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Flood T, Hughes CM, Wilson I, McLaughlin M. Applying the COM-B behaviour model to understand factors which impact 15-16 year old students' ability to protect themselves against acquirement of Human Papilloma virus (HPV) in Northern Ireland, UK. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003100. [PMID: 38630731 PMCID: PMC11023437 DOI: 10.1371/journal.pgph.0003100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 03/18/2024] [Indexed: 04/19/2024]
Abstract
High-risk strains of Human Papillomavirus (HPV) can lead to the development of a number of cancers including cervical, vulvar, penile, anal and oropharyngeal. HPV vaccination programmes offer the HPV vaccine to males and females 12-13 years old in schools throughout the UK. However, knowledge of HPV remains low in post-primary schools. The aim of this study is to capture 15-16 year old students' perceptions regarding the current provision of HPV education, and whether providing HPV education to 15-16 year olds could influence their intention to be vaccinated and/or future sexual health decisions related to HPV. Between 5th November 2021 and 6th May 2022, seven focus groups were conducted with 34 students in post-primary schools in Northern Ireland, United Kingdom. The data was analysed using the COM-B behaviour model to explore the perceived facilitators and barriers impacting students' ability to protect themselves from acquirement of HPV. Students perceived their knowledge of HPV to be poor and supported the addition of comprehensive mandatory HPV education at 15-16 years old when many of them were becoming sexually active. They identified barriers including lack of parental education, school ethos and religion and insufficient education regarding their legal rights to self-consent to HPV vaccination. Students felt that removal of these barriers would lead to safer sexual practices, increased awareness of the importance of HPV screening and increased HPV vaccination uptake. The recommendations provided by students need to be supported by the Education Authority in conjunction with the Department of Health in order to be successfully implemented into the post-primary school curriculum.
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Affiliation(s)
- Terri Flood
- School of Health Sciences, Ulster University, Londonderry, Derry, United Kingdom
| | - Ciara M. Hughes
- School of Health Sciences, Ulster University, Londonderry, Derry, United Kingdom
| | - Iseult Wilson
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, United Kingdom
| | - Marian McLaughlin
- School of Psychology, Ulster University, Londonderry, Derry, United Kingdom
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2
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Myrick JG, Willoughby JF, Francis DB, Noar SM. The Impact of Celebrity and Influencer Illness Disclosures. HEALTH COMMUNICATION 2024:1-4. [PMID: 38594789 DOI: 10.1080/10410236.2024.2326261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
When celebrities, political figures, influencers, or anyone with a large following publicly disclose an illness or die, the news becomes a de facto public health campaign. Until health communicators began studying such disclosures and the effects of the following waves of media coverage, however, it was not known to what extent these events impacted the public. A growing body of research has empirically documented these events and examined the factors that predict which types of audiences are most affected and why. Beyond motivating research opportunities, celebrity and influencer health disclosures or deaths can impact calls to hotlines, views on health-related websites, discussions of related topics on social media, behavioral changes relevant to the disclosure, increased news coverage of celebrity health research, integration of celebrity health narratives into strategic health campaigns, and even policy changes. We provide an overview of research conducted in this area and detail examples of the impact that celebrity health disclosures and studies about those disclosures have had on public discourse and public health.
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Affiliation(s)
| | | | | | - Seth M Noar
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill
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3
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Cho SJ, Tian Y. Celebrity Identification and Reasoned Action: An Integrative Model of the Relationship Between Media Use and Breast Cancer Screening Intention. HEALTH COMMUNICATION 2023:1-10. [PMID: 37733416 DOI: 10.1080/10410236.2023.2258308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
This study investigates the relationship between media use and breast cancer screening intentions by integrating the celebrity identification model and the theory of reasoned action. It tests an integrative model with survey data from 315 U.S. adult women. The study found that media use for breast cancer information was positively associated with parasocial interaction (PSI) and identification with celebrities who have or have had breast cancer; PSI was positively associated with attitudes, descriptive and injunctive norms in breast cancer screening, while identification with celebrities was positively associated with descriptive norms; attitudes, injunctive norms and descriptive norms were positively associated with breast cancer screening intentions. The study supports the mediating effect of PSI, identification, attitudes, and descriptive and injunctive norms on the association between media use and breast cancer prevention intentions.
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Affiliation(s)
- Suahn Jang Cho
- Department of Communication & Media, University of Missouri-St. Louis
| | - Yan Tian
- Department of Communication & Media, University of Missouri-St. Louis
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4
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Batchelor S, Lunnay B, Macdonald S, Ward PR. Extending the sociology of candidacy: Bourdieu's relational social class and mid-life women's perceptions of alcohol-related breast cancer risk. SOCIOLOGY OF HEALTH & ILLNESS 2023; 45:1502-1522. [PMID: 37056162 DOI: 10.1111/1467-9566.13644] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 03/30/2023] [Indexed: 06/19/2023]
Abstract
Alcohol is a modifiable breast cancer risk, increasing risk in a dose-dependent manner. Mid-life women (aged 45-64 years) consume alcohol at higher rates than younger women and this, combined with age, make them a high-risk group for breast cancer. This critical public health problem has a seemingly obvious solution (reduce drinking); however, women do not necessarily know alcohol causes breast cancer, and if they do, reducing consumption is not always possible, or desirable. To innovate public health responses, we employ an interpretative sociological framework 'candidacy' to understand women's perspectives on breast cancer risk relative to alcohol consumption and their social class. Drawing on 50 interviews with Australian mid-life women, our findings reveal the socio-structural determinants of 'candidacy', that mean modifying alcohol consumption for breast cancer prevention is impacted by social class. Utilising Bourdieu's relational capitals, our interpretations show how social class shapes women's ascriptions and enactments of breast cancer candidacy. We offer an important theoretical extension to 'candidacy' by demonstrating more or less fluidity in women's assessment of breast cancer risk according to their agency to adopt breast cancer prevention messages. Understanding the social class possibilities and limitations in women's perceptions of breast cancer risk provides a new opportunity to reduce inequities in breast cancer incidence.
