- Department of Surgery, Division of Public Health Sciences, Washington University in St. Louis, Saint Louis, MO, USA
| | - Hank Dart
- Department of Surgery, Division of Public Health Sciences, Washington University in St. Louis, Saint Louis, MO, USA
| | | | | | - Graham A Colditz
- Department of Surgery, Division of Public Health Sciences, Washington University in St. Louis, Saint Louis, MO, USA
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Klasko-Foster LB, Przybyla S, Orom H, Gage-Bouchard E, Kiviniemi MT. The influence of affect on HPV vaccine decision making in an HPV vaccine naïve college student population. Prev Med Rep 2020; 20:101195. [PMID: 32983851 PMCID: PMC7498828 DOI: 10.1016/j.pmedr.2020.101195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/30/2020] [Accepted: 08/23/2020] [Indexed: 01/05/2023] Open
Abstract
The HPV vaccine is recommended for all adolescents starting at age 11, but coverage is low, especially in the young adult population. The CDC is prioritizing catch-up vaccination and has expanded recommendations for all young adults to age 26. College students may be ideal targets for HPV vaccine interventions as they typically have on-site clinics that offer prevention services and students are in the position to make decisions about their own healthcare. We examined the risk perceptions of 101 HPV vaccine-naïve college students, both in terms of risk cognition (beliefs about susceptibility to HPV-related cancers and genital warts) and affect (worry and fear regarding HPV-related health outcomes) as they relate to HPV vaccine intentions. Participants completed an online survey, reporting absolute and comparative risk perceptions for HPV-related cancers/genital warts, fear and worry related to getting HPV-related cancer and/or genital warts, desire for positive emotions, affective associations with the HPV vaccine, and intentions to get the HPV vaccine. More fear/worry about vaccination was directly associated with increased vaccine intentions. The perceived risk to intentions relation included an indirect effect via fear/worry. Desire for positive affect strengthened this relation. Positive affective associations with the HPV vaccine were also related to increased vaccine intentions. Given the public health impact of increasing HPV vaccine coverage for young adults, educational strategies framing the HPV vaccine positively while decreasing fear/worry related to negative health outcomes might increase interest in on-campus catch-up vaccination.
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Klasko-Foster LB, Keller MM, Kiviniemi MT. Is it disgusting or am I just easily disgusted? The relation between situational disgust, dispositional disgust, and colonoscopy intentions. Eur J Cancer Care (Engl) 2020; 29:e13244. [PMID: 32596994 DOI: 10.1111/ecc.13244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 03/03/2020] [Accepted: 04/16/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE While early detection is an effective way to reduce mortality from colorectal cancer, screening rates are low. An underlying factor in screening completion failure may be experiences of disgust when learning about screening and/or dispositional disgust. METHOD Participants recruited via Amazon MTurk (N = 296) read information about colonoscopy and completed an online survey assessing both dispositional forms of disgust (i.e. trait disgust and disgust sensitivity) and situational forms, including state disgust and disgust associated with colonoscopy. Participants reported intentions to discuss colonoscopy with a provider and to prepare for and complete screening. RESULTS Greater state disgust and the degree to which one associated disgust with colonoscopy predicted lower screening, preparation and provider discussion intentions. By contrast, neither trait disgust nor disgust sensitivity was associated with intentions. Both disgust sensitivity and trait disgust moderated the state disgust to intentions relation. CONCLUSIONS This is one of few investigations of disgust examining the relation between specific types and colonoscopy intentions. Screening uptake may be improved by identifying specific components of disgust that have an effect on colonoscopy intentions. Future work focusing on the interplay between different disgust mechanisms as they relate to colonoscopy behaviour is important for intervention development.
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Affiliation(s)
- Lynne B Klasko-Foster
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, USA
| | - Maria M Keller
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, SUNY, Buffalo, NY, USA
| | - Marc T Kiviniemi
- Department of Health, Behavior, and Society, College of Public Health, University of Kentucky, Lexington, KY, USA
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O'Reilly SM, Hughes KN, Mooney T, Fitzpatrick P, O'Donoghue D, McNally S, Codd M, Ryan E, Doherty G, Mason O, Mulcahy HE, Cullen G. Characteristics and attitudes of first round invitees in the Irish National Colorectal Cancer Screening Programme. Frontline Gastroenterol 2020; 12:374-379. [PMID: 35401954 PMCID: PMC8989011 DOI: 10.1136/flgastro-2020-101417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/17/2020] [Accepted: 05/08/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND/OBJECTIVE Colorectal cancer (CRC) screening is proven to reduce CRC-related mortality. Faecal immunochemical testing (FIT)-positive clients in the Irish National CRC Screening Programme underwent colonoscopy. Round 1 uptake was 40.2%. We sought to identify barriers to participation by assessing knowledge of CRC screening and examining attitudes towards FIT test and colonoscopy. METHODS Questionnaires based on a modified Champion's Health Belief Model were mailed to 3500 invitees: 1000 FIT-positive, 1000 FIT-negative and 1500 non-participants. 44% responded: 550 (46%) FIT-positive, 577 (48%) FIT-negative and 69 (6%) non-responders (NR). RESULTS 25% of respondents (n=286) did not perceive a personal risk of cancer, did not perceive CRC to be a serious disease and did not perceive benefits to screening. These opinions were more likely to be expressed by men (p=0.035). One-fifth (n=251) found screening stressful. Fear of cancer diagnosis and test results were associated with stress. FIT-positive clients, women and those with social medical insurance were more likely to experience stress. CONCLUSIONS The CRC screening process causes stress to one-fifth of participants. Greater use of media and involvement of healthcare professionals in disseminating information on the benefits of screening may lead to higher uptake in round 2.
