Influence of Family History of Cancer on Engagement in Protective Health Behaviors

Are College Students Interested in Family Health History Education? A Large Needs Assessment Survey Study

Family health history (FHH) is an essential foundation for personalized disease prevention. As the incidence of early-onset chronic diseases is increasing among college students, it is important to provide them with the education required to learn about their FHH. This study aimed to assess college students' interest in receiving FHH education, preferred topics, and desired learning methods. We invited college students to complete an online survey from a large research-intensive university. A total of 2276 college students completed the survey. Nearly half of the participants self-identified as non-Hispanic white (45.5%). Slightly more than half of the sample (53.9%) were not interested in receiving FHH education mainly due to low prioritization. Among those who expressed interest in obtaining FHH education, the three most desired learning topics were the ability to interpret FHH information (76.1%), the application of FHH in disease prevention (72.0%), and FHH information collection strategies (63.6%). Computer-based learning (51.1%) was the most preferred educational method. Moreover, females, older individuals, those who have FHH in first-degree relatives, and participants who were members of racial and ethnic groups showed greater interests in receiving FHH education (ps < 0.05). Strategies to promote college students' awareness, collection, and use of FHH are needed.

The Effect of Individual Education on the Participation of Relatives of Cancer Patients in General Health and Cancer Screenings: A One Group Pretest-Post Test Study

Objective: The aim of this study was to evaluate whether or not there were changes in the behaviors of relatives of cancer patients such as learning the warning signs of cancer, engaging in cancer prevention strategies, and participating in screenings after education sessions in the clinic. Methods: This one-group pretest-posttest study was conducted with 238 relatives in a medical oncology clinic in Antalya, Turkey. Individual education sessions were conducted as an intervention, banners were hung about cancer, and general health information on checkups in the form of leaflets were distributed to each relative regarding cancer screenings. Reminder messages were sent to individuals to participate in screenings one and two months after the first interview. The posttest data were collected by phone in the third month. Four questionnaires were prepared based on the literature and national cancer screening standards. The face validity of the tools was evaluated by three experts and 15 relatives who not included as participants. Results: The rate of having a mammography increased from 19.8% to 33.9%, rates of having the fecal occult blood test increased from 16.9% to 23.8%, and rates of having the HPV test increased from 43.5% to 49.6%. The rate of having blood pressure checks within the last 12 months increased from 75.8% to 83.1%, rates of blood cholesterol measurement increased from 68.5% to 79%, and rates of blood glucose measurement increased from 70.2% to 79%. Conclusion: Education provided to the relatives increased participation in screenings.

Two Peas in a Pod? An Exploratory Examination Into Cancer-Related Psychosocial Characteristics and Health Behaviors Among Black Immigrants and African Americans

Introduction. Most studies lump Black immigrants (BIs) and African Americans (AAs) as "Black/African American" during investigation. Such categorization assumes that the sociocultural determinants that influence BIs are the same as for AAs. This study attempts to disentangle the AA and BI subgroups to recognize the differences in cancer-related psychosocial characteristics and health behaviors. Methods. Merged data from the Health Information National Survey (2011-2017) were used. Two groups were created: those who identified as AA and those who identified as AA but were born outside the United States (BI). Between-group differences were assessed with Mann-Whitney U and chi-square tests. Results. Positive communication patterns with health care providers were significantly higher among AAs (M [mean] = 3.41, SD [standard deviation] = 0.68) compared with BIs (M = 3.28, SD = 0.71) (p = .004). A greater proportion of BIs indicated that their health was excellent (14.2%), compared with AAs (7.9%). AAs reported higher cancer family history (75.1%) than BIs (46.5%). More AAs had smoked at least 100 cigarettes in their lifetime (41.5%) than BIs (16.7%). BIs consumed significantly more fruits each day (M = 2.77, SD = 1.43) than AAs (M = 2.40, SD = 1.44) (p < .001). BIs also reported more physical activity (M = 2.62, SD = 2.15) than AAs (M = 2.37, SD = 2.18) (p = .030). AA women were more likely to have had a pap smear test (M = 2.07, SD = 1.44) compared with BI women (M = 1.73, SD = 1.21) (p = .002). Discussion. Evidence suggests the need to disentangle the "Black/African American" ethnic grouping. Lumping the BI populations together with the AAs, who have been in the United States for generations, may limit the ability to uncover and consequently address culturally driven disease prevention efforts and promote understanding of the biological, environmental, and psychosocial risk factors within Black heterogeneous populations.

Preventative Health and Risk Behaviors Among Adolescent Girls With and Without Family Histories of Breast Cancer

PURPOSE

To compare health behaviors (smoking, alcohol use, fruit and vegetable intake, and exercise frequency) and breast self-exam (BSE) between girls with breast cancer family history (BCFH+) and without (BCFH-) and assess associates of behaviors across all girls.

METHODS

A total of 208 BCFH+ girls (11-19 years old), with first- or second-degree relatives with breast cancer or a mother with a BRCA1/2 mutation, and 112 BCFH- peers reported their health behaviors, beliefs, and psychosocial function.

RESULTS

Despite higher BCFH+ girls' greater perceived breast cancer risk, there were no differences between BCFH+ and BCFH- girls on diet, exercise, alcohol initiation, or BSE. BCFH+ girls were slightly more likely to report trying cigarettes (11% vs. 5%, p = .04). In multivariable models with all girls, categorical associations with behaviors included the following: developmental and demographic factors with smoking, alcohol, diet, and exercise; family breast cancer history and experience with smoking, alcohol, and diet; psychosocial factors with smoking; girls perceptions of cancer controllability and mother support for health behaviors with alcohol, diet, exercise, and BSE; and mother behaviors with diet.

CONCLUSIONS

Adolescent girls from BCFH+ families reported similar health behaviors to BCFH- peers, signaling that they are not translating their higher perceived risk into cancer control behaviors. Both uncontrollable (i.e., breast cancer experiences) and modifiable factors relate to health behaviors and warrant further investigation. Results indicate that interventions with teens and parents that target modifiable variables such as controllability perceptions, maternal modeling, and communication may relate to better health behaviors and reduced future breast cancer risk.

Mediators of a physical activity intervention among women with a family history of breast cancer

The current study examined mediators of an efficacious physical activity intervention. Women with a mean age of 42.6 (range 23-61) years and a family history of breast cancer were randomized to either an Internet-based physical activity intervention (n = 28) or an active control condition (n = 27) for three months. Data were collected between November 2010 and August 2011. Hypothesized mediators were examined using a product of coefficients model with bootstrapped standard errors. Significant mediation was observed for both self-efficacy and behavioral processes. Specifically, the regression coefficients of the indirect effects ("ab path": unstandardized effect of the intervention on physical activity that occurred through the mediator) were ab = 38.58 (95% confidence interval [CI]: 8.66-92.76) for self-efficacy, and ab = 42.02 (95% CI: 6.76-104.84) for behavioral processes. Other factors examined in this study, including cognitive processes, decisional balance, and perceived risk of breast cancer, were not statistically significant mediators. Findings suggest that self-efficacy and behavioral processes may be key constructs to use in targeting future physical activity interventions among women with a family history of breast cancer.