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Affiliation(s)
- Samantha Batchelor
- Research Centre for Public Health, Equity and Human Flourishing, Adelaide Campus, Torrens University, Adelaide, Australia
| | - Belinda Lunnay
- Research Centre for Public Health, Equity and Human Flourishing, Adelaide Campus, Torrens University, Adelaide, Australia
| | - Sara Macdonald
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Paul R Ward
- Research Centre for Public Health, Equity and Human Flourishing, Adelaide Campus, Torrens University, Adelaide, Australia
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Siegenthaler P, Aegerter T, Fahr A. A Longitudinal Study on the Effects of Parasocial Relationships and Breakups With Characters of a Health-Related TV Show on Self-Efficacy and Exercise Behavior: The Case of The Biggest Loser. COMMUNICATION & SPORT 2023; 11:744-769. [PMID: 37426744 PMCID: PMC10326891 DOI: 10.1177/21674795211045039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Overweight is one of the major health-related challenges in industrialized countries and mostly preventable through a healthy diet and regular engagement in physical activity. Health communication practitioners and researchers, therefore, started using the media's persuasive potential by creating entertainment-education (E-E) programs that promote healthy nutrition and exercise. By observing the characters in E-E programs, audience members can learn vicariously and eventually develop personal bonds with them. The current study investigates the effects of parasocial relationships (PSRs) with characters of a health-related E-E show, as well as the impact of parasocial breakups (PSBUs) on health-relevant outcomes. Using the setting of the show The Biggest Loser (TBL), we conducted a quasi-experimental longitudinal field study. Participants (N = 149) watched shortened episodes of the show once a week for 5 weeks. Results showed that PSRs with the reality TV characters did not increase over time and after repeated exposure. Findings furthermore suggest that PSR did not influence self-efficacy perceptions or exercise behavior over time. Parasocial breakup distress intensity was neither related to self-efficacy nor to exercise behavior. Interpretations of these findings and implications for better understanding the effects of PSRs and PSBUs are discussed.
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Affiliation(s)
- Perina Siegenthaler
- Department of Communication and Media Research, University of Fribourg, Fribourg, Switzerland
| | - Tanja Aegerter
- Department of Communication and Media Research, University of Fribourg, Fribourg, Switzerland
| | - Andreas Fahr
- Department of Communication and Media Research, University of Fribourg, Fribourg, Switzerland
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6
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Ward MS, Feldman MJ, Ward BN, Ong V, Brown NJ, Shahrestani S, Yi Yang C, Abraham ME, Paskhover B, Nanda A. Characterizing internet search patterns for neurologic and neurosurgical conditions following celebrity diagnosis. J Neurosurg Sci 2023; 67:523-528. [PMID: 34763394 DOI: 10.23736/s0390-5616.21.05569-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Social media and internet platforms have become significant drivers of mass-information. Highly publicized events, such as John McCain's announcement of his glioblastoma diagnosis, often drive national public interest in medical topics. Improved understanding of the temporality of interest spikes as well as the nature of the information that garners attention from outside the medical community can help inform ways in which the medical community can boost awareness of (and interest in) the field of neurosurgery. We utilized the "explore topics" feature on Google Trends to obtain web, news, and YouTube search data from May 1, 2015, to May 1, 2019 for the terms "glioblastoma," "brain tumor," "stroke," and "multiple sclerosis" to identify periods of visibly increased search interest. Search results for "glioblastoma" showed significantly elevated average interest during the period of July 3-23, 2017, as compared to that generated since this specific time period (42.6 vs. 8.73, P<0.001). This increased search activity therefore directly correlated with John McCain's public announcement of his glioblastoma diagnosis, and a similar search interest spike was evident using the search term "brain tumor" (87.3 vs. 64.2, P<0.001). Search results for "multiple sclerosis" showed - as a result of the online buzz created by Selma Blair's battle with the disease - significantly elevated average interest from October 8, 2018, to October 28, 2018, and February 11, 2019, to March 3, 2019, when compared to the average interest of the remaining time (59 vs. 40.16, P<0.001 and 69 vs. 40.16, P<0.001). Finally, there were no corresponding elevations in YouTube search interest for any of the terms associated with increased interest on Google Trends. Following major events related to the neurological disease of public figures there is an expected rise in Google search interest relevant to these topics. Our findings suggest that there is an optimal window of approximately 2 weeks following each of these events for activist and clinical groups to publicize their desired message, and for the field of neurosurgery and neurological science to increase public awareness regarding specific diseases, with a regression to baseline interest by 4 months following the event.
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Affiliation(s)
- Max S Ward
- Zucker School of Medicine at Hofstra/Northwell, Unit of Neurological Surgery, Manhasset, NY, USA -
| | - Michael J Feldman
- Unit Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Vera Ong
- John H. Burns Medical School, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Nolan J Brown
- Department of Neurological Surgery, University of California, Orange, CA, USA
| | - Shane Shahrestani
- Keck School of Medicine of USC, Department of Neurological Surgery, Los Angeles, CA, USA
- California Institute of Technology, Pasadena, CA, USA
| | - Chen Yi Yang
- Department of Neurological Surgery, University of California, Orange, CA, USA
| | - Mickey E Abraham
- Unit of Neurological Surgery, University of California San Diego, San Diego, CA, USA
| | - Boris Paskhover
- Rutgers New Jersey Medical School, Unit of Otolaryngology, Head and Neck Surgery, Newark, NJ, USA
| | - Anil Nanda
- Rutgers New Jersey Medical School, Neurological Surgery, Newark, NJ, USA
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7
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Koch VG. Medical Decision Making and the Previvor. THE JOURNAL OF CLINICAL ETHICS 2022. [DOI: 10.1086/jce2022332141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Vafeiadis M, Wang W, Baker M, Shen F. Examining the Effects of Celebrity (Vs. Noncelebrity) Narratives on Opioid Addiction Prevention: Identification, Transportation, and the Moderating Role of Personal Relevance. JOURNAL OF HEALTH COMMUNICATION 2022; 27:271-280. [PMID: 35833499 DOI: 10.1080/10810730.2022.2097752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Celebrity disclosures and narratives are popular strategies in health promotion. However, less is known about their joint effects and the mechanisms through which they function. A 2 (narrative type: celebrity vs. layperson) x 2 (personal relevance: low vs. high) online experiment (N = 248) tested the impact of different narrative types in increasing awareness about prescription opioid abuse. Results indicated that a celebrity narrative is more persuasive than its layperson counterpart. Also, personal relevance toward opioid addiction moderated the influence of narrative type. Celebrity narratives evoked more positive attitudes toward opioid prevention and greater behavioral compliance intentions with the recommended action for low-relevance individuals. Transportation and identification mediated the effects of celebrity narratives on participants' issue attitudes and behavioral intentions, but only for low-relevance individuals. Practically, the data suggest that incorporating celebrities in health narratives about opioid addiction prevention facilitates behavioral compliance, especially for individuals to whom a pressing health issue like opioid misuse is currently of low relevance.