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Affiliation(s)
- Susanne M O'Reilly
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - Katie N Hughes
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - Therese Mooney
- BowelScreen, National Screening Service, Dublin, Ireland
| | | | - Diarmuid O'Donoghue
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland,BowelScreen, National Colorectal Cancer Screening Programme, Dublin, Ireland
| | - Sara McNally
- BowelScreen, National Screening Service, Dublin, Ireland
| | - Mary Codd
- School of Public Health, University College Dublin, Dublin, Ireland
| | - Elizabeth Ryan
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - Glen Doherty
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - Olivia Mason
- School of Public Health, University College Dublin, Dublin, Ireland
| | - Hugh E Mulcahy
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - Garret Cullen
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
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16
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Bowen DJ, Hyams T, Laurino M, Woolley T, Cohen S, Leppig KA, Jarvik G. Development of FamilyTalk: an Intervention to Support Communication and Educate Families About Colorectal Cancer Risk. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:470-478. [PMID: 30737640 PMCID: PMC6688969 DOI: 10.1007/s13187-019-1484-3] [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: 05/07/2023]
Abstract
IFamily members of individuals with colorectal cancer (CRC) may be at increased risk of developing the disease. However, the majority of CRC can be prevented through colonoscopy screening and family members may not be aware if they are recommended to pursue earlier screening because of their family history of CRC. As such, tools must be developed to effectively communicate potential changes to the recommended age for colonoscopy screening and other important CRC-related information to family members. We modified and adapted a successful intervention for families with melanoma to be appropriate for families with CRC to increase communication and screening in family members. The multistep process included the following: (1) developing a paper version of the intervention, (2) piloting the paper version among families with CRC, (3) developing the web-based version, and (4) testing the intervention for usability. Qualitative data was collected and analyzed for pilot testing. Usability testing utilized both qualitative and quantitative data. Patients with CRC liked the paper version and had multiple suggestions, including adding a better introduction, sections on genetics and family history, and clearer communication assistance. The web-based tool was well received and improved upon the linear book format with links, better section instructions, and more proactive communication tools for families. These processes produced materials that satisfied individuals from various families with assistance and support for communicating about CRC. Evaluating the effects of the tools in rigorous research projects is the next step.
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Affiliation(s)
- Deborah J Bowen
- Department of Bioethics and Humanities, University of Washington, Box 357120, Seattle, WA, 98195, USA.
| | - Travis Hyams
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
| | - Mercy Laurino
- Genetics and Cancer Prevention Programs, Seattle Cancer Care Alliance, Seattle, WA, USA
| | | | - Stacey Cohen
- Division of Oncology, University of Washington, Seattle, WA, USA
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Gail Jarvik
- Department of Medicine, Division of Medical Genetics, University of Washington, Seattle, WA, USA
- Department of Genome Sciences, University of Washington, Seattle, WA, USA
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17
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Klasko-Foster LB, Kiviniemi MT, Jandorf LH, Erwin DO. Affective components of perceived risk mediate the relation between cognitively-based perceived risk and colonoscopy screening. J Behav Med 2020; 43:121-130. [PMID: 31065890 PMCID: PMC6834895 DOI: 10.1007/s10865-019-00049-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 04/24/2019] [Indexed: 11/28/2022]
Abstract
Perceived risk is a common component of health decision making theory. When affective components of risk are assessed as predictors of a behavior, they are usually examined separately from cognitive components. Less frequently examined are more complex interplays between affect and cognition. We hypothesized that cognitive and affective risk components would both have direct effects on colonoscopy behavior/intentions and that affective components would mediate the relationship of cognitively-based perceived risk to colonoscopy screening. In two secondary analyses, participants reported their cognitive and affective perceived risk for colorectal cancer, past colonoscopy behavior, and future screening intentions. In both studies, cognitive and affective risk components were associated with increased screening behavior/intentions and cognitive risk components were mediated through affective risk. Given the impact of early detection on colorectal cancer prevention, educational strategies highlighting both components of risk may be important to increase screening rates.
