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Greene NK, Dean D, Han PKJ. Patient-Provider Discussions About Alcohol Use by Cancer History. Am J Prev Med 2024; 67:46-54. [PMID: 38479566 DOI: 10.1016/j.amepre.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/01/2024] [Accepted: 03/03/2024] [Indexed: 04/09/2024]
Abstract
INTRODUCTION The U.S. Preventive Services Task Force recommends that all adults be screened for alcohol use and those with hazardous use be provided a brief discussion. However, it is unclear to what extent healthcare providers screen for and discuss alcohol use with cancer survivors. METHODS Frequency and content of alcohol prescreening and provider discussion about alcohol use was examined comparing cancer survivors and non-cancer controls in the 2015-2019 National Survey on Drug Use and Health. Multivariable Poisson regression with robust variance and complex survey procedures were used to estimate prevalence ratios (PR) adjusted for demographic characteristics. Data were analyzed in 2022. RESULTS The prevalence of alcohol prescreening in a healthcare setting (78.4% vs 74.3%; PR: 1.05 [95% CI: 1.03-1.08]) and self-report of an in-person discussion about alcohol use with a healthcare provider (58.7% vs 55.0%; PR: 1.07 [95% CI: 1.03-1.10]) was higher among cancer survivors compared with non-cancer controls. Among those who had a discussion, the prevalence of being asked about drinking quantity was higher among cancer survivors compared with non-cancer controls (PR: 1.05 [95% CI: 1.02-1.08]). Among cancer survivors who reported usually consuming 3+ drinks per day in the past 30 days, only 15% (95% CI: 10.8-20.5) reported that a healthcare provider advised them to cut down on their drinking. CONCLUSIONS Cancer survivors are being screened for alcohol use, but heavier users are infrequently advised by healthcare providers to reduce their consumption.
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Affiliation(s)
- Naomi K Greene
- Health Behaviors Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland.
| | - David Dean
- Health Behaviors Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland
| | - Paul K J Han
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland
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Kokole D, Ferreira-Borges C, Galea G, Tran A, Rehm J, Neufeld M. Public awareness of the alcohol-cancer link in the EU and UK: a scoping review. Eur J Public Health 2023; 33:1128-1147. [PMID: 37802887 PMCID: PMC10710347 DOI: 10.1093/eurpub/ckad141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Alcohol increases cancer risk, but less is known about public awareness of this link. This scoping review summarizes recent findings on the public awareness of alcohol as a cancer risk factor in European Union and UK. METHODS Four databases (Web of Science, MEDLINE, PsycInfo, CINAHL) were searched for papers containing data on awareness of alcohol as cancer risk factor in EU or UK published between January 2017 and December 2022, and complemented with grey literature searches. RESULTS In total, 45 studies were included covering 18 EU countries (Austria, Belgium, Cyprus, Czechia, Denmark, Finland, France, Germany, Hungary, Ireland, Italy, Netherlands, Poland, Romania, Slovakia, Slovenia, Spain, Sweden) and UK, presenting data collected between 2009 and 2022. Studies covered general population (17 studied a nationally representative sample), women, health professionals, patients and young people. Awareness of alcohol causing cancer in general was higher and studied more often than awareness of alcohol's impact on specific cancers. Among the EU general population, awareness of the link between alcohol and breast cancer ranged between 10% and 20%, head and neck cancer 15-25%, colorectal and oesophagus cancer 15-45% and liver cancer 40%. Awareness was higher among young people and specialized health professions and lower among women (the latter specifically for the breast cancer). CONCLUSIONS While awareness rates varied depending on the exact question wording, many studies showed low awareness of the alcohol-cancer link, especially for specific types such as breast and colon cancer. Public should be better informed about alcohol consumption-related cancer risk.
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Affiliation(s)
- Daša Kokole
- WHO Regional Office for Europe, UN City, Copenhagen, Denmark
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | | | - Gauden Galea
- WHO Regional Office for Europe, UN City, Copenhagen, Denmark
| | - Alexander Tran
- WHO Regional Office for Europe, UN City, Copenhagen, Denmark
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jürgen Rehm
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, World Health Organization/Pan American Health Organization Collaborating Centre, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
- Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
| | - Maria Neufeld
- WHO Regional Office for Europe, UN City, Copenhagen, Denmark
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King AJ, Dunbar NM, Margolin D, Chunara R, Tong C, Jih-Vieira L, Matsen CB, Niederdeppe J. Global prevalence and content of information about alcohol use as a cancer risk factor on Twitter. Prev Med 2023; 177:107728. [PMID: 37844803 PMCID: PMC10872596 DOI: 10.1016/j.ypmed.2023.107728] [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: 07/27/2023] [Revised: 09/29/2023] [Accepted: 10/13/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVES Alcohol use is a major risk factor for several forms of cancer, though many people have limited knowledge of this link. Public health communicators and cancer advocates desire to increase awareness of this link with the long-term goal of reducing cancer burden. The current study is the first to examine the prevalence and content of information about alcohol use as a cancer risk on social media internationally. METHODS We used a three-phase process (hashtag search, dictionary-based auto-identification of content, and human coding of content) to identify and evaluate information from Twitter posts between January 2019 and December 2021. RESULTS Our hashtag search retrieved a large set of cancer-related tweets (N = 1,122,397). The automatic search process using an alcohol dictionary identified a small number of messages about cancer that also mentioned alcohol (n = 9061, 0.8%), a number that got small after adjusting for human coded estimates of the dictionary precision (n = 5927, 0.5%). When cancer-related messages also mentioned alcohol, 82% (n = 1003 of 1225 examined through human coding) indicated alcohol use as a risk factor. Coding found rare instances of problematic information (e.g., promotion of alcohol, misinformation) in messages about alcohol use and cancer. CONCLUSIONS Few social media messages about cancer types that can be linked to alcohol mention alcohol as a cancer risk factor. If public health communicators and cancer advocates want to increase knowledge and understanding of alcohol use as a cancer risk factor, efforts will need to be made on social media and through other communication platforms to increase exposure to this information over time.
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Affiliation(s)
- Andy J King
- Cancer Control & Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA; Department of Communication, University of Utah, Salt Lake City, UT, USA.