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Affiliation(s)
- Michail Vafeiadis
- School of Communication & Journalism, Auburn University, Auburn, Alabama, USA
| | - Weirui Wang
- 2 Department of Communication, Florida International University, North Miami, Florida, USA
| | - Michelle Baker
- 3 Donald P. Bellisario College of Communications, Pennsylvania State University, Pennsylvania, USA
| | - Fuyuan Shen
- Donald P. Bellisario College of Communications, Pennsylvania State University, Pennsylvania, USA
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Varriano B, Porplycia D, Friedman SM. Unhelmeted Injured Cyclists in a Canadian Emergency Department: Cycling Behavior and Attitudes Towards Helmet Use. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221083276. [PMID: 35357244 PMCID: PMC8977697 DOI: 10.1177/00469580221083276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction We seek to characterize unhelmeted injured cyclists presenting to the
emergency department: demographics, cycling behavior, and attitudes towards
cycling safety and helmet use. Methods This was a prospective case series in a downtown teaching hospital. Injured
cyclists presenting to the emergency department were recruited for a
standardized survey if not wearing a helmet at time of injury and over age
18. Exclusion criteria included inability to consent (language barrier,
cognitive impairment) or admission to hospital. Results We surveyed 72 UICs (unhelmeted injured cyclists) with mean age of 34.3 years
(range 18–68, median 30, IQR 15.8 years). Most UICs cycled daily or most
days per week in non-winter months (88.9%, n = 64). Most regarded cycling in
Toronto as somewhat dangerous (44.4%, n = 32) or very dangerous (5.9%, n =
4). Almost all (98.6%, n = 71) had planned to cycle when departing home that
day. UICs reported rarely (11.1%, n = 8) or never (65.3%, n = 47) wearing a
helmet. Reported factors discouraging helmet use included inconvenience
(31.9%, n = 23) and lack of ownership (33.3%, n = 24), but few characterized
helmets as unnecessary (11.1%, n = 7) or ineffective (1.4%, n = 1). Conclusions Unhelmeted injured cyclists were frequent commuter cyclists who generally do
not regard cycling as safe yet choose not to wear helmets for reasons
largely related to convenience and comfort. Initiatives to increase helmet
use should address these perceived barriers, and further explore cyclist
perception regarding risk of injury and death.
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Affiliation(s)
- Brenda Varriano
- Department of Emergency Medicine, University Health Network, Ontario, Canada
- College of Medicine, Central Michigan University, Mount Pleasant, MI, USA
| | - Danielle Porplycia
- Department of Emergency Medicine, University Health Network, Ontario, Canada
- Faculty of Medicine, London Health Sciences Centre, Ontario, Canada
| | - Steven Marc Friedman
- Department of Emergency Medicine, University Health Network, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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10
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Pedrazzani C, Ming C, Bürki N, Caiata-Zufferey M, Chappuis PO, Duquette D, Heinimann K, Heinzelmann-Schwarz V, Graffeo-Galbiati R, Merajver SD, Milliron KJ, Monnerat C, Pagani O, Rabaglio M, Katapodi MC. Genetic Literacy and Communication of Genetic Information in Families Concerned with Hereditary Breast and Ovarian Cancer: A Cross-Study Comparison in Two Countries and within a Timeframe of More Than 10 Years. Cancers (Basel) 2021; 13:cancers13246254. [PMID: 34944873 PMCID: PMC8699808 DOI: 10.3390/cancers13246254] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 12/05/2021] [Accepted: 12/07/2021] [Indexed: 12/16/2022] Open
Abstract
Simple Summary This cross-study comparison uses data collected over 10 years from families living in the US and in Switzerland in order to compare genetic literacy between individuals who had genetic counselling for hereditary breast/ovarian cancer (HBOC) and one or more of their relatives who did not, and examines factors influencing genetic literacy both at the individual and at the family level. The study identifies genetic risk factors and signs of HBOC that remain unclear, even to individuals who had genetic consultation, and highlights the gaps in the dissemination of genetic information. Sensitivity analysis examines the dissemination of genetic information from the individual who had counselling to relatives within the same family that did not. Abstract Examining genetic literacy in families concerned with hereditary breast and ovarian cancer (HBOC) helps understand how genetic information is passed on from individuals who had genetic counseling to their at-risk relatives. This cross-study comparison explored genetic literacy both at the individual and the family level using data collected from three sequential studies conducted in the U.S. and Switzerland over ≥10 years. Participants were primarily females, at-risk or confirmed carriers of HBOC-associated pathogenic variants, who had genetic counselling, and ≥1 of their relatives who did not. Fifteen items assessed genetic literacy. Among 1933 individuals from 518 families, 38.5% had genetic counselling and 61.5% did not. Although genetic literacy was higher among participants who had counselling, some risk factors were poorly understood. At the individual level, genetic literacy was associated with having counselling, ≤5 years ago, higher education, and family history of cancer. At the family level, genetic literacy was associated with having counselling, higher education, and a cancer diagnosis. The findings suggest that specific genetic information should be emphasized during consultations, and that at-risk relatives feel less informed about inherited cancer risk, even if information is shared within families. There is a need to increase access to genetic information among at-risk individuals.
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Affiliation(s)
- Carla Pedrazzani
- Department of Clinical Research, Faculty of Medicine, University of Basel, 4055 Basel, Switzerland; (C.P.); (C.M.)
| | - Chang Ming
- Department of Clinical Research, Faculty of Medicine, University of Basel, 4055 Basel, Switzerland; (C.P.); (C.M.)
| | - Nicole Bürki
- Women’s Clinic, University Hospital Basel, 4031 Basel, Switzerland; (N.B.); (V.H.-S.)
| | - Maria Caiata-Zufferey
- Department of Business Economics, Health and Social Care, University of Applied Science and Arts of Southern Switzerland, 6928 Manno, Switzerland;
| | - Pierre O. Chappuis
- Oncogenetics Unit, Service of Oncology, University Hospital of Geneva, 1205 Geneva, Switzerland;
| | - Debra Duquette
- Feinberg School of Medicine, Northwestern University, Chicago, IL 60208, USA;
| | - Karl Heinimann
- Medical Genetics, University Hospital Basel, 4031 Basel, Switzerland;
| | | | | | - Sofia D. Merajver
- University of Michigan School of Public Health, Ann Arbor, MI 48109, USA;
- Roger Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Kara J. Milliron
- Roger Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA;
| | | | - Olivia Pagani
- Oncology Institute of Southern Switzerland, 6900 Lugano, Switzerland; (R.G.-G.); (O.P.)
| | | | - Maria C. Katapodi
- Department of Clinical Research, Faculty of Medicine, University of Basel, 4055 Basel, Switzerland; (C.P.); (C.M.)