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Affiliation(s)
- Lynne B Klasko-Foster
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, SUNY, 3435 Main Street, 312 Kimball Tower, Buffalo, NY, 14214, USA.
| | - Marc T Kiviniemi
- Department of Health, Behavior, and Society, College of Public Health, University of Kentucky, Bowman Hall Room 346, 151 Washington Avenue, Lexington, KY, 40536, USA
| | - Lina H Jandorf
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1077, New York, NY, 10029, USA
| | - Deborah O Erwin
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14263, USA
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18
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Oh A, Gaysynsky A, Knott CL, Nock NL, Erwin DO, Vinson CA. Customer discovery as a tool for moving behavioral interventions into the marketplace: insights from the NCI SPRINT program. Transl Behav Med 2019; 9:1139-1150. [PMID: 31313817 PMCID: PMC7184906 DOI: 10.1093/tbm/ibz103] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
The National Cancer Institute established a dissemination and implementation accelerator program called Speeding Research-tested INTerventions (SPRINT) in order to expedite the translation of behavioral research into practice. The goal of SPRINT is to introduce researchers to a new method for moving their research into practice in order to increase the real-world impact of their evidence-based interventions. The goal of this article is to present case studies on three teams that have completed the SPRINT program to date. Each case study provides a description of the intervention the team came into the program with, the team's motivation for participating in the SPRINT program, the team's experience in the program, lessons learned from "customer discovery" interviews conducted by the team during the course, and the team's future plans for their intervention. The case studies suggest that by focusing on behavioral researchers, SPRINT addresses an unmet need in the commercialization training space; that the definition of "success" can vary across SPRINT projects; that identifying and engaging "payors" for behavioral interventions is an ongoing challenge; and that there are potential "misalignments" between the research process and market demands. Overall, these examples show that customer discovery is a potentially useful method for making interventions more responsive to the needs of stakeholders, and that researchers can benefit from learning the "language" of business and working with individuals who have business experience before trying to move their research from the lab to the real world.
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Affiliation(s)
- April Oh
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Anna Gaysynsky
- Engagement and Transformation, ICF Next, Rockville, MD, USA
| | - Cheryl L Knott
- Department of Behavioral and Community Health, University of Maryland, College Park, MD, USA
| | - Nora L Nock
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Deborah O Erwin
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Cynthia A Vinson
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
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19
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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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20
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Klasko-Foster LB, Jandorf LM, Erwin DO, Kiviniemi MT. Predicting Colonoscopy Screening Behavior and Future Screening Intentions for African Americans Older than 50 Years. Behav Med 2019; 45:221-230. [PMID: 30427773 PMCID: PMC6517076 DOI: 10.1080/08964289.2018.1510365] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
African Americans experience a disproportionate burden of morbidity and mortality from colorectal cancer, which may be due to low adherence to screening recommendations. Previous studies have found relationships between decision-making factors and screening behavior, but few have looked at both cognitive and affective factors or within a specifically African American sample. To better understand determinants that drive screening behavior, this study examines affective, cognitive, and social variables as predictors of colonoscopy in an age-eligible African American population. Participants completed surveys assessing affective associations with colonoscopy, perceived benefits and barriers, self-efficacy, knowledge, fear of colonoscopy, perceived risk, and colorectal cancer worry and fear. Regression analysis was used to model decision-making constructs as predictors of screening behavior/intentions. Affective, cognitive, and health care experience variables predicted colonoscopy completion and intentions. Provider-level factors and previous cancer screenings predicted prior screening only, but not intentions. Affective and cognitive components of perceived risk were associated with decreased likelihood of colonoscopy behavior, but increased likelihood of colonoscopy intentions. These findings suggest that colonoscopy decision making involves a complex array of both cognitive and affective determinants. This work extends our knowledge of colorectal cancer screening decision making by evaluating the effects of these multiple determinants on screening behavior in an African American sample. Future work exploring the interplay of affect and cognitions as influences on colonoscopy decision making and how health care experiences may moderate this effect is needed to develop effective intervention approaches and reduce screening disparities.
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Affiliation(s)
- Lynne B. Klasko-Foster
- University at Buffalo, SUNY, School of Public Health and Health Professions, Department of Community Health and Health Behavior, 3435 Main Street, 312 Kimball Tower, Buffalo, NY 14214
| | - Lina M. Jandorf
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1130, New York, NY, 10029,
| | - Deborah O. Erwin
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263,
| | - Marc T. Kiviniemi
- Department of Community Health and Health Behavior, University at Buffalo, SUNY, School of Public Health and Health Professions, 3435 Main Street, 314 Kimball Tower, Buffalo, NY 14214
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21
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Sarma EA, Silver MI, Kobrin SC, Marcus PM, Ferrer RA. Cancer screening: health impact, prevalence, correlates, and interventions. Psychol Health 2019; 34:1036-1072. [DOI: 10.1080/08870446.2019.1584673] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Elizabeth A. Sarma
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
| | - Michelle I. Silver
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
| | - Sarah C. Kobrin
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
| | - Pamela M. Marcus
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
| | - Rebecca A. Ferrer
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
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22
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Itzhaki M. Knowledge and feelings about colorectal cancer among the Jewish adult population in Israel: A mixed methods study. Appl Nurs Res 2018; 43:64-68. [PMID: 30220366 DOI: 10.1016/j.apnr.2018.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 06/29/2018] [Accepted: 07/25/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Few previous studies found that people's knowledge of colorectal cancer (CRC) risk factors and symptoms is a predictor of high compliance with CRC screening. Feelings about CRC have rarely been examined. AIM This mixed method study is aimed at examining knowledge and feelings about CRC among the Jewish adult population in Israel. METHODS One hundred and ninety six Jewish Israelis were interviewed using semi-structured face to face personal interviews. Clinical characteristics and knowledge about CRC were analyzed by quantitative methods. Feelings about CRC were analyzed by the qualitative constant comparative method. RESULTS Most of the participants were at risk for developing CRC due to their native background as Jews of Eastern European origin. The most well known risk factor was family history of CRC, but only a third were aware of it. Screening for CRC by colonoscopy was known to about half the participants. CRC evoked negative feelings of fear of contracting an oncological disease, stress as a result of a new realty, sadness at the possibility of late discovery, disgust and embarrassment because of the involvement of an intimate area and the connection to body secretions. Positive feelings of optimistic faith and hope were found with regard to survival. CONCLUSION The knowledge level of the participants about CRC symptoms, risk factors, and recommended screening was low to moderate. CRC evoked mainly negative feelings. Increasing knowledge about CRC and reducing negative feelings evoked by CRC are essential.