| | - Natalie M Dunbar
- Greenlee School of Journalism and Communication, Iowa State University, Ames, IA, USA
| | - Drew Margolin
- Department of Communication, Cornell University, Ithaca, NY, USA
| | - Rumi Chunara
- Department of Biostatistics, New York University, New York City, NY, USA; Department of Computer Science & Engineering, New York University, New York City, NY, USA
| | - Chau Tong
- Department of Communication, Cornell University, Ithaca, NY, USA
| | - Lea Jih-Vieira
- Department of Communication, Cornell University, Ithaca, NY, USA
| | - Cindy B Matsen
- Cancer Control & Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA; Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Jeff Niederdeppe
- Department of Communication, Cornell University, Ithaca, NY, USA; Jeb E. Brooks School of Public policy, Cornell University, Ithaca, NY, USA
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Grigg J, Manning V, Lockie D, Giles M, Bell RJ, Stragalinos P, Bernard C, Greenwood CJ, Volpe I, Smith L, Bragge P, Lubman DI. A brief intervention for improving alcohol literacy and reducing harmful alcohol use by women attending a breast screening service: a randomised controlled trial. Med J Aust 2023. [PMID: 37247850 DOI: 10.5694/mja2.51991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 05/31/2023]
Abstract
OBJECTIVES To assess the effectiveness of a brief alcohol intervention for improving awareness of alcohol as a breast cancer risk factor, improving alcohol literacy, and reducing alcohol consumption by women attending routine breast screening. DESIGN Single-site, double-blinded randomised controlled trial. SETTING Maroondah BreastScreen (Eastern Health, Melbourne), part of the national breast cancer screening program. PARTICIPANTS Women aged 40 years or more, with or without a history of breast cancer and reporting any alcohol consumption, who attended the clinic for routine mammography during 5 February - 27 August 2021. INTERVENTION Active arm: animation including brief alcohol intervention (four minutes) and lifestyle health promotion (three minutes). CONTROL ARM lifestyle health promotion only. MAJOR OUTCOME MEASURE Change in proportion of women who identified alcohol use as a clear risk factor for breast cancer (scaled response measure). RESULTS The mean age of the 557 participants was 60.3 years (standard deviation, 7.7 years; range, 40-87 years); 455 had recently consumed alcohol (82%). The proportions of participants aware that alcohol use increased the risk of breast cancer were larger at four weeks than at baseline for both the active intervention (65% v 20%; odds ratio [OR], 41; 95% confidence interval [CI], 18-97) and control arms of the study (38% v 20%; OR, 4.9; 95% CI, 2.8-8.8), but the change over time was greater for the active intervention arm (arm × time: P < 0.001). Alcohol literacy also increased to a greater extent in the active than the control arm, but alcohol consumption did not significantly change in either arm. CONCLUSION A tailored brief alcohol intervention for women attending breast screening was effective for improving awareness of the increased breast cancer risk associated with alcohol use and alcohol literacy more broadly. Such interventions are particularly important given the rising prevalence of risky drinking among middle-aged and older women and evidence that even very light alcohol consumption increases breast cancer risk. REGISTRATION ClinicalTrials.gov, NCT04715516 (prospective; 20 January 2021).
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Affiliation(s)
- Jasmin Grigg
- Turning Point, Eastern Health, Melbourne, VIC
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC
| | - Victoria Manning
- Turning Point, Eastern Health, Melbourne, VIC
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC
| | - Darren Lockie
- Maroondah BreastScreen, Eastern Health, Melbourne, VIC
| | | | | | - Peta Stragalinos
- Turning Point, Eastern Health, Melbourne, VIC
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC
| | - Chloe Bernard
- Turning Point, Eastern Health, Melbourne, VIC
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC
| | - Christopher J Greenwood
- Deakin University, Geelong, VIC
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC
| | - Isabelle Volpe
- Turning Point, Eastern Health, Melbourne, VIC
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC
| | - Liam Smith
- Monash Sustainable Development Institute, Monash University, Melbourne, VIC
| | - Peter Bragge
- Monash Sustainable Development Institute, Monash University, Melbourne, VIC
| | - Dan I Lubman
- Turning Point, Eastern Health, Melbourne, VIC
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC
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Manthey J, Kokole D, Riedel-Heller S, Rowlands G, Schäfer I, Schomerus G, Soellner R, Kilian C. Improving alcohol health literacy and reducing alcohol consumption: recommendations for Germany. Addict Sci Clin Pract 2023; 18:28. [PMID: 37161561 PMCID: PMC10169338 DOI: 10.1186/s13722-023-00383-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 04/24/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Although the detrimental health effects of alcohol are well established, consumption levels are high in many high-income countries such as Germany. Improving alcohol health literacy presents an integrated approach to alcohol prevention and an important complement to alcohol policy. Our aim was to identify and prioritize measures to enhance alcohol health literacy and hence to reduce alcohol consumption, using Germany as an example. METHODS A series of recommendations for improving alcohol health literacy were derived from a review of the literature and subsequently rated by five experts. Recommendations were rated according to their likely impact on enhancing (a) alcohol health literacy and (b) reducing alcohol consumption. Inter-rater agreement was assessed using a two-way intra-class correlation coefficient (ICC). RESULTS Eleven recommendations were established for three areas of action: (1) education and information, (2) health care system, and (3) alcohol control policy. Education and information measures were rated high to increase alcohol health literacy but low to their impact on alcohol consumption, while this pattern was reversed for alcohol control policies. The ratings showed good agreement (ICC: 0.85-0.88). CONCLUSIONS Improving alcohol health literacy and reducing alcohol consumption should be considered complementary and become part of a comprehensive alcohol strategy to curb the health, social, and economic burden of alcohol.
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Affiliation(s)
- Jakob Manthey
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany.
- Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany.
| | - Daša Kokole
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, POB 616, 6200 MD, Maastricht, The Netherlands
| | - Steffi Riedel-Heller
- Public Health Sciences Institute, Campus for Ageing & Vitality, Westgate Rd, Newcastle Upon Tyne, NE4 6BE, UK
| | - Gill Rowlands
- Institute of Social Medicine, Medical Faculty, Occupational Health and Public Health (ISAP), University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Ingo Schäfer
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
| | - Georg Schomerus
- Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany
| | - Renate Soellner
- Institute for Psychology, University of Hildesheim, Universitätsplatz 1, 34414, Hildesheim, Germany
| | - Carolin Kilian
- Centre for Addiction and Mental Health (CAMH), Institute for Mental Health Policy Research (IMHPR), 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
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Jiang K, Wang Y, Yu Z, Feng Z, Huang Z. The use of car safety seats for children in China: A questionnaire survey based on the theory of planned behavior. TRAFFIC INJURY PREVENTION 2023; 24:414-422. [PMID: 37052991 DOI: 10.1080/15389588.2023.2193279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVE The purpose of this study was to analyze the psychological characteristics underlying Chinese parents' behaviors in using child car seats and to understand their decision-making processes. Based on the theory of planned behavior (TPB), three extended variables of perceived accident severity, perceived benefits, and perceived barriers were introduced. From the perspective of social psychology, the psychological factors that influence parents' use of child car seats and their interrelationships were explored. METHODS A questionnaire was designed to collect data, including information on demographic characteristics, basic components of the TPB, and relevant extension variables. Using on online survey, 585 valid questionnaires were collected. Structural equation modeling was used to calibrate the data, and multiple group analysis was performed on the demographic variables. RESULTS The extended TPB can effectively explain and predict parents' behaviors when using children's car seats. The results of the model show that parents' positive attitudes toward child safety seats (CSSs), others' recognition of their own use and perceptual control of the use of CSSs increase their willingness to use CSSs. Parents' willingness to use has a positive impact on the use of CSSs. Additionally, for the three extended variables introduced, perceived benefit significantly promoted parental intention and behavior to use CSS for children; perceived barriers significantly reduced parental use of CSS; and perceived accident severity had no significant effect on parental use of CSS. CONCLUSIONS This study established the validity of the extended TPB model in predicting parents' behaviors in using car seats for their children. In addition, the current findings may provide a theoretical basis for policy development to promote CSS use.