- Correspondence: ; Tel.: +41-061-207-0430
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Powell K, Rakestraw J, Gupta S, Shou W, Lee K, Leitner O. Following NCCN guidelines within one hospital system in the United States: Comparison between cancer centers and genetic counselor utilization. J Genet Couns 2021; 31:356-363. [PMID: 34369024 DOI: 10.1002/jgc4.1495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 11/08/2022]
Abstract
Genetic testing is an instrumental tool used to determine whether an individual has a predisposition to certain cancers. Knowing of a hereditary cancer predisposition may allow a patient and their family to consider high-risk screening or risk-reducing options. Genetic counselors work with physicians to identify patients at increased risk for genetic testing using available guidelines such as those provided by the National Comprehensive Cancer Network (NCCN). Information within one hospital system's cancer registry was used to identify individuals who qualify for genetic testing. This includes patients with a history of cancer of the breast (diagnosis ≤45, triple negative (TN) ≤60, and male), ovaries, colon (diagnosis ≤50), or uterus (diagnosis ≤50). Within this hospital system's registry, there are six cancer centers. Data were collected from cancer centers that utilized genetic counselors (GCs), and cancer centers that did not (non-GC) to determine whether there was a difference in genetic testing rates between GC and non-GC cancer centers. An analysis of 695 patients demonstrated a significantly higher proportion of eligible patients undergoing genetic testing at the GC cancer centers than at the non-GC cancer centers (91.6% versus 68.7%, p < .001). Further analysis of specific cancers showed a significantly higher uptake of genetic testing for eligible patients with colon cancer (90.8% versus 50%, p < .001), breast cancer ≤45 (99.5% versus 86%, p < .001), and ovarian cancer (91.3% versus 62.8%, p < .001) at the GC cancer centers than at the non-GC cancer centers. There was no significant difference in the proportion of testing of TN breast cancer ≤60 or uterine cancer ≤50 between cancer centers. These data suggest that having a GC working within a cancer center increases the ability to identify and offer testing to patients who meet NCCN genetic testing criteria based on their cancer type.
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Affiliation(s)
- Karen Powell
- Genetic Counseling Program, Cone Health Cancer Center, Greensboro, NC, USA
| | - Jonathan Rakestraw
- Oncology Informatics System, Cone Health Cancer Center, Greensboro, NC, USA
| | - Sat Gupta
- Department of Mathematics and Statistics, The University of North Carolina, Greensboro, NC, USA
| | - Wenhao Shou
- Department of Mathematics and Statistics, The University of North Carolina, Greensboro, NC, USA
| | - Kyung Lee
- Informatics and Analytics Program, The University of North Carolina, Greensboro, NC, USA
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12
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Trends and timing of risk-reducing mastectomy uptake in unaffected BRCA1 and BRCA2 carriers in Slovenia. Eur J Surg Oncol 2021; 47:1900-1906. [PMID: 33812767 DOI: 10.1016/j.ejso.2021.03.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/22/2021] [Accepted: 03/19/2021] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES Risk-reducing mastectomy (RRM) is one of key prevention strategies in female carriers of germline BRCA pathogenic/likely pathogenic variants (PV/LPV). We retrospectively investigated the rate, timing and longitudinal trends of bilateral RRM uptake and the incidence and types of cancers among unaffected BRCA carriers who underwent genetic counseling at the Institute of Oncology Ljubljana in Slovenia. MATERIALS AND METHODS Female BRCA carriers without personal history of cancer were included in the study. Clinical data on PV/LPV type, date of RRM, type of reconstructive procedure, occult carcinoma and histopathology results was collected and analyzed. RESULTS Of the 346 unaffected BRCA carriers (median age 43 years, 70% BRCA1, 30% BRCA2, median follow-up 46 months) who underwent genetic testing between October 1999 and December 2019, 25.1% had a RRM (range 35-50 years, median age at surgery 38 years). A significant difference in time to prophylactic surgery between women undergoing RRM only vs. women undergoing RRM combined with risk-reducing salpingo-oophorectomy was observed (22.6 vs 8.7 months, p = 0.0009). We observed an upward trend in the annual uptake in line with the previously observed Angelina Jolie effect. In 5.7% of cases, occult breast cancer was detected. No women developed breast cancer after RRM. Women who did not opt for surgical prevention developed BRCA1/2-related cancers (9.3%). CONCLUSION The uptake of RRM among unaffected BRCA carriers is 25.1% and is similar to our neighboring countries. No women developed breast cancer after RRM while women who did not opt for surgical prevention developed BRCA1/2 related cancers in 9.3% of cases. The reported data may provide meaningful aid for carriers when deciding on an optimal prevention strategy.
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13
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Sajjadi NB, Feldman K, Shepard S, Reddy AK, Torgerson T, Hartwell M, Vassar M. Public Interest and Behavior Change in the United States Regarding Colorectal Cancer Following the Death of Chadwick Boseman: Infodemiology Investigation of Internet Search Trends Nationally and in At-Risk Areas. JMIR INFODEMIOLOGY 2021; 1:e29387. [PMID: 37114199 PMCID: PMC10014084 DOI: 10.2196/29387] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/29/2021] [Accepted: 08/09/2021] [Indexed: 04/29/2023]
Abstract
Background Colorectal cancer (CRC) has the third highest cancer mortality rate in the United States. Enhanced screening has reduced mortality rates; however, certain populations remain at high risk, notably African Americans. Raising awareness among at-risk populations may lead to improved CRC outcomes. The influence of celebrity death and illness is an important driver of public awareness. As such, the death of actor Chadwick Boseman from CRC may have influenced CRC awareness. Objective We sought to assess the influence of Chadwick Boseman's death on public interest in CRC in the United States, evidenced by internet searches, website traffic, and donations to prominent cancer organizations. Methods We used an auto-regressive integrated moving average model to forecast Google searching trends for the topic "Colorectal cancer" in the United States. We performed bivariate and multivariable regressions on state-wise CRC incidence rate and percent Black population. We obtained data from the American Cancer Society (ACS) and the Colon Cancer Foundation (CCF) for information regarding changes in website traffic and donations. Results The expected national relative search volume (RSV) for colorectal cancer was 2.71 (95% CI 1.76-3.66), reflecting a 3590% (95% CI 2632%-5582%) increase compared to the expected values. With multivariable regression, the statewise RSV increased for each percent Black population by 1.09 (SE 0.18, P<.001), with 42% of the variance explained (P<.001). The American Cancer Society reported a 58,000% increase in CRC-related website traffic the weekend following Chadwick Boseman's death compared to the weekend before. The Colon Cancer Foundation reported a 331% increase in donations and a 144% increase in revenue in the month following Boseman's death compared to the month prior. Conclusions Our results suggest that Chadwick Boseman's death was associated with substantial increases in awareness of CRC. Increased awareness of CRC may support earlier detection and better prognoses.