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Affiliation(s)
- M Itzhaki
- Nursing Department, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
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23
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Katz ML, Young GS, Zimmermann BJ, Tatum CM, Paskett ED. Assessing Colorectal Cancer Screening Barriers by Two Methods. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:536-543. [PMID: 27933460 PMCID: PMC7076560 DOI: 10.1007/s13187-016-1148-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Colorectal cancer (CRC) is commonly diagnosed in the USA despite screening tests that have decreased CRC incidence and mortality. Finding the best method to identify patient-level screening barriers is important to improve CRC screening rates. A group-randomized trial was conducted among ten primary-care clinics. Clinics were randomized to a multi-level (clinic, provider, patient) CRC screening intervention or usual care (2007-2013). Subsequent to clinic- and provider-level interventions, a three-step, patient-level intervention was conducted. One step of the patient-level intervention was a CRC screening barriers counseling call conducted by a lay health advisor (LHA). During the call, two methods were used to identify CRC screening barriers. An open-ended question was used first to determine why participants had not completed screening (without probes). Subsequently, the LHA read a list of additional potential screening barriers and asked participants whether each barrier was applicable (with probes). A generalized estimating equation approach was used to compare the two methods. Participants (n = 109) were female (59%), had a mean age of 57.2 years, and were white (67%) or black (31%). Most participants had some college education or a college degree (79%), annual household income $30,000+ (60%), and health insurance (80%). The number of CRC screening barriers increased with probing compared to the open-ended question format (OR 2.10, 95% CI 1.92-2.31; p < 0.01). The ranking of reported CRC screening barriers did not vary by assessment method. However, the methodology used to document CRC screening barriers may influence the content of patient-directed interventions.
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Affiliation(s)
- Mira L Katz
- College of Public Health, The Ohio State University, Suite 525 1590 North High Street, Columbus, OH, 43201, USA.
- Comprehensive Cancer Center, The Ohio State University, Suite 525 1590 North High Street, Columbus, OH, 43201, USA.
- College of Medicine, The Ohio State University, Suite 525 1590 North High Street, Columbus, OH, 43201, USA.
| | - Gregory S Young
- Comprehensive Cancer Center, The Ohio State University, Suite 525 1590 North High Street, Columbus, OH, 43201, USA
| | - Barret J Zimmermann
- College of Public Health, The Ohio State University, Suite 525 1590 North High Street, Columbus, OH, 43201, USA
- Comprehensive Cancer Center, The Ohio State University, Suite 525 1590 North High Street, Columbus, OH, 43201, USA
| | - Cathy M Tatum
- Comprehensive Cancer Center, The Ohio State University, Suite 525 1590 North High Street, Columbus, OH, 43201, USA
| | - Electra D Paskett
- College of Public Health, The Ohio State University, Suite 525 1590 North High Street, Columbus, OH, 43201, USA
- Comprehensive Cancer Center, The Ohio State University, Suite 525 1590 North High Street, Columbus, OH, 43201, USA
- College of Medicine, The Ohio State University, Suite 525 1590 North High Street, Columbus, OH, 43201, USA
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24
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Kiviniemi MT, Klasko-Foster LB, Erwin DO, Jandorf L. Decision-making and socioeconomic disparities in colonoscopy screening in African Americans. Health Psychol 2018; 37:481-490. [PMID: 29595298 PMCID: PMC5920714 DOI: 10.1037/hea0000603] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Socioeconomic status (SES) disparities in colorectal cancer screening are persistent. Lower education and income are both associated with lower screening rates. Both cognitive (e.g., perceived barriers) and affective (e.g., disgust, fear) decision-making constructs are known determinants of colorectal cancer screening behavior. This study tests the hypotheses that SES may be related to decision-making constructs and that this SES-decision-making construct relation may contribute to explaining the SES-screening behavior disparity. METHOD Surveys assessing perceived benefits and barriers to screening, self-efficacy, positive and negative affective associations with colonoscopy, fear of colonoscopy, colorectal cancer knowledge, past screening behavior, and demographics including education and income were completed by 2,015 African American participants ages 50 and older. Both univariable and multivariable relations of SES to decision-making constructs were examined, as were univariable and multivariable models of the indirect effect of SES on screening via decision-making constructs. RESULTS Socioeconomic status was related to both screening compliance and the decision-making constructs. Bootstrap modeling of the indirect effect showed that the total effect of the SES-screening behavior relation included an indirect effect via social cognitive decision-making constructs. CONCLUSION These findings suggest that cognitive and affective decision-making constructs account for at least some of the SES disparities in colorectal cancer screening behavior. As such, more research is needed to explore the intra individual-level influences of disparities in colorectal cancer screening. In addition, work is needed to develop effective intervention approaches to address the relation of SES to decision-making constructs. (PsycINFO Database Record
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Affiliation(s)
| | | | - Deborah O Erwin
- Office of Cancer Health Disparities Research, Roswell Park Cancer Institute
| | - Lina Jandorf
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai
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25