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Affiliation(s)
- Kang Jiang
- School of Automobile and Traffic Engineering, Hefei University of Technology, Hefei, P.R. China
| | - Yu Wang
- School of Automobile and Traffic Engineering, Hefei University of Technology, Hefei, P.R. China
| | - Zhenhua Yu
- School of Mechanical Engineering, Hefei University of Technology, Hefei, P.R. China
| | - Zhongxiang Feng
- School of Automobile and Traffic Engineering, Hefei University of Technology, Hefei, P.R. China
- School of Transportation, Southeast University, Nanjing, P.R. China
| | - Zhipeng Huang
- School of Automobile and Traffic Engineering, Hefei University of Technology, Hefei, P.R. China
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Seidenberg AB, Wiseman KP, Klein WMP. Do Beliefs about Alcohol and Cancer Risk Vary by Alcoholic Beverage Type and Heart Disease Risk Beliefs? Cancer Epidemiol Biomarkers Prev 2023; 32:46-53. [PMID: 36453075 PMCID: PMC9839574 DOI: 10.1158/1055-9965.epi-22-0420] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/18/2022] [Accepted: 09/21/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Alcohol is a leading risk factor for cancer, yet awareness of the alcohol-cancer link is low. Awareness may be influenced by perceptions of potential health benefits of alcohol consumption or certain alcoholic beverage types. The purpose of this study was to estimate awareness of the alcohol-cancer link by beverage type and to examine the relationship between this awareness and concomitant beliefs about alcohol and heart disease risk. METHODS We analyzed data from the 2020 Health Information National Trends Survey 5 Cycle 4, a nationally representative survey of U.S. adults. RESULTS Awareness of the alcohol-cancer link was highest for liquor (31.2%), followed by beer (24.9%) and wine (20.3%). More U.S. adults believed wine (10.3%) decreased cancer risk, compared with beer (2.2%) and liquor (1.7%). Most U.S. adults (>50%) reported not knowing how these beverages affected cancer risk. U.S. adults believing alcoholic beverages increased heart disease risk had higher adjusted predicted probabilities of being aware of the alcohol-cancer link (wine: 58.6%; beer: 52.4%; liquor: 59.4%) compared with those unsure (wine: 6.0%; beer: 8.6%; liquor: 13.2%), or believing alcoholic beverages reduced (wine: 16.2%; beer: 21.6%; liquor: 23.8%) or had no effect on heart disease risk (wine: 10.2%; beer: 12.0%; liquor: 16.9%). CONCLUSIONS Awareness of the alcohol-cancer link was low, varied by beverage type, and was higher among those recognizing that alcohol use increased heart disease risk. IMPACT These findings underscore the need to educate U.S. adults about the alcohol-cancer link, including raising awareness that drinking all alcoholic beverage types increases cancer risk. See related commentary by Hay et al., p. 9.
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Affiliation(s)
- Andrew B. Seidenberg
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Kara P. Wiseman
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - William M. P. Klein
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
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Grigg J, Manning V, Lockie D, Giles M, Bell R, Stragalinos P, Bernard C, Volpe I, Greenwood CJ, Smith L, Bragge P, Lubman DI. A Brief Intervention for Improving Alcohol Literacy and Addressing Harmful Alcohol use Among Women Attending an Australian Breast Screening Service (Health4Her): Protocol for a Hybrid Effectiveness-Implementation Trial (Preprint). JMIR Res Protoc 2022; 12:e44867. [PMID: 36995739 PMCID: PMC10131813 DOI: 10.2196/44867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Alcohol consumption is a major modifiable risk factor for female breast cancer, even in small amounts. However, awareness of this risk remains low. National breast screening programs are uniquely positioned to provide timely and targeted health information and behavior change strategies to improve alcohol literacy and reduce consumption. A breast screening service is a novel health care setting for brief alcohol intervention, with the potential for extensive reach. OBJECTIVE This study aimed to conduct a formative evaluation with breast screening service consumers to understand the need for, and acceptability of, brief alcohol intervention in the breast screening setting and collaboratively design a brief alcohol intervention (Health4Her); to test the effectiveness of Health4Her in improving knowledge of alcohol as a breast cancer risk factor (primary outcome), improving alcohol literacy, and reducing consumption among women attending a breast screening service; and to examine the implementation strategy through process evaluation. METHODS This was a hybrid type II effectiveness-implementation trial comprising a randomized controlled trial (RCT) alongside a mixed methods program evaluation guided by applicable elements of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework and Consolidated Framework for Implementation Research. Formative evaluation comprised a retrospective analysis of alcohol consumption data (n=49,240), a web-based survey (n=391), and focus groups and interviews (n=31) with breast screening service consumers. Women attending routine mammography, drinking at any level, were recruited to the single-site, double-blind RCT (n=558), and completed a baseline assessment before randomization (1:1) to receive Health4Her (alcohol brief intervention + lifestyle information) or control (lifestyle information) via animation on an iPad. Follow-up assessments were performed 4 and 12 weeks after randomization. The process evaluation included evaluation of trial administrative data, participant quantitative (n=497) and qualitative feedback (n=30), and site staff qualitative feedback (n=11). RESULTS This research was funded in March and May 2019. Data collection for the formative evaluation and trial recruitment occurred between January and April 2020 and February and August 2021, respectively, with finalization of follow-up data collection in December 2021. Quantitative process evaluation data were collected during trial implementation, and collection of participant and staff feedback was finalized in December 2021. Results of the retrospective analysis of alcohol consumption data from breast screening service consumers is anticipated to be published in March 2023 and the results of the RCT to be published in March 2023. CONCLUSIONS This study is anticipated to generate new substantial knowledge on the alcohol consumption and literacy needs of women attending breast screening and the extent to which these can be addressed using a novel, tailored brief alcohol intervention. The study design permits the evaluation of the effectiveness and implementation of Health4Her to predict and facilitate uptake in breast screening services. TRIAL REGISTRATION ClinicalTrials.gov NCT04715516; https://clinicaltrials.gov/ct2/show/NCT04715516. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/44867.
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Affiliation(s)
- Jasmin Grigg
- Turning Point, Eastern Health, Melbourne, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Victoria Manning
- Turning Point, Eastern Health, Melbourne, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Darren Lockie
- Maroondah BreastScreen, Eastern Health, Melbourne, Australia
| | - Michelle Giles
- Maroondah BreastScreen, Eastern Health, Melbourne, Australia
| | - Robin Bell
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | | | | | - Christopher J Greenwood
- School of Psychology, Deakin University, Geelong, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
| | - Liam Smith
- BehaviourWorks Australia, Monash University, Melbourne, Australia
| | - Peter Bragge
- BehaviourWorks Australia, Monash University, Melbourne, Australia
| | - Dan I Lubman
- Turning Point, Eastern Health, Melbourne, Australia
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
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Smolarz B, Nowak AZ, Romanowicz H. Breast Cancer-Epidemiology, Classification, Pathogenesis and Treatment (Review of Literature). Cancers (Basel) 2022; 14:2569. [PMID: 35626173 PMCID: PMC9139759 DOI: 10.3390/cancers14102569] [Citation(s) in RCA: 88] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/12/2022] [Accepted: 05/23/2022] [Indexed: 12/22/2022] Open
Abstract
Breast cancer is the most-commonly diagnosed malignant tumor in women in the world, as well as the first cause of death from malignant tumors. The incidence of breast cancer is constantly increasing in all regions of the world. For this reason, despite the progress in its detection and treatment, which translates into improved mortality rates, it seems necessary to look for new therapeutic methods, and predictive and prognostic factors. Treatment strategies vary depending on the molecular subtype. Breast cancer treatment is multidisciplinary; it includes approaches to locoregional therapy (surgery and radiation therapy) and systemic therapy. Systemic therapies include hormone therapy for hormone-positive disease, chemotherapy, anti-HER2 therapy for HER2-positive disease, and quite recently, immunotherapy. Triple negative breast cancer is responsible for more than 15-20% of all breast cancers. It is of particular research interest as it presents a therapeutic challenge, mainly due to its low response to treatment and its highly invasive nature. Future therapeutic concepts for breast cancer aim to individualize therapy and de-escalate and escalate treatment based on cancer biology and early response to therapy. The article presents a review of the literature on breast carcinoma-a disease affecting women in the world.