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Affiliation(s)
- Nicholas B Sajjadi
- Office of Medical Student Research College of Osteopathic Medicine Oklahoma State University Center for Health Sciences Tulsa, OK United States
| | - Kaylea Feldman
- Office of Medical Student Research College of Osteopathic Medicine Oklahoma State University Center for Health Sciences Tulsa, OK United States
| | - Samuel Shepard
- Office of Medical Student Research College of Osteopathic Medicine Oklahoma State University Center for Health Sciences Tulsa, OK United States
| | - Arjun K Reddy
- Office of Medical Student Research College of Osteopathic Medicine Oklahoma State University Center for Health Sciences Tulsa, OK United States
| | - Trevor Torgerson
- Office of Medical Student Research College of Osteopathic Medicine Oklahoma State University Center for Health Sciences Tulsa, OK United States
| | - Micah Hartwell
- Office of Medical Student Research College of Osteopathic Medicine Oklahoma State University Center for Health Sciences Tulsa, OK United States
- Department of Psychiatry and Behavioral Sciences College of Osteopathic Medicine Oklahoma State University Center for Health Sciences Tulsa, OK United States
| | - Matt Vassar
- Office of Medical Student Research College of Osteopathic Medicine Oklahoma State University Center for Health Sciences Tulsa, OK United States
- Department of Psychiatry and Behavioral Sciences College of Osteopathic Medicine Oklahoma State University Center for Health Sciences Tulsa, OK United States
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Klein WMP, Ferrer RA, Kaufman AR. How (or Do) People “Think” About Cancer Risk, and Why That Matters. JAMA Oncol 2020; 6:983-984. [DOI: 10.1001/jamaoncol.2020.0170] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Rebecca A. Ferrer
- Behavioral Research Program, National Cancer Institute, Bethesda, Maryland
| | - Annette R. Kaufman
- Behavioral Research Program, National Cancer Institute, Bethesda, Maryland
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15
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Kresovich A, Noar SM. The Power of Celebrity Health Events: Meta-analysis of the Relationship between Audience Involvement and Behavioral Intentions. JOURNAL OF HEALTH COMMUNICATION 2020; 25:501-513. [PMID: 32990198 DOI: 10.1080/10810730.2020.1818148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Audience involvement processes - such as parasocial interaction and identification - may impact an individual's response to celebrity health events, yet to date, no synthesis of the literature exists. The present meta-analysis examined audience involvement processes and their influence on health behavior intentions in the context of celebrity health events. Fourteen studies (N = 5,718) met criteria and were analyzed using meta-analytic procedures. The weighted mean effect of the association between audience involvement and behavioral intentions was r = 0.20 (95% CI, 0.08-0.31, p <.001), indicating a statistically significant small-to-medium-sized positive association. Moderator analyses revealed that celebrity disclosures and events had greater effects than depictions of a media persona with a health condition; greater effects were also found for health behaviors not requiring a medical procedure. Our findings suggest that those who most feel a sense of attachment or affinity for a celebrity or media personae may be the ones who are most likely to modify their behavioral intentions in the wake of a celebrity health event. Results highlight the need for health practitioners to recognize the role of audience involvement in celebrity health events and to better assess how to harness these opportunities to promote healthy behaviors.
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Affiliation(s)
- Alex Kresovich
- Hussman School of Journalism and Media, University of North Carolina , Chapel Hill, NC, USA
| | - Seth M Noar
- Hussman School of Journalism and Media, University of North Carolina , Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina , Chapel Hill, NC, USA
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16
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Vos SC, Sutton J, Gibson CB, Butts CT. Celebrity Cancer on Twitter: Mapping a Novel Opportunity for Cancer Prevention. Cancer Control 2019; 26:1073274819825826. [PMID: 30816059 PMCID: PMC6396054 DOI: 10.1177/1073274819825826] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Social media platforms have the potential to facilitate the dissemination of cancer prevention and control messages following celebrity cancer diagnoses. However, cancer communicators have yet to systematically leverage these naturally occurring interventions on social media as these events are difficult to identify as they are unfolding and little research has analyzed their effect on social media conversations. In this study, we add to the research by analyzing how a celebrity cancer announcement influenced Twitter conversations in terms of the volume of social media messages and the type of content. Over a 9-day period, during which actor Ben Stiller announced that he had been treated for prostate cancer, we collected 1.2 million Twitter messages about cancer. We conducted automated content analyses to identify how often common cancer sites (prostate, breast, colon, or lung) were discussed. Then, we used manual content analysis on a sample of messages to identify cancer continuum content (awareness, prevention, early detection, diagnosis, treatment, survivorship, and end of life). Chi-square analyses were implemented to evaluate changes in cancer site and cancer continuum content before and after the announcement. We found that messages related to prostate cancer increased significantly more than expected for 2 days following Stiller’s announcement. However, the number of cancer messages that described other cancer locations either did not increase or did not increase by the same magnitude. In terms of message content, results showed larger than expected increases in diagnosis messages. These results suggest opportunities to shape social media conversations following celebrity cancer announcements and increase prevention and early detection messages.
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Affiliation(s)
- Sarah C Vos
- 1 Department of Health Management & Policy, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Jeannette Sutton
- 2 Department of Communication, University of Kentucky, Lexington, KY, USA
| | - C Ben Gibson
- 3 Department of Sociology, University of California, Irvine, CA, USA
| | - Carter T Butts
- 3 Department of Sociology, University of California, Irvine, CA, USA
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17
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Myrick JG. An Experimental Test of the Roles of Audience Involvement and Message Frame in Shaping Public Reactions to Celebrity Illness Disclosures. HEALTH COMMUNICATION 2019; 34:1060-1068. [PMID: 29652513 DOI: 10.1080/10410236.2018.1461170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Much research has investigated what happens when celebrities disclose an illness (via media) to the public. While audience involvement (i.e., identification and parasocial relationships) is often the proposed mechanism linking illness disclosures with audience behavior change, survey designs have prevented researchers from understanding if audience involvement prior to the illness disclosure actually predicts post-disclosure emotions, cognitions, and behaviors. Rooted in previous work on audience involvement as well as the Extended Parallel Process Model, the present study uses a national online experiment (N = 1,068) to test how pre-disclosure audience involvement may initiate post-disclosure effects for the message context of skin cancer. The data demonstrate that pre-disclosure audience involvement as well as the celebrity's framing of the disclosure can shape emotional responses (i.e., fear and hope), and that cognitive perceptions of the illness itself also influence behavioral intentions.