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Becker D, Grapendorf J, Greving H, Sassenberg K. Perceived Threat and Internet Use Predict Intentions to Get Bowel Cancer Screening (Colonoscopy): Longitudinal Questionnaire Study. J Med Internet Res 2018; 20:e46. [PMID: 29415872 PMCID: PMC5822037 DOI: 10.2196/jmir.9144] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 12/08/2017] [Accepted: 12/08/2017] [Indexed: 01/29/2023] Open
Abstract
Background Many people use the Internet for health-related information search, which is known to help regulate their emotional state. However, not much is known yet about how Web-based information search together with negative emotional states (ie, threat of cancer diagnosis) relate to preventive medical treatment decisions (ie, colonoscopy intentions). Objective The aim of this study was to investigate how frequency of health-related Internet use together with perceived threat of a possible (bowel) cancer diagnosis influences intentions to get a colonoscopy. Previous research has shown that people who experience threat preferentially process positive information in an attempt to downregulate the aversive emotional state. The Internet can facilitate this regulatory strategy through allowing self-directed, unrestricted, and thus biased information search. In the context of threat regarding a possible bowel cancer diagnosis, feelings of threat can still be effectively reduced through cancer screening (ie, colonoscopy). We, therefore, predict that in that particular context, feelings of threat should be related to stronger colonoscopy intentions, and that this relationship should be enhanced for people who use the Internet often. Methods A longitudinal questionnaire study was conducted among healthy participants who were approaching or just entering the bowel cancer risk group (aged 45-55 years). Perceived threat of a possible (bowel) cancer diagnosis, frequency of health-related Internet use, and intentions to have a colonoscopy were assessed at 2 time points (6-month time lag between the 2 measurement points T1 and T2). Multiple regression analyses were conducted to test whether threat and Internet use at T1 together predicted colonoscopy intentions at T2. Results In line with our predictions, we found that the threat of a possible (bowel) cancer diagnosis interacted with the frequency of Internet use (both T1) to predict colonoscopy intentions (T2; B=.23, standard error [SE]=0.09, P=.01). For people who used the Internet relatively often (+1 SD), the positive relationship between threat and colonoscopy intentions was significantly stronger (B=.56, SE=0.15, P<.001) compared with participants who used the Internet less often (−1 SD; B=.17, SE=0.09, P=.07). This relationship was unique to Web-based (vs other types of) information search and independent of risk factors (eg, body mass index [BMI] and smoking). Conclusions The results of this study suggest that health-related Internet use can facilitate emotion-regulatory processes. People who feel threatened by a possible (bowel) cancer diagnosis reported stronger colonoscopy intentions, especially when they used the Internet often. We propose that this is because people who experience threat are more likely to search for and process information that allows them to downregulate their aversive emotional state. In the present case of (bowel) cancer prevention, the most effective way to reduce threat is to get screened.
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Affiliation(s)
- Daniela Becker
- Social Processes Lab, Leibniz-Institut für Wissensmedien, Tübingen, Germany
| | | | - Hannah Greving
- Knowledge Construction Lab, Leibniz-Institut für Wissensmedien, Tübingen, Germany
| | - Kai Sassenberg
- Social Processes Lab, Leibniz-Institut für Wissensmedien, Tübingen, Germany.,University of Tübingen, Tübingen, Germany
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26
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Ellis EM, Erwin DO, Jandorf L, Saad-Harfouche F, Sriphanlop P, Clark N, Dauphin C, Johnson D, Klasko-Foster LB, Martinez C, Sly J, White D, Winkel G, Kiviniemi MT. Designing a randomized controlled trial to evaluate a community-based narrative intervention for improving colorectal cancer screening for African Americans. Contemp Clin Trials 2018; 65:8-18. [PMID: 29198730 PMCID: PMC5803387 DOI: 10.1016/j.cct.2017.11.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 11/29/2017] [Accepted: 11/29/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To describe the methodology of a 2-arm randomized controlled trial that compared the effects of a narrative and didactic version of the Witness CARES (Community Awareness, Reach, & Empowerment for Screening) intervention on colorectal cancer screening behavior among African Americans, as well as the cognitive and affective determinants of screening. METHODS Witness CARES targeted cognitive and affective predictors of screening using a culturally competent, community-based, narrative or didactic communication approach. New and existing community partners were recruited in two New York sites. Group randomization allocated programs to the narrative or didactic arm. Five phases of data collection were conducted: baseline, post-intervention, three-month, six-month, and qualitative interviews. The primary outcome was screening behavior; secondary outcomes included cognitive and affective determinants of screening. RESULTS A total of 183 programs were conducted for 2655 attendees. Of these attendees, 19.4% (N=516) across 158 programs (50% narrative; 50% didactic) were study-eligible and consented to participate. Half (45.6%) of the programs were delivered to new community partners and 34.8% were delivered at faith-based organizations. Mean age of the total sample was 64.7years and 75.4% were female. CONCLUSION The planned number of programs was delivered, but the proportion of study-eligible attendees was lower than predicted. This community-based participatory research approach was largely successful in involving the community served in the development and implementation of the intervention and study.