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Affiliation(s)
- Beata Smolarz
- Laboratory of Cancer Genetics, Department of Pathology, Polish Mother’s Memorial Hospital Research Institute, Rzgowska 281/289, 93-338 Lodz, Poland;
| | - Anna Zadrożna Nowak
- Department of Chemotherapy, Medical University of Lodz, Copernicus Memorial Hospital, 93-513 Lodz, Poland;
| | - Hanna Romanowicz
- Laboratory of Cancer Genetics, Department of Pathology, Polish Mother’s Memorial Hospital Research Institute, Rzgowska 281/289, 93-338 Lodz, Poland;
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Htay MNN, Dahlui M, Schliemann D, Cardwell CR, Loh SY, Ibrahim Tamin NSB, Somasundaram S, Donnelly M, Su TT. Changing Health Beliefs about Breast Cancer Screening among Women in Multi-Ethnic Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1618. [PMID: 35162641 PMCID: PMC8835215 DOI: 10.3390/ijerph19031618] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 01/27/2023]
Abstract
This study evaluated the impact of the 'Be Cancer Alert' mass media campaign for breast cancer (BCAC-BC) in terms of changes to women's health beliefs regarding BC susceptibility and the benefits and barriers of breast cancer screening in Malaysia. Pre- and post-campaign surveys evaluated changes in health beliefs among women aged 40 years and above (n = 676). The perceived susceptibility to breast cancer was significantly higher at follow-up (mean ± SD: 7.30 ± 2.77 vs. 7.63 ± 2.58, p = 0.008) whereas the mean score for the perceived benefits of undertaking screening was high at baseline and follow-up (16.34 ± 2.36 vs. 15.95 ± 2.07, p = 0.001). The perceptions or beliefs about barriers to screening did not change significantly (31.70 ± 8.26 vs. 31.77 ± 7.63, p = 0.841). Regression analyses indicated that mean scores for the barriers subscale were significantly lower among Chinese women (-2.61, 95% CI -4.67, -0.55, p = 0.013) compared to Malay, and among single compared to married women (-2.40, 95% CI -4.60, -0.21, p = 0.032) after adjustment for other demographic variables and past screening history. Malaysian women appeared to already have positive perceptions before the BCAC-BC mass media campaign about the benefits of BC screening. However, the campaign appeared to be linked to both an increased awareness of the susceptibility to breast cancer and to positive beliefs that countered emotional barriers to screening, particularly among single women and Chinese-Malay women.
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Affiliation(s)
- Mila Nu Nu Htay
- Centre of Population Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia;
- Department of Community Medicine, Manipal University College Malaysia, Manipal Academy of Higher Education (MAHE), Melaka 75150, Malaysia
| | - Maznah Dahlui
- Centre of Population Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia;
- Department of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Désirée Schliemann
- Centre for Public Health and UKCRC, Centre of Excellence for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK; (D.S.); (C.R.C.); (M.D.)
| | - Christopher R. Cardwell
- Centre for Public Health and UKCRC, Centre of Excellence for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK; (D.S.); (C.R.C.); (M.D.)
| | - Siew Yim Loh
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | | | | | - Michael Donnelly
- Centre for Public Health and UKCRC, Centre of Excellence for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK; (D.S.); (C.R.C.); (M.D.)
| | - Tin Tin Su
- Centre of Population Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia;
- South East Asia Community Observatory (SEACO) and Global Public Health, Jeffery Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Malaysia
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11
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Buqué A, Montrose DC, Galluzzi L. Emergent impact of lifestyle on tumor progression and response to therapy. INTERNATIONAL REVIEW OF CELL AND MOLECULAR BIOLOGY 2022; 373:ix-xvii. [DOI: 10.1016/s1937-6448(22)00132-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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12
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OUP accepted manuscript. Health Promot Int 2022:6554410. [DOI: 10.1093/heapro/daac021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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13
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Van Asbroeck S, van Boxtel MPJ, Steyaert J, Köhler S, Heger I, de Vugt M, Verhey F, Deckers K. Increasing knowledge on dementia risk reduction in the general population: Results of a public awareness campaign. Prev Med 2021; 147:106522. [PMID: 33744328 DOI: 10.1016/j.ypmed.2021.106522] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 03/11/2021] [Accepted: 03/14/2021] [Indexed: 11/30/2022]
Abstract
Strategies to reduce dementia risk are needed to minimize the burden of this growing public health concern. Most individuals are not aware that dementia risk reduction is possible, let alone how this could be achieved. Health education, such as public awareness campaigns on the topic of dementia risk reduction, can meet this need. A public health campaign (including social media and offering an online individual risk assessment tool) was carried out over a 7-month period in Flanders, Belgium. Impact was assessed in two independent online surveys, before (n = 1003) and after the campaign (n = 1008), in representative samples of adults aged 40-75 years. Questions regarding personal needs, wishes and barriers were also included. After the campaign, more individuals (10.3%) were aware that dementia risk reduction is possible than before the campaign, and more individuals correctly identified 10 out of 12 surveyed modifiable dementia risk and protective factors. However, no differences were observed in low-educated individuals. Further, specific differences in potential needs, wishes and barriers for future campaigns or interventions were observed between demographic strata. The majority of the respondents (89%) indicated that they would welcome more information on improving their brain-health. More than half (54%) also believed that they lacked the necessary knowledge to make brain-healthy behavior changes. In conclusion, effective public awareness campaigns on the topic of dementia risk reduction are feasible and timely, given the state of the evidence. Special efforts need to be made to develop effective campaigns, tailored towards low-educated individuals.
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Affiliation(s)
- Stephanie Van Asbroeck
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Dr. Tanslaan 12, 6229, ET, Maastricht, the Netherlands.
| | - Martin P J van Boxtel
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Dr. Tanslaan 12, 6229, ET, Maastricht, the Netherlands.
| | - Jan Steyaert
- Department of Sociology, University of Antwerp, Antwerp, Belgium; The Flanders Centre of Expertise on Dementia, Lokkaardstraat 8, 2018 Antwerp, Belgium.
| | - Sebastian Köhler
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Dr. Tanslaan 12, 6229, ET, Maastricht, the Netherlands.
| | - Irene Heger
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Dr. Tanslaan 12, 6229, ET, Maastricht, the Netherlands.
| | - Marjolein de Vugt
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Dr. Tanslaan 12, 6229, ET, Maastricht, the Netherlands.
| | - Frans Verhey
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Dr. Tanslaan 12, 6229, ET, Maastricht, the Netherlands.
| | - Kay Deckers
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Dr. Tanslaan 12, 6229, ET, Maastricht, the Netherlands.