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Affiliation(s)
- Jessica Gall Myrick
- a Department of Film/Video and Media Studies, Donald P. Bellisario College of Communications , Pennsylvania State University
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18
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Social Network, Surgeon, and Media Influence on the Decision to Undergo Contralateral Prophylactic Mastectomy. Am J Clin Oncol 2019; 41:519-525. [PMID: 27465657 PMCID: PMC5976223 DOI: 10.1097/coc.0000000000000321] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES The rate of contralateral prophylactic mastectomy (CPM) has risen sharply in the past decade. The current study was designed to examine social network, surgeon, and media influence on patients' CPM decision-making, examining not only who influenced the decision, and to what extent, but also the type of influence exerted. METHODS Patients (N=113) who underwent CPM at 4 Indiana University-affiliated hospitals between 2008 and 2012 completed structured telephone interviews in 2013. Questions addressed the involvement and influence of the social network (family, friends, and nonsurgeon health professionals), surgeon, and media on the CPM decision. RESULTS Spouses, children, family, friends, and health professionals were reported as exerting a meaningful degree of influence on patients' decisions, largely in ways that were positive or neutral toward CPM. Most surgeons were regarded as providing options rather than encouraging or discouraging CPM. Media influence was present, but limited. CONCLUSIONS Patients who choose CPM do so with influence and support from members of their social networks. Reversing the increasing choice of CPM will require educating these influential others, which can be accomplished by encouraging patients to include them in clinical consultations, and by providing patients with educational materials that can be shared with their social networks. Surgeons need to be perceived as having an opinion, specifically that CPM should be reserved for those patients for whom it is medically indicated.
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Drizin JH, Malcarne VL, Schiaffino MK, Wells KJ. College Women's Responses to a Celebrity Health Disclosure. HEALTH COMMUNICATION 2018; 33:1302-1307. [PMID: 28820618 DOI: 10.1080/10410236.2017.1351276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Celebrities can have a powerful influence on people's health-related attitudes and behaviors, often by publicly disclosing their own personal health decisions. In May 2013, Angelina Jolie, an internationally recognized actress, director, and author, wrote an op-ed for the New York Times disclosing her decision to undergo a prophylactic double mastectomy to reduce her risk of breast cancer after learning that she carried the BRCA1 gene mutation. This cross-sectional study examined whether exposure to Angelina Jolie and her mastectomy disclosure and parasocial involvement (PSI) with Angelina Jolie were related to female college students' perceived risk of breast cancer and breast cancer screening intentions. Participants were 198 female undergraduate college students. Data were collected anonymously via an online questionnaire and analyzed using bivariate correlations and hierarchical linear regression analyses. Neither exposure to Angelina and her disclosure nor PSI with Angelina Jolie was related to participants' attitudes or behaviors related to breast cancer. However, having a family history of cancer was associated with more exposure to Angelina Jolie and her disclosure. Findings suggest that exposure to and PSI with a celebrity who has disclosed a health-related message may not be sufficient to motivate young women to change their health-related attitudes and behaviors. Future studies should explore how celebrities disclosing different types of health issues might influence the attitudes and behaviors of young women.
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Affiliation(s)
| | - Vanessa L Malcarne
- a Department of Psychology , San Diego State University
- b SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology
- c University of California , San Diego Moores Cancer Center
| | - Melody K Schiaffino
- c University of California , San Diego Moores Cancer Center
- d Graduate School of Public Health , San Diego State University
| | - Kristen J Wells
- a Department of Psychology , San Diego State University
- b SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology
- c University of California , San Diego Moores Cancer Center
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20
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FANatics: Systematic literature review of factors associated with celebrity worship, and suggested directions for future research. CURRENT PSYCHOLOGY 2018. [DOI: 10.1007/s12144-018-9978-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
AbstractA ‘culture of celebrity’ began to emerge in the twentieth century, profoundly impacting the social world. Recent years have seen the publication of an increasing wealth of literature focusing on people who are enthralled with celebrities – often to the point of obsession – termed ‘celebrity worshippers’. The current paper systematically reviews this literature to gain a comprehensive understanding of the various factors associated with celebrity worship and to identify gaps in the literature. Papers were identified through a systematic literature search and 62 were deemed relevant for inclusion in the review. These provided evidence that celebrity worship may be related to demographic factors (e.g. age); personality factors (e.g. dimensions of the psychoticism-extraversion-neuroticism model, materialism); religiosity; behavioural and cognitive-behavioural factors (e.g. fantasy proneness, obsessive behaviours); feelings about the self or the world (e.g. self-esteem); cognitive factors (e.g. cognitive flexibility, critical thinking); relationships with others (e.g. attachment style, romantic relationship style); attitudes towards the body, eating, and cosmetic surgery; and psychological wellbeing (e.g. depression, anxiety). The results are used to help researchers understand the individual and psychosocial factors associated with celebrity worship, and directions for future research in this area are identified.
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21
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Francis DB. Young Black Men's Information Seeking following Celebrity Depression Disclosure: Implications for Mental Health Communication. JOURNAL OF HEALTH COMMUNICATION 2018; 23:687-694. [PMID: 30111256 DOI: 10.1080/10810730.2018.1506837] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Celebrity health disclosures motivate people to seek information about various health topics. However, limited systematic evaluations exist on effects of celebrity disclosures of mental illness, despite observations that this is a growing phenomenon and have important implications for public health education. Further, research has rarely examined the impact of such disclosures on minority populations. This study sought to understand factors associated with young Black men's information seeking following exposure to a depression disclosure by Scott Mescudi. Mescudi is a well-known Black male hip-hop artist who shared his depression diagnosis and subsequent treatment plans with his fans in October 2016. For this study, I surveyed 182 Black males aged 18-34, 1 month after the disclosure. Fifty percent sought general information about depression, and 16% sought information to ascertain whether they themselves were at risk for depression. Feeling emotional distress following the disclosure and having current depression symptoms were significantly associated with information seeking behaviors. Identification was indirectly related to information seeking through emotional distress. Thus, emotional distress appears to play an important role in information seeking behaviors following celebrity health disclosures. The findings suggest celebrity health disclosures are associated with proactive health behaviors among this sample. Implications of the results for theorization of celebrity health effects and research on mental health communication with young Black men are discussed.
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Affiliation(s)
- Diane B Francis
- a Department of Communication , University of Kentucky , Lexington , Kentucky , USA
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22
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Mao J, Jorm L, Sedrakyan A. Trends in Use of Risk-Reducing Mastectomy in a Context of Celebrity Decisions and Media Coverage: An Observational Study in the United States and Australia. Health Serv Res 2018; 53 Suppl 1:2682-2695. [PMID: 28944955 PMCID: PMC6056602 DOI: 10.1111/1475-6773.12774] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE To examine trends in risk-reducing mastectomy (RRM) and immediate breast reconstruction in New York State and New South Wales, especially before and after Angelina Jolie's announcement of her surgery in 2013. DATA SOURCE Hospital discharge data, 2004-2014. STUDY DESIGN Trends in procedures were assessed using Poisson regression and the Cochrane-Armitage test. DATA EXTRACTION METHODS Extracted using procedure codes. PRINCIPAL FINDINGS There was an increase in RRM procedures after May 2013 in both regions, with a peak during late 2013-early 2014. The average bimonthly RRM procedures were significantly higher after Jolie's announcement than before. CONCLUSIONS In both countries, we found a substantial increase of RRM after Jolie's announcement, highlighting the impact of celebrity health care coverage on preventive surgical choice and the need for decision aids to assist patients.