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Affiliation(s)
- Erin M Ellis
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, SUNY, Buffalo, NY 14214, United States.
| | - Deborah O Erwin
- Office of Cancer Health Disparities Research, Division of Cancer Prevention and Control, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, United States
| | - Lina Jandorf
- Department of Population Health Science and Policy, Center for Behavioral Oncology, Division of Cancer Prevention and Control, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029, United States
| | - Frances Saad-Harfouche
- Office of Cancer Health Disparities Research, Division of Cancer Prevention and Control, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, United States
| | - Pathu Sriphanlop
- Department of Population Health Science and Policy, Center for Behavioral Oncology, Division of Cancer Prevention and Control, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029, United States
| | - Nikia Clark
- Office of Cancer Health Disparities Research, Division of Cancer Prevention and Control, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, United States
| | - Cassandre Dauphin
- Office of Cancer Health Disparities Research, Division of Cancer Prevention and Control, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, United States
| | - Detric Johnson
- Office of Cancer Health Disparities Research, Division of Cancer Prevention and Control, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, United States
| | - Lynne B Klasko-Foster
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, SUNY, Buffalo, NY 14214, United States
| | - Clarissa Martinez
- Department of Population Health Science and Policy, Center for Behavioral Oncology, Division of Cancer Prevention and Control, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029, United States
| | - Jamilia Sly
- Department of Population Health Science and Policy, Center for Behavioral Oncology, Division of Cancer Prevention and Control, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029, United States
| | - Drusilla White
- Department of Population Health Science and Policy, Center for Behavioral Oncology, Division of Cancer Prevention and Control, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029, United States
| | - Gary Winkel
- Department of Population Health Science and Policy, Center for Behavioral Oncology, Division of Cancer Prevention and Control, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, New York, NY 10029, United States
| | - Marc T Kiviniemi
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, SUNY, Buffalo, NY 14214, United States
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Driedger SM, Annable G, Brouwers M, Turner D, Maier R. Can you un-ring the bell? A qualitative study of how affect influences cancer screening decisions. BMC Cancer 2017; 17:647. [PMID: 28903742 PMCID: PMC5598010 DOI: 10.1186/s12885-017-3596-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 08/23/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The belief that early detection is the best protection against cancer underlies cancer screening. Emerging research now suggests harms associated with early detection may sometimes outweigh the benefits. Governments, cancer agencies, and organizations that publish screening guidelines have found it is difficult to "un-ring the bell" on the message that "early detection is your best protection" because of its widespread communication and enduring resonance. This study explores affective factors-and their interplay with relevant analytical factors-in public/laypersons' decision making about cancer screening. METHODS A total of 93 people (47 men, 46 women) attended focus groups about, respectively, prostate cancer screening and breast cancer screening in two Canadian cities. RESULTS Affective factors were a major influence on many focus group participants' decision making about cancer screening, including fear of cancer and a generalized enthusiasm for prevention/screening, and they were often inspired by anecdotes about the cancer experiences of family and friends. Affect also existed alongside more analytical factors including assessments of reduced risk in the management of any cancer diagnosis if caught early, and, for men, the belief that an unreliable test is "better than nothing," and that men deserve prostate cancer screening because women have breast and cervical cancer screening. Affective factors were particularly noticeable in the sub-groups most supportive of screening and the "early detection" message: older women who felt that mammogram screening should begin at age 40 rather than 50, and older men who felt that prostate cancer screening should be expanded beyond its current unorganized, opportunistic usage. In contrast, younger participants displayed less affective attachments to "early detection" messages and had greater concerns about harms of screening and were more receptive to nuanced messages informed by evidence. CONCLUSION Policymakers attempting to communicate more nuanced versions of the "early detection" message need to understand the role of affect alongside other judgments brought into laypersons' decision making processes and anticipate how affective responses to their messages will be shaped, transformed, and potentially subverted by external forces beyond their control. Particularly overt external factors are campaigns by cancer advocacy organizations actively promoting breast and prostate cancer awareness and screening to younger women and men using affectively-charged messages.