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14
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Sun Q, Xie W, Wang Y, Chong F, Song M, Li T, Xu L, Song C. Alcohol Consumption by Beverage Type and Risk of Breast Cancer: A Dose-Response Meta-Analysis of Prospective Cohort Studies. Alcohol Alcohol 2021; 55:246-253. [PMID: 32090238 DOI: 10.1093/alcalc/agaa012] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 01/09/2020] [Accepted: 01/27/2020] [Indexed: 02/07/2023] Open
Abstract
AIMS Alcohol intake has been shown to increase the risk of breast cancer. However, the dose-response analysis of different alcoholic beverages (spirits, wine and beer) is not clear. Our meta-analysis aims to provide a dose-response estimation between different alcohols and breast cancer risk. METHODS Search of PubMed and Web of Science and manual searches were conducted up to 1 December 2018, and summary relative risks (RRs) and attributable risk percentage (ARP) for alcohol intake on the development of breast cancer were calculated. Dose-response meta-analysis modeled relationships between drinking type and breast cancer risk. Sources of heterogeneity were explored, and sensitivity analyses were conducted to test the robustness of findings. RESULTS In total, 22 cohort studies and 45,350 breast cancer cases were included. Current drinkers for ER+ had an increased risk compared with never drinkers. In dose-response analysis, there was a statistically significant linear trend with breast cancer risk increasing gradually by total alcohol and wine dose: when adding 10 g per day, the risk increased by 10.5% (RR = 1.10, 95%CI = 1.08-1.13) in total alcohol and 8.9% (RR = 1.08, 95%CI = 1.04-1.14) in wine. For postmenopausal women, the risk increases by 11.1% (RR = 1.11, 95%CI = 1.09-1.13) with every 10 g of total alcohol increase. Furthermore, the breast cancer alcohol-attributed percentage is higher in Europe than in North America and Asia. CONCLUSIONS The effect of drinking on the incidence of breast cancer is mainly manifested in ER+ breast cancer. Quantitative analysis showed total drinking had a significant risk for breast cancer, especially for postmenopausal women. However, for different alcohols, just wine intake has the similar results.
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Affiliation(s)
- Qiuyu Sun
- Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, Henan, China.,Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
| | - Weihong Xie
- Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, Henan, China
| | - Yanli Wang
- Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, Henan, China.,Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
| | - Feifei Chong
- Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, Henan, China.,Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
| | - Mengmeng Song
- Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, Henan, China.,Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
| | - Tiandong Li
- Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, Henan, China.,Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
| | - Linping Xu
- Department of Teaching and Research, Henan Tumor Hospital, No. 127, Dongming Road, Zhengzhou 450003, Henan, China
| | - Chunhua Song
- Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, 100 Science Avenue, Zhengzhou 450001, Henan, China.,Henan Key Laboratory of Tumor Epidemiology, Zhengzhou University, 40 Daxue Road, Zhengzhou 450052, China
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15
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Hobin E, Weerasinghe A, Vallance K, Hammond D, McGavock J, Greenfield TK, Schoueri-Mychasiw N, Paradis C, Stockwell T. Testing Alcohol Labels as a Tool to Communicate Cancer Risk to Drinkers: A Real-World Quasi-Experimental Study. J Stud Alcohol Drugs 2020. [PMID: 32359056 PMCID: PMC7201213 DOI: 10.15288/jsad.2020.81.249] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective: This study tested the initial and continued effects of cancer warning labels on drinkers’ recall and knowledge that alcohol can cause cancer. Method: A quasi-experiment was conducted to examine changes in the intervention versus comparison site for three outcomes: unprompted and prompted recall of the cancer warning, and knowledge that alcohol can cause cancer. The intervention site applied cancer warning labels to alcohol containers in its liquor store for 1 month, and the two liquor stores in the comparison site did not apply cancer labels. In total, 2,049 unique cohort participants (1,056 male) were recruited at liquor stores in the intervention and comparison sites to participate in surveys 4 months before labels were applied and 2 and 6 months after the cancer label was halted because of alcohol industry interference. Generalized estimating equations tested differences in outcomes between sites over time adjusting for socio-demographics and other covariates. Results: Two months after the cancer label, unprompted (+24.2% vs. +0.6%; adjusted odds ratio [AOR] = 32.7, 95% CI [5.4, 197.7]) and prompted (+35.7% vs. +4.1%; AOR = 6.2, 95% CI [3.6, 10.9]) recall increased to a greater extent in the intervention versus comparison site. There was a 10% greater increase in knowledge (+12.1% vs. +11.6%; AOR = 1.1, 95% CI [0.7, 1.5]) 2 months after the cancer label in the intervention versus comparison site. Similar results were found 6 months after the cancer label for all three outcomes. Conclusions: In a real-world setting, cancer warning labels get noticed and increase knowledge that alcohol can cause cancer. Additional cancer label intervention studies are required that are not compromised by industry interference.
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Affiliation(s)
- Erin Hobin
- Public Health Ontario, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Jonathan McGavock
- Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | | | - Catherine Paradis
- Canadian Centre for Substance Use and Addiction, Ottawa, Ontario, Canada
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
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16
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Vallance K, Vincent A, Schoueri-Mychasiw N, Stockwell T, Hammond D, Greenfield TK, McGavock J, Hobin E. News Media and the Influence of the Alcohol Industry: An Analysis of Media Coverage of Alcohol Warning Labels With a Cancer Message in Canada and Ireland. J Stud Alcohol Drugs 2020. [PMID: 32359058 PMCID: PMC7201216 DOI: 10.15288/jsad.2020.81.273] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Media coverage of alcohol-related policy measures can influence public debate and is often more aligned with interests of the alcohol industry than public health. The purpose of this study was to examine the framing of news coverage of alcohol warning label (AWL) initiatives that included a cancer message on alcohol containers in two different countries. Policy contexts and industry perspectives were also evaluated. METHOD We identified and systematically reviewed news articles published between 2017-2019 covering an AWL academic study in Yukon, Canada, and labeling provisions in a Public Health (Alcohol) Bill in Ireland. Both included a cancer message. News stories were coded for media type and topic slant; inclusion of alcohol industry perspectives was examined using content analysis. RESULTS Overall, 68.4% of media articles covering the Yukon Study (n = 38) and 18.9% covering the Ireland Bill (n = 37) were supportive of AWLs with a cancer message. The majority of articles in both sites presented alcohol industry perspectives (Yukon, 65.8%; Ireland, 86.5%), and industry arguments opposing AWLs were similar across both contexts. In articles with statements from industry representatives, the label message was frequently disputed by distorting or denying the evidence that alcohol causes cancer (n = 33/43). CONCLUSIONS News coverage of AWLs with a cancer message was more supportive in Canada than Ireland, where alcohol industry perspectives were consistently foregrounded. Industry arguments opposing the cancer label bore similarities across contexts, often distorting or denying the evidence. Increasing awareness of industry messaging strategies may generate more critical coverage of industry lobbying activities and increase public support for alcohol policies.