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Affiliation(s)
- Jialin Mao
- Department of Healthcare Policy and ResearchWeill Cornell Medical CollegeNew YorkNY
| | - Louisa Jorm
- Center for Big Data Research in HealthUniversity of New South WalesSydneyNSWAustralia
| | - Art Sedrakyan
- Department of Healthcare Policy and ResearchWeill Cornell Medical CollegeNew YorkNY
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23
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Crifasi CK, Doucette ML, McGinty EE, Webster DW, Barry CL. Storage Practices of US Gun Owners in 2016. Am J Public Health 2018; 108:532-537. [PMID: 29470124 DOI: 10.2105/ajph.2017.304262] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To examine gun storage practices and factors influencing those practices among gun owners. METHODS We conducted a nationally representative online survey of US gun owners (n = 1444) in 2016 to assess gun storage practices and attitudes, factors influencing storage practices, and groups that might effectively communicate regarding safe storage. We generated descriptive statistics by using cross-tabulations and used logistic regression to estimate characteristics that influenced safe storage practices. RESULTS Forty-six percent of gun owners reported safely storing all of their guns. Factors associated with higher odds of reporting safe storage were having a child in the home (adjusted odds ratio [AOR] = 1.44; 95% confidence interval [CI] = 1.03, 2.03), only owning handguns (AOR = 1.84; 95% CI = 1.24, 2.73), and reporting that storage decisions were influenced by a gun safety course (AOR = 2.05; 95% CI = 1.54, 2.74) or discussions with family members (AOR = 1.39; 95% CI = 1.05, 1.86). Gun owners ranked law enforcement, hunting or outdoors groups, active-duty military, and the National Rifle Association as most effective in communicating safe storage practices. CONCLUSIONS Public health campaigns to promote safe gun storage should consider partnering with groups that garner respect among gun owners for their experience with safe use of guns.
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Affiliation(s)
- Cassandra K Crifasi
- All of the authors are with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Mitchell L Doucette
- All of the authors are with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Emma E McGinty
- All of the authors are with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Daniel W Webster
- All of the authors are with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Colleen L Barry
- All of the authors are with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Okur V, Chung WK. The impact of hereditary cancer gene panels on clinical care and lessons learned. Cold Spring Harb Mol Case Stud 2017; 3:mcs.a002154. [PMID: 29162654 PMCID: PMC5701305 DOI: 10.1101/mcs.a002154] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Mutations in hereditary cancer syndromes account for a modest fraction of all cancers; however, identifying patients with these germline mutations offers tremendous health benefits to both patients and their family members. There are about 60 genes that confer a high lifetime risk of specific cancers, and this information can be used to tailor prevention, surveillance, and treatment. With advances in next-generation sequencing technologies and the elimination of gene patents for evaluating genetic information, we are now able to analyze multiple genes simultaneously, leading to the widespread clinical use of gene panels for germline cancer testing. Over the last 4 years since these panels were introduced, we have learned about the diagnostic yield of testing, the expanded phenotypes of the patients with mutations, and the clinical utility of genetic testing in patients with cancer and/or without cancer but with a family history of cancer. We have also experienced challenges including the large number of variants of unknown significance (VUSs), identification of somatic mutations and need to differentiate these from germline mutations, technical issues with particular genes and mutations, insurance coverage and reimbursement issues, lack of access to data, and lack of clinical management guidelines for newer and, especially, moderate and low-penetrance genes. The lessons learned from cancer genetic testing panels are applicable to other clinical areas as well and highlight the problems to be solved as we advance genomic medicine.
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Affiliation(s)
- Volkan Okur
- Division of Molecular Genetics, Department of Pediatrics, Columbia University Medical Center, New York, New York 10032, USA
| | - Wendy K Chung
- Division of Molecular Genetics, Department of Pediatrics, Columbia University Medical Center, New York, New York 10032, USA; .,Department of Medicine, Columbia University Medical Center, New York, New York 10032, USA
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25
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The impact of “Be Clear on Cancer” campaign on breast care services provided by a specialist oncoplastic unit – A retrospective case control study. Int J Surg 2017; 47:54-60. [DOI: 10.1016/j.ijsu.2017.09.056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 09/15/2017] [Accepted: 09/18/2017] [Indexed: 11/23/2022]
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26
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Han X, Jemal A. Recent Patterns in Genetic Testing for Breast and Ovarian Cancer Risk in the U.S. Am J Prev Med 2017; 53:504-507. [PMID: 28669566 DOI: 10.1016/j.amepre.2017.04.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 04/06/2017] [Accepted: 04/17/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Mutations in BRCA genes are strongly associated with increased risk of breast and ovarian cancer, and it is recommended that women at high risk for these mutations be referred for genetic counseling and testing. The Affordable Care Act (ACA) provision implemented in 2010 eliminated cost sharing for BRCA genetic testing for privately insured women with family history of BRCA-related cancers. METHODS Using a nationally representative sample from the National Health Interview Survey, this study examined trends in genetic testing for breast and ovarian cancer risk from 2005 to 2015 among women by family history and insurance status. To assess the impact of the ACA provision, a difference-in-differences strategy was used to compare changes in genetic testing after ACA implementation between women with a family history of breast or ovarian cancer and those with a family history of other cancers, stratified by insurance type. Analyses were conducted in 2016. RESULTS Genetic testing for breast and ovarian cancer risk increased among women with private or public insurance, but not among uninsured women. Among privately insured women, those with family history of breast or ovarian cancer experienced a net increase of 2.9 percentage points (p=0.001) over those with a family history of other cancers, but no significant difference was observed among women with public insurance, suggesting a positive effect of the ACA provision. CONCLUSIONS This study underscores the continued need to improve access to care for all populations. Future work should monitor the impact of policy on genetic testing among the high-risk population.