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Affiliation(s)
- S. Michelle Driedger
- Community Health Sciences, College of Medicine, Faculty of Health Sciences, University of Manitoba, S113-750 Bannatyne Avenue, Winnipeg, MB R3E 0W3 Canada
| | - Gary Annable
- Community Health Sciences, College of Medicine, Faculty of Health Sciences, University of Manitoba, S113-750 Bannatyne Avenue, Winnipeg, MB R3E 0W3 Canada
| | - Melissa Brouwers
- Department of Oncology, McMaster University, Juravinski Site, 60 (G) Wing, 711 Concession Street, Hamilton, ON L8V 1C3 Canada
| | - Donna Turner
- Population Oncology, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, MB R3E 0V9 Canada
| | - Ryan Maier
- Community Health Sciences, College of Medicine, Faculty of Health Sciences, University of Manitoba, S113-750 Bannatyne Avenue, Winnipeg, MB R3E 0W3 Canada
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Magnan RE, Shorey Fennell BR, Brady JM. Health decision making and behavior: The role of affect-laden constructs. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2017. [DOI: 10.1111/spc3.12333] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kiviniemi MT, Ellis EM, Hall MG, Moss JL, Lillie SE, Brewer NT, Klein WM. Mediation, moderation, and context: Understanding complex relations among cognition, affect, and health behaviour. Psychol Health 2017; 33:98-116. [DOI: 10.1080/08870446.2017.1324973] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Marc T. Kiviniemi
- Department of Community Health and Health Behavior, University at Buffalo, SUNY, Buffalo, NY, USA
| | - Erin M. Ellis
- Behavioral Research Program, National Cancer Institute, Rockville, MD, USA
| | - Marissa G. Hall
- Department of Health Behavior, University of North Carolina, Chapel Hill, NC, USA
| | - Jennifer L. Moss
- Behavioral Research Program, National Cancer Institute, Rockville, MD, USA
| | - Sarah E. Lillie
- Minneapolis Veteran Affairs Health Care System, Minneapolis, MN, USA
| | - Noel T. Brewer
- Department of Health Behavior, University of North Carolina, Chapel Hill, NC, USA
| | - William M.P. Klein
- Behavioral Research Program, National Cancer Institute, Rockville, MD, USA
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Kiviniemi MT. Structure and content of affective associations with health behaviours: Is the behaviour 'good OR bad' or 'good AND bad'. Psychol Health 2017; 33:159-175. [PMID: 28391707 DOI: 10.1080/08870446.2017.1314476] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The feelings and emotions individuals associate with health-related behaviours influence engagement in those behaviours. However, the structure and the content of these affective associations have not been examined. The studies reported here examined competing hypotheses about the structure (unidimensional or bidimensional) and content (generalised affect or specific emotions) of affective associations with two health-related behaviours: physical activity and fruit/vegetable consumption. DESIGN For each behaviour, participants (fruit and vegetable consumption n = 149; physical activity n = 199) completed an assessment of the association of 40 positive and 51 negative affect concepts with the behaviour. MAIN OUTCOME MEASURES Ratings of affective associations with each behaviour. RESULTS Confirmatory factor analyses comparing unidimensional and bidimensional affect structure models showed that the structure of individuals' affective associations was bidimensional for both behaviours - positive and negative affective associations were shown to be separate and distinct constructs. Exploratory factor analyses supported a model of affective associations as generalised affect for both behaviours. CONCLUSION Affective associations with both physical activity and with fruit/vegetable consumption consist of separate positive and negative dimensions of generalised affect. These findings lead to recommendations for research and intervention development based on the implications for how affective associations might operate to influence behavioural decision-making.
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Affiliation(s)
- Marc T Kiviniemi
- a Department of Community Health and Health Behavior , University at Buffalo , Buffalo , NY , USA
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31
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Emanuel AS, Kiviniemi MT, Howell JL, Hay JL, Waters EA, Orom H, Shepperd JA. Avoiding cancer risk information. Soc Sci Med 2015; 147:113-20. [PMID: 26560410 DOI: 10.1016/j.socscimed.2015.10.058] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 10/06/2015] [Accepted: 10/23/2015] [Indexed: 10/22/2022]
Abstract
RATIONALE Perceived risk for health problems such as cancer is a central construct in many models of health decision making and a target for behavior change interventions. However, some portion of the population actively avoids cancer risk information. The prevalence of, explanations for, and consequences of such avoidance are not well understood. OBJECTIVE We examined the prevalence and demographic and psychosocial correlates of cancer risk information avoidance preference in a nationally representative sample. We also examined whether avoidance of cancer risk information corresponds with avoidance of cancer screening. RESULTS Based on our representative sample, 39% of the population indicated that they agreed or strongly agreed that they would "rather not know [their] chance of getting cancer." This preference was stronger among older participants, female participants, and participants with lower levels of education. Preferring to avoid cancer risk information was stronger among participants who agreed with the beliefs that everything causes cancer, that there's not much one can do to prevent cancer, and that there are too many recommendations to follow. Finally, the preference to avoid cancer risk information was associated with lower levels of screening for colon cancer. CONCLUSION These findings suggest that cancer risk information avoidance is a multi-determined phenomenon that is associated with demographic characteristics and psychosocial individual differences and also relates to engagement in cancer screening.