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Affiliation(s)
- Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | | | - Nour Schoueri-Mychasiw
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario, Canada
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - David Hammond
- School of Public Health & Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Thomas K Greenfield
- Alcohol Research Group, Public Health Institute, Emeryville, California, United States
| | - Jonathan McGavock
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Erin Hobin
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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17
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Schoueri-Mychasiw N, Weerasinghe A, Stockwell T, Vallance K, Hammond D, Greenfield TK, McGavock J, Hobin E. Use as directed: do standard drink labels on alcohol containers help consumers drink (ir)responsibly? Real-world evidence from a quasi-experimental study in Yukon, Canada. Drug Alcohol Rev 2020; 40:247-257. [PMID: 33078447 DOI: 10.1111/dar.13165] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 08/18/2020] [Accepted: 08/18/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS This paper examines the impact of an alcohol labelling intervention on recall of and support for standard drink (SD) labels, estimating the number of SDs in alcohol containers, and intended and unintended use of SD labels. DESIGN AND METHODS A quasi-experimental study was conducted in Canada where labels with a cancer warning, national drinking guidelines and SD information were applied to alcohol containers in the single liquor store in the intervention site, while usual labelling continued in the two liquor stores in the comparison site. Three waves of surveys were conducted in both sites before and at two time-points after the intervention with 2049 cohort participants. Generalised estimating equations were applied to estimate changes in all outcomes. RESULTS Participants in the intervention relative to the comparison site had greater odds of recalling [adjusted odds ratio (AOR) 5.69, 95% confidence interval (CI) 3.02, 10.71] and supporting SD labels (AOR 1.49, 95% CI 1.04, 2.12) and lower odds of reporting using SD labels to purchase high strength, low-cost alcohol (AOR 0.65, 95% CI 0.45, 0.93). Exposure to the labels had negligible effects on accurately estimating the number of SDs (AOR 1.06, 95% CI 0.59, 1.93) and using SD labels to drink within guidelines (AOR 1.04, 95% CI 0.75, 1.46). DISCUSSION AND CONCLUSIONS Evidence-informed labels increased support for and decreased unintended use of SD labels. Such labels can improve accuracy in estimating the number of SDs in alcohol containers and adherence to drinking guidelines.
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Affiliation(s)
- Nour Schoueri-Mychasiw
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada
| | - Ashini Weerasinghe
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
| | - Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | | | - Jonathan McGavock
- Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Canada
| | - Erin Hobin
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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18
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Brennan E, Schoenaker DAJM, Durkin SJ, Dunstone K, Dixon HG, Slater MD, Pettigrew S, Wakefield MA. Comparing responses to public health and industry-funded alcohol harm reduction advertisements: an experimental study. BMJ Open 2020; 10:e035569. [PMID: 32988938 PMCID: PMC7523211 DOI: 10.1136/bmjopen-2019-035569] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 04/22/2020] [Accepted: 08/04/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Conduct a head-to-head experimental test of responses to alcohol harm reduction advertisements developed by alcohol industry Social Aspects/Public Relations Organisations (SAPROs) versus those developed by public health (PH) agencies. We hypothesised that, on average, SAPRO advertisements would be less effective at generating motivation (H1) and intentions to reduce alcohol consumption (H2) but more effective at generating positive perceptions of people who drink (H3). DESIGN Online experiment with random assignment to condition. PARTICIPANTS 2923 Australian adult weekly drinkers (49% high-risk drinkers) recruited from an opt-in online panel. INTERVENTIONS Participants viewed 3 of 83 advertisements developed by PH agencies (n=2174) or 3 of 28 advertisements developed by SAPROs (n=749). PRIMARY OUTCOME MEASURES Participants reported their motivation to reduce the amount of alcohol consumed; behave responsibly and/or not get drunk; and limit their drinking around/never supply to minors, as well as intentions to avoid drinking alcohol completely; reduce the number of drinking occasions; and reduce the amount of alcohol consumed per occasion. Participants also reported their perceptions of people who drink alcohol on six success-related items and four fun-related items. RESULTS Compared with drinkers exposed to PH advertisements, those exposed to SAPRO advertisements reported lower motivation to reduce the amount of alcohol consumed (β=-0.091, 95% CI -0.171 to -0.010), and lower odds of intending to avoid alcohol completely (OR=0.77, 0.63 to 0.94) and to reduce the amount of alcohol consumed per occasion (OR=0.82, 0.69 to 0.97). SAPRO advertisements generated more favourable fun-related perceptions of drinkers (β=0.095, 0.013 to 0.177). CONCLUSIONS The alcohol harm reduction advertisements produced by alcohol industry SAPROs that were tested in this study were not as effective at generating motivation and intentions to reduce alcohol consumption as those developed by PH organisations. These findings raise questions as to whether SAPROs should play a role in alcohol harm reduction efforts.
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Affiliation(s)
- Emily Brennan
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Danielle A J M Schoenaker
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Sarah J Durkin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Kimberley Dunstone
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Helen G Dixon
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Michael D Slater
- School of Communication, Ohio State University, Columbus, Ohio, United States
| | - Simone Pettigrew
- George Institute for Global Health, Sydney, New South Wales, Australia
| | - Melanie A Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
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19
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Khushalani JS, Qin J, Ekwueme DU, White A. Awareness of breast cancer risk related to a positive family history and alcohol consumption among women aged 15-44 years in United States. Prev Med Rep 2020; 17:101029. [PMID: 31890475 PMCID: PMC6926360 DOI: 10.1016/j.pmedr.2019.101029] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 09/24/2019] [Accepted: 12/01/2019] [Indexed: 11/20/2022] Open
Abstract
Awareness of the link between breast cancer and risk factors such as family history of breast cancer and alcohol consumption may help modify health behaviors. To reduce risk factors for breast cancer among young women, it is important to understand overall levels of risk awareness and socioeconomic differences in awareness. Data from the National Survey of Family Growth 2011-2015 were used to examine awareness of two risk factors for breast cancer, positive family history and alcohol consumption, among women aged 15-44 years (n = 10,940) in the United States by presence of risk factors and by socioeconomic characteristics. Prevalence of positive family history, non-binge, and binge drinking was 30%, 29%, and 31%, respectively among women aged 15-44. Awareness of positive family history of breast cancer as a risk factor for breast cancer was 88%, whereas for alcohol consumption it was 25%. Awareness of family history as a risk factor was higher among women with positive family history of breast cancer compared to those without. Current drinkers were more likely to believe that alcohol was not a risk factor for breast cancer compared to those who did not drink. Racial/ethnic minority women and those with lower education and income had lower awareness of family history as a risk factor. Awareness of alcohol consumption as a risk factor for breast cancer was low across all socioeconomic groups. Evidence-based interventions to increase risk awareness and decrease excessive alcohol use among young women are needed to reduce the risk of developing breast cancer.