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Affiliation(s)
- Xuesong Han
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia.
| | - Ahmedin Jemal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
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Vicari S. Twitter and Non-Elites: Interpreting Power Dynamics in the Life Story of the (#)BRCA Twitter Stream. SOCIAL MEDIA + SOCIETY 2017; 3:2056305117733224. [PMID: 29278246 PMCID: PMC5731555 DOI: 10.1177/2056305117733224] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In May 2013 and March 2015, actress Angelina Jolie wrote in the New York Times about her choice to undergo preventive surgery. In her two op-eds, she explained that - as a carrier of the BRCA1 gene mutation - preventive surgery was the best way to lower her heightened risk of developing breast and ovarian cancer. By applying a digital methods approach to BRCA-related tweets from 2013 and 2015, before, during, and after the exposure of Jolie's story, this study maps and interprets Twitter discursive dynamics at two time points of the BRCA Twitter stream. Findings show an evolution in curation and framing dynamics occurring between 2013 and 2015, with individual patient advocates replacing advocacy organizations as top curators of BRCA content and coming to prominence as providers of specialist illness narratives. These results suggest that between 2013 and 2015, Twitter went from functioning primarily as an organization-centered news reporting mechanism, to working as a crowdsourced specialist awareness system. This article advances a twofold contribution. First, it points at Twitter's fluid functionality for an issue public and suggests that by looking at the life story-rather than at a single time point-of an issue-based Twitter stream, we can track the evolution of power roles underlying discursive practices and better interpret the emergence of non-elite actors in the public arena. Second, the study provides evidence of the rise of activist cultures that rely on fluid, non-elite, collective, and individual social media engagement.
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28
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Chung JE. Retweeting in health promotion: Analysis of tweets about Breast Cancer Awareness Month. COMPUTERS IN HUMAN BEHAVIOR 2017. [DOI: 10.1016/j.chb.2017.04.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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29
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Jain P, Pandey US, Roy E. Perceived Efficacy and Intentions Regarding Seeking Mental Healthcare: Impact of Deepika Padukone, A Bollywood Celebrity's Public Announcement of Struggle with Depression. JOURNAL OF HEALTH COMMUNICATION 2017; 22:713-720. [PMID: 28759348 DOI: 10.1080/10810730.2017.1343878] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The current research examines the impact of Deepika Padukone's (one of the most popular Bollywood celebrities) public announcement of struggle with depression on people's perceived efficacy and intentions to seek help for mental healthcare. A survey conducted with 206 participants from India, the country with the highest depression rates in the world, revealed that parasocial interaction with the celebrity mediated the effect of exposure on intentions and efficacy perceptions regarding seeking mental healthcare. Our study expands the research on celebrity influence on health conditions in an international realm and in a mental health context. The findings have immense practical implications and may raise awareness about mental health in India given the popularity and reach of Bollywood among audiences in India and beyond, the level of stigmatization attached to mental health issues in India, and the lack of available resources for care. Theoretically, the study explores processes and effects of involvement with a celebrity and discusses potential implications for the behaviors related to health.
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Affiliation(s)
- Parul Jain
- a Scripps College of Communication , Ohio University , Athens , Ohio , USA
| | - Uma Shankar Pandey
- b Department of Journalism and Mass Communication , Surendranath College for Women , Kolkata , India
| | - Enakshi Roy
- a Scripps College of Communication , Ohio University , Athens , Ohio , USA
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Lee J, Kim S, Kang E, Park S, Kim Z, Lee MH. Influence of the Angelina Jolie Announcement and Insurance Reimbursement on Practice Patterns for Hereditary Breast Cancer. J Breast Cancer 2017; 20:203-207. [PMID: 28690658 PMCID: PMC5500405 DOI: 10.4048/jbc.2017.20.2.203] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 04/25/2017] [Indexed: 11/30/2022] Open
Abstract
Lack of awareness, the stigma of carrying a genetic mutation, and economic factors are barriers to acceptance of BRCA genetic testing or appropriate risk management. We aimed to investigate the influence of Angelina Jolie's announcement of her medical experience and also health insurance reimbursement for BRCA gene testing on practice patterns for hereditary breast and ovarian cancer (HBOC). A survey regarding changes in practice patterns for HBOC before and after the announcement was conducted online. The rate of BRCA gene testing was obtained from the National Health Insurance Review and Assessment Service database. From May to August 2016, 70 physicians responded to the survey. Genetic testing recommendations and prophylactic management were increased after the announcement. Risk-reducing salpingo-oophorectomy and contralateral prophylactic mastectomy was significantly increased in BRCA carriers with breast cancer. The BRCA testing rate increased annually. Health insurance and a celebrity announcement were associated with increased genetic testing.
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Affiliation(s)
- Jihyoun Lee
- Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Sungwon Kim
- Department of Surgery, Daerim St. Mary's Hospital, Seoul, Korea
| | - Eunyoung Kang
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Suyeon Park
- Department of Biostatistics, Soonchunhyang University College of Medical Sciences, Seoul, Korea
| | - Zisun Kim
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Min Hyuk Lee
- Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea
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Familial breast cancer: Genetic counseling over time, including patients´ expectations and initiators considering the Angelina Jolie effect. PLoS One 2017; 12:e0177893. [PMID: 28542378 PMCID: PMC5444628 DOI: 10.1371/journal.pone.0177893] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 05/04/2017] [Indexed: 11/19/2022] Open
Abstract
Purpose The German Consortium for hereditary breast/ovarian cancer (GC-HBOC) aims for nationwide access to professional, individualized yet structured care for families at high risk. The identification of such families remains key for optimal care. Our study evaluates counselees’ characteristics, referral practices, expectations and motivations in respect to their first genetic consultation. The impact of the Angelina Jolie Effect (AJE) was prospectively assessed. Methods All counselees could participate through a questionnaire. Groups were built in respect to neoadjuvant chemotherapy (FT) and before/after AJE. Results The 917 (88.5%) counselees (FT: 8.2%) were on average female (97.3%), with a mean age of 44.6, had children (71.9%), higher education (88%), personal (46.4%) or at least one first-degree relative (74.6%) with BC/OC or known BRCA1/2 mutation (11.8%), were in a relationship (76.1%), and living in a village (40.7%). The AJE is associated with significantly fewer cancelations (p = 0.005), more attendance among men (4.2% vs. 0.8%, p = 0.002), and people with familial BRCA1/2 (14.8% vs. 7.5%, p = 0.003). The majority seek information regarding their cancer risk (83%) or relatives’ risk (74.8%), HBOC (69.1%), and surveillance programs for themselves (66.6%) or relatives (60.6%). Conclusion Enhanced media awareness of genetic cancer motivates patients, including other patient groups. A higher number of participants, including more men, are attending GC due to the AJE. In terms of the rising complexity of genetic testing, the analysis of patients’ expectations and initiators for GC suggests that there is an urgent need to develop to participate motivation analysis. The factors revealed as impediments to accessing GC-HBOC guide recommendations to optimize access to genetic counseling. Medical educational programs for primary gynecologists and families at risk might be options to reach more participants.
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