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Affiliation(s)
| | | | | | | | - Erika A Waters
- Washington University at Saint Louis School of Medicine, USA
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Ferrer RA, Green PA, Barrett LF. Affective science perspectives on cancer control: strategically crafting a mutually beneficial research agenda. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2015; 10:328-45. [PMID: 25987511 PMCID: PMC4438787 DOI: 10.1177/1745691615576755] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Cancer control research involves the conduct of basic and applied behavioral and social sciences to reduce cancer incidence, morbidity, and mortality and improve quality of life. Given the importance of behavior in cancer control, fundamental research is necessary to identify psychological mechanisms underlying cancer risk, prevention, and management behaviors. Cancer prevention, diagnosis, and treatment are often emotionally laden. As such, affective science research to elucidate questions related to the basic phenomenological nature of emotion, stress, and mood is necessary to understand how cancer control can be hindered or facilitated by emotional experiences. To date, the intersection of basic affective science research and cancer control remains largely unexplored. The goal of this article is to outline key questions in the cancer control research domain that provide an ecologically valid context for new affective science discoveries. We also provide examples of ways in which basic affective discoveries could inform future cancer prevention and control research. These examples are not meant to be exhaustive or prescriptive but instead are offered to generate creative thought about the promise of a cancer research context for answering basic affective science questions. Together, these examples provide a compelling argument for fostering collaborations between affective and cancer control scientists.
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Affiliation(s)
- Rebecca A Ferrer
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Paige A Green
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Lisa Feldman Barrett
- Department of Psychology, Northeastern University, Boston, MA Department of Psychiatry and the Martinos Center for Biomedical Imaging, Massachusetts General Hospital/Harvard Medical School, Boston
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Kiviniemi MT, Brown-Kramer CR. Planning versus action: Different decision-making processes predict plans to change one's diet versus actual dietary behavior. J Health Psychol 2015; 20:556-68. [PMID: 25903243 DOI: 10.1177/1359105315576605] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Most health decision-making models posit that deciding to engage in a health behavior involves forming a behavioral intention which then leads to actual behavior. However, behavioral intentions and actual behavior may not be functionally equivalent. Two studies examined whether decision-making factors predicting dietary behaviors were the same as or distinct from those predicting intentions. Actual dietary behavior was proximally predicted by affective associations with the behavior. By contrast, behavioral intentions were predicted by cognitive beliefs about behaviors, with no contribution of affective associations. This dissociation has implications for understanding individual regulation of health behaviors and for behavior change interventions.
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Brown-Kramer CR, Kiviniemi MT. Affective associations and cognitive beliefs relate to individuals’ decisions to perform testicular or breast self-exams. J Behav Med 2015; 38:664-72. [DOI: 10.1007/s10865-015-9641-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 03/30/2015] [Indexed: 10/23/2022]
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Rondonotti E, Pennazio M. Colorectal polyp diagnosis: results with the second-generation colon capsule (CCE-2). Colorectal Dis 2015; 17 Suppl 1:31-5. [PMID: 25511859 DOI: 10.1111/codi.12819] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- E Rondonotti
- Gastroenterology Unit, Ospedale Valduce, Como, Italy
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Kiviniemi MT, Ellis EM. Worry about skin cancer mediates the relation of perceived cancer risk and sunscreen use. J Behav Med 2013; 37:1069-74. [PMID: 24072431 DOI: 10.1007/s10865-013-9538-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 09/04/2013] [Indexed: 10/26/2022]
Abstract
Preventive health behaviors are believed to be motivated in part by a person's perception of risk for a particular health problem. Risk contains a cognitive component, beliefs about the chances of a health problem occurring, and an affective component, fear or worry about the health problem. Although both have been shown to influence behavior, the nature of their interrelation as an influence on behavior has not been examined. Data from the 2005 Health Information National Trends Survey, a US nationally-representative telephone survey was analyzed. Participants reported perceived absolute and comparative risk for skin cancer, feelings of worry about skin cancer, and sunscreen use behavior. Analyses examined main effects models for the relation between perceived risk, worry, and sunscreen use, as well as both moderated and mediated models. For both absolute and comparative risk, the relation between cognitively-based perceived risk for skin cancer and sunscreen use was fully mediated by feelings of worry, as evidenced by significant direct effects of worry (bs > 0.046, ps < 0.01) and indirect effects of risk through worry (bs > 0.19, ps < 0.01). When worry was included in the models, direct effects of risk perceptions were non-significant (bs < 0.11, ps < 0.10). No evidence was found for moderated effects of worry on the relation between risk and behavior. While cognitive risk appraisals do influence decision making and may be addressed by interventions, these findings demonstrate that affectively-based risk components play a key role in behavior regulation. Affectively-based risk might be an effective target for interventions and should be incorporated more fully in decision-making models.
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Affiliation(s)
- Marc T Kiviniemi
- Department of Community Health and Health Behavior, University at Buffalo, SUNY, 314 Kimball Tower, 3435 Main Street, Buffalo, NY, 14214, USA,
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