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Affiliation(s)
- Jaya S. Khushalani
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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20
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Weerasinghe A, Schoueri-Mychasiw N, Vallance K, Stockwell T, Hammond D, McGavock J, Greenfield TK, Paradis C, Hobin E. Improving Knowledge that Alcohol Can Cause Cancer is Associated with Consumer Support for Alcohol Policies: Findings from a Real-World Alcohol Labelling Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E398. [PMID: 31936173 PMCID: PMC7014334 DOI: 10.3390/ijerph17020398] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 12/25/2022]
Abstract
Knowledge that alcohol can cause cancer is low in Canada. Alcohol labels are one strategy for communicating alcohol-related harms, including cancer. Extending existing research observing an association between knowledge of the alcohol-cancer link and support for alcohol policies, this study examined whether increases in individual-level knowledge that alcohol is a carcinogen following an alcohol labelling intervention are associated with support for alcohol polices. Cancer warning labels were applied to alcohol containers at the intervention site, and the comparison site did not apply cancer labels. Pre-post surveys were conducted among liquor store patrons at both sites before and two-and six-months after the intervention was stopped due to alcohol industry interference. Limiting the data to participants that completed surveys both before and two-months after the cancer label stopped, logistic regression was used to examine the association between increases in knowledge and support for policies. Support for pricing and availability policies was low overall; however, increases in individual-level knowledge of the alcohol-cancer link was associated with higher levels of support for pricing policies, specifically, setting a minimum unit price per standard drink of alcohol (OR = 1.86, 95% CI: 1.11-3.12). Improving knowledge that alcohol can cause cancer using labels may increase support for alcohol policies. International Registered Report Identifier (IRRID): RR2-10.2196/16320.
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Affiliation(s)
| | | | - Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC V8P 2Y2, Canada; (K.V.); (T.S.)
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC V8P 2Y2, Canada; (K.V.); (T.S.)
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
| | - Jonathan McGavock
- Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB R3E 3P4, Canada;
| | | | - Catherine Paradis
- Canadian Centre for Substance Use and Addiction, Ottawa, ON K1P 5E7, Canada;
| | - Erin Hobin
- Public Health Ontario, Toronto, ON M5G 1V2, Canada; (A.W.); (N.S.-M.)
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21
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Can a mass media campaign raise awareness of alcohol as a risk factor for cancer and public support for alcohol related policies? Prev Med 2019; 126:105722. [PMID: 31125628 DOI: 10.1016/j.ypmed.2019.05.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 05/08/2019] [Accepted: 05/19/2019] [Indexed: 11/23/2022]
Abstract
Alcohol consumption increases the risk of several cancers, but public awareness of alcohol as a risk factor for cancer is low. Research indicates that public opinion about alcohol related policies can be influenced by mass media campaigns and awareness of alcohol as a carcinogen. The objective of this study was to test whether a mass media campaign intended to raise awareness of the relation between alcohol and cancer is associated with higher public awareness of alcohol as a risk factor for cancer, and higher levels of support for alcohol related policies. Cross-sectional surveys of a nationally representative sample of N = 6000 Danish adults were conducted pre- (n = 3000) and post campaign (n = 3000) in 2017-2018. Awareness of alcohol as a cancer risk factor significantly increased between the pre and post campaign survey (approximately 5 percentage points). The proportion of respondents who supported minimum unit pricing, a ban on alcohol advertising, and mandatory nutrition labelling was significantly higher post campaign than pre campaign, while support for limited number of retail outlets and limited sale hours were unchanged. For males, but not females, higher support for an 18 year age limit for purchasing alcohol, age limits for buying alcohol at secondary education school parties, and increased enforcement of age limits was found after the campaign than prior to it. Conclusively, the results show that a mass media campaign was associated with an increase in awareness of alcohol as a risk factor for cancer as well as alcohol policy support at a population level.
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22
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Miller CL, Dono J, Wakefield MA, Pettigrew S, Coveney J, Roder D, Durkin SJ, Wittert G, Martin J, Ettridge KA. Are Australians ready for warning labels, marketing bans and sugary drink taxes? Two cross-sectional surveys measuring support for policy responses to sugar-sweetened beverages. BMJ Open 2019; 9:e027962. [PMID: 31248926 PMCID: PMC6597645 DOI: 10.1136/bmjopen-2018-027962] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE To assess public support for 10 potential policy initiatives to reduce sugar-sweetened beverage (SSB) consumption. DESIGN A 2014 historical data set, which employed a face-to-face survey in one Australian state (study 1), provided the basis for comparison with our 2017 nationally representative, cross-sectional, computer-assisted telephone interviewing population survey (study 2). PARTICIPANTS Study 1: South Australians, 15+ years (n=2732); study 2: Australians, 18+ years (n=3430). PRIMARY OUTCOME MEASURES levels of support for SSB-specific policy initiatives. For the 2017 national study (study 2), demographic characteristics, body mass index, knowledge of potential harms caused by consuming SSBs and SSB consumption were included in multivariable regression analyses. RESULTS In 2017, all 10 potential policy initiatives received majority support (60%-88% either 'somewhat' or 'strongly' in favour). Initiatives with educative elements or focused on children received high support (>70%), with highest support observed for text warning labels on drink containers (88%) and government campaigns warning of adverse health effects (87%). Higher support was observed for SSB tax paired with using funds for obesity prevention (77%) than a stand-alone tax (60%). Support for policy initiatives was generally greater among those who believed SSB daily consumption could cause health problems in adults (4%-18% absolute difference) and/or in children (8%-26% absolute difference) and lower among SSB high consumers (7+ drinks per week; 9%-29% absolute difference). State-specific data comparison indicated increased support from 2014 to 2017 for taxation (42%vs55%; χ2=15.7, p<0.001) and graphic health warnings (52%vs68%; χ2=23.4. p<0.001). CONCLUSIONS There is strong public support for government action, particularly regulatory and educational interventions, to reduce SSB consumption, which appears to have increased since 2014. The findings suggest that framing policies as protecting children, presenting taxation of SSBs in conjunction with other obesity prevention initiatives and education focused on the harms associated with SSB consumption will increase support.
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Affiliation(s)
- Caroline L Miller
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Joanne Dono
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Melanie A Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Simone Pettigrew
- School of Psychology, Curtin University, Perth, Western Australia, Australia
| | - John Coveney
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - David Roder
- Cancer Epidemiology and Population Health, University of South Australia, Adelaide, South Australia, Australia
| | - Sarah J Durkin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Gary Wittert
- Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
- Centre for Nutrition and GI Diseases, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Jane Martin
- Obesity Policy Coalition and Alcohol and Obesity Policy, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Kerry A Ettridge
- Health Policy Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
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Wiseman KP, Klein WMP. Evaluating Correlates of Awareness of the Association between Drinking Too Much Alcohol and Cancer Risk in the United States. Cancer Epidemiol Biomarkers Prev 2019; 28:1195-1201. [PMID: 31043419 DOI: 10.1158/1055-9965.epi-18-1010] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 11/15/2018] [Accepted: 04/23/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Awareness that alcohol consumption is associated with cancer is low in the United States, and predictors of awareness are not well understood. METHODS Data from the 2017 Health Information National Trends Survey (HINTS 5 Cycle 1) were used to describe knowledge of the association between drinking too much alcohol and cancer ("Yes," aware of the association; "No"; or "Don't know") among 3,009 adults. Weighted multinomial multivariable logistic regression determined personal characteristics (e.g., demographic characteristics, health-related self-efficacy, cancer beliefs, and information seeking) associated with reporting "Yes" or "Don't know" compared with "No." RESULTS Thirty-eight percent of the U.S. population believed there was an association (38.36%), 36.17% were uncertain, and 25.47% believed there was no association. People believing that everything causes cancer and people who had ever looked up information about cancer had 1.61 and 1.80 higher odds of reporting "Yes" [95% confidence intervals (CI), 1.08-2.42 and 1.27-2.57, respectively]. Compared with people who were completely confident in their ability to take care of their health, people only somewhat confident had 2.32 higher odds of reporting "Don't know" (95% CI, 1.30-4.14). Younger age was negatively associated with reporting "Don't know." CONCLUSIONS Awareness of the association between alcohol and cancer is low in the United States. Personal characteristics associated with awareness differed between reporting "Yes" and "Don't know," and there were few associations between demographic characteristics and awareness. IMPACT A significant knowledge gap exists in the population. Broad reaching public health media campaigns, particularly those that increase information seeking, are needed to increase awareness.
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Affiliation(s)
- Kara P Wiseman
- Behavioral Research Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
| | - William M P Klein
- Behavioral Research Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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Meyer SB, Foley K, Olver I, Ward PR, McNaughton D, Mwanri L, Miller ER. Alcohol and breast cancer risk: Middle-aged women's logic and recommendations for reducing consumption in Australia. PLoS One 2019; 14:e0211293. [PMID: 30759125 PMCID: PMC6374008 DOI: 10.1371/journal.pone.0211293] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 01/10/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND We aimed to understand the factors shaping alcohol consumption patterns in middle-aged women (45-64), and to identify participant-driven population- and policy-level strategies that may be used to addresses alcohol consumption and reduce breast cancer risk. METHODS Semi-structured interviews (n = 35) were conducted with 'middle-aged' women conversant in English and living in South Australia with no history of breast cancer diagnosis. Data were deductively coded using a co-developed framework including variables relevant to our study objectives. Women were asked about their current level of awareness of the association between alcohol and breast cancer risk, and their personal recommendations for how to decrease consumption in middle-aged Australian women. RESULTS Women discussed their previous efforts to decrease consumption, which we drew on to identify preliminary recommendations for consumption reduction. We identified a low level of awareness of alcohol and breast cancer risk, and confusion related to alcohol as a risk for breast cancer, but not always causing breast cancer. Participants suggested that education and awareness, through various means, may help to reduce consumption. CONCLUSIONS Participants' description of strategies used to reduce their own consumption lead us to suggest that campaigns might focus on the more salient and immediate effects of alcohol (e.g. on physical appearance and mental health) rather than longer-term consequences. Critical considerations for messaging include addressing the personal, physical and social pleasures that alcohol provides, and how these may differ across socio-demographics.
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Affiliation(s)
- Samantha B. Meyer
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Kristen Foley
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Ian Olver
- University of South Australia Cancer Research Institute, Adelaide, South Australia, Australia
| | - Paul R. Ward
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Darlene McNaughton
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Lillian Mwanri
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Emma R. Miller
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
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Gibson DG, Tamrat T, Mehl G. The State of Digital Interventions for Demand Generation in Low- and Middle-Income Countries: Considerations, Emerging Approaches, and Research Gaps. GLOBAL HEALTH, SCIENCE AND PRACTICE 2018; 6:S49-S60. [PMID: 30305339 PMCID: PMC6203418 DOI: 10.9745/ghsp-d-18-00165] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 09/08/2018] [Indexed: 01/08/2023]
Abstract
The recent introduction of digital health into generating demand for health commodities and services has provided practitioners with an expanded universe of potential tools to strengthen demand and ensure service delivery receipt. However, considerable gaps remain in our understanding of which interventions are effective, which characteristics mediate their benefit for different target populations and health domains, and what is necessary to ensure effective deployment. This paper first provides an overview of the types of digital health interventions for demand generation, including untargeted client communication, client-to-client communication, on-demand information services, personal health tracking, client financial transactions, and targeted client communication. It then provides a general overview of 118 studies published between January 1, 2010, and October 3, 2017, that used digital interventions to generate demand for health interventions. The majority (61%) of these studies used targeted client communication to provide health education or reminders to improve treatment adherence, and the most frequently (27%) studied health condition was HIV/AIDS. Intervention characteristics that have been found to have some effect on gains in demand generation include modality, directionality, tailoring, phrasing, and schedule. The paper also explores new emergent digital approaches that expand the potential effect of traditional demand generation in terms of personalization of content and services, continuity of care, and accountability tracking. Applying existing frameworks for monitoring and evaluation and reporting, research on emerging approaches will need to consider not only their feasibility but also their effectiveness in achieving demand generation outcomes. We propose a research agenda to help guide the field of digital demand generation studies and programs within a broader health systems strengthening agenda, including establishing and documenting the influence of intervention characteristics within different populations and health domains and examining the long-term effects and cost-effectiveness of digital demand generation interventions, as well as equity in access to such interventions.
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Affiliation(s)
- Dustin G Gibson
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Tigest Tamrat
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Garrett Mehl
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Bates S, Holmes J, Gavens L, de Matos EG, Li J, Ward B, Hooper L, Dixon S, Buykx P. Awareness of alcohol as a risk factor for cancer is associated with public support for alcohol policies. BMC Public Health 2018; 18:688. [PMID: 29866082 PMCID: PMC5987582 DOI: 10.1186/s12889-018-5581-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 05/21/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Globally, alcohol is causally related to 2.5 million deaths per year and 12.5% of these are due to cancer. Previous research has indicated that public awareness of alcohol as a risk factor for cancer is low and this may contribute to a lack of public support for alcohol policies. The aim of this study was to investigate the relationship between awareness of the alcohol-cancer link and support for a range of alcohol policies in an English sample and policy context. METHODS A cross-sectional survey of 2100 adult residents in England was conducted in which respondents answered questions regarding awareness of the link between alcohol and cancer and support for 21 policy proposals. Principal component analysis (PCA) was used to reduce the 21 policy proposals down to a set of underlying factors. Multiple regression analyses were conducted to estimate the relationship between awareness of the alcohol-cancer link and each of these policy factors. RESULTS Thirteen per cent of the sample were aware of the alcohol-cancer link unprompted, a further 34% were aware when prompted and 53% were not aware of the link. PCA reduced the policy items to four policy factors, which were named price and availability, marketing and information, harm reduction and drink driving. Awareness of the alcohol-cancer link unprompted was associated with increased support for each of four underlying policy factors: price and availability (Beta: 0.06, 95% CI: 0.01, 0.10), marketing and information (Beta: 0.05, 95% CI: 0.00, 0.09), harm reduction (Beta: 0.09, 95% CI: 0.05, 0.14), and drink driving (Beta: 0.16, 95% CI: 0.11, 0.20). CONCLUSIONS Support for alcohol policies is greater among individuals who are aware of the link between alcohol and cancer. At the same time, a large proportion of people are unaware of the alcohol-cancer link and so increasing awareness may be an effective approach to increasing support for alcohol policies.
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Affiliation(s)
- Sarah Bates
- University of Sheffield, 30 Regent Street, Sheffield, S1 4DA UK
| | - John Holmes
- University of Sheffield, 30 Regent Street, Sheffield, S1 4DA UK
| | - Lucy Gavens
- University of Sheffield, 30 Regent Street, Sheffield, S1 4DA UK
| | | | | | | | | | - Simon Dixon
- University of Sheffield, 30 Regent Street, Sheffield, S1 4DA UK
| | - Penny Buykx
- University of Sheffield, 30 Regent Street, Sheffield, S1 4DA UK
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27
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Hassan L, Shiu E. Communicating Messages About Drinking. Alcohol Alcohol 2017; 53:1-2. [DOI: 10.1093/alcalc/agx112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Indexed: 11/13/2022] Open
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