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Zhong J, Zhang Z, Zhao Z, Peng L, Zhang Y, Zhang B, Zhai X, Wu Y. Relating caregiver experiences to personalized "push" content in mobile applications among caregivers of pediatric patients with oncology conditions. Pediatr Blood Cancer 2024; 71:e31198. [PMID: 39016596 DOI: 10.1002/pbc.31198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 06/08/2024] [Accepted: 07/01/2024] [Indexed: 07/18/2024]
Abstract
OBJECTIVE With the evolution of data algorithms and personalized push systems in mobile applications, patients who have searched for disease-related information may repeatedly receive similar content on app homepages or through notifications. This study aims to assess the influence of health-related content delivered through mobile applications on the anxiety and depression levels of caregivers of pediatric oncology patients. METHODS A survey consisting of 16 questions was conducted among 91 caregivers of pediatric oncology patients at the Children's Hospital affiliated with Chongqing Medical University. The questionnaire was designed by oncologists and the Hospital Anxiety and Depression Scale was used to assess the caregivers' psychological states. RESULTS The study found that 31.5% of caregivers exhibited borderline anxiety symptoms, while 20.2% displayed borderline depression symptoms. Caregivers who noticed changes in homepage recommendations reported higher levels of anxiety (p = .004) and depression (p = .034). Additionally, 50.6% occasionally felt anxious or uneasy due to personalized notifications and 19.1% frequently felt this way. Moreover, 53.9% of the caregivers reported a negative impact on their emotions or daily life. SIGNIFICANCE Personalized push notifications related to disease information in mobile applications can impose a significant psychological burden on patients and their caregivers. Mobile application developers and healthcare providers must strengthen their support in the digital health domain to enhance the emotional well-being of cancer patients and their caregivers.
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Affiliation(s)
- Jiaqiao Zhong
- School of Medicine and Life Sciences, Chengdu University of Chinese Medicine, Chengdu, China
| | - Zaiyu Zhang
- Department of Surgical Oncology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
| | - Zhenzhen Zhao
- Department of Surgical Oncology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
| | - Liang Peng
- Department of Surgical Oncology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
| | - Yunlong Zhang
- Department of Surgical Oncology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
| | - Bao Zhang
- Department of Surgical Oncology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
| | - Xuan Zhai
- Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
- Department of Neurosurgery, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Yuxin Wu
- Department of Surgical Oncology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
- Department of Neurosurgery, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
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Stimpson JP, Park S, Rodriguez M, Cano MÁ, Ortega AN. Cancer fatalism, social media informational awareness, and education. Cancer Causes Control 2024:10.1007/s10552-024-01896-y. [PMID: 38951386 DOI: 10.1007/s10552-024-01896-y] [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: 12/18/2023] [Accepted: 06/19/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVE Understand if cancer fatalism among adult social media users in the United States is linked to social media informational awareness and if the relationship varies by education level. METHODS Cross-sectional data from the 2022 Health Information National Trends Survey (n = 3,948) were analyzed using multivariable linear probability models. The study population was defined as social media users active within the past year. The outcome variable was cancer fatalism and the predictor variables were social media informational awareness and education level. RESULTS Participants with low social media informational awareness were 9% (95% CI = 3, 15), 6% (95% CI = 1, 11), and 21% (95% CI = 14, 27) percentage points more likely to agree that it seems like everything causes cancer, you cannot lower your chances of getting cancer, and there are too many cancer prevention recommendations to follow, respectively. Participants with a college degree or higher level of education and who reported high social media informational awareness were the least likely to agree that everything causes cancer (60%; 95% CI = 54, 66), you cannot lower your chances of getting cancer (14%; 95% CI = 10, 19), and there are too many cancer prevention recommendations to follow (52%; 95% CI = 46, 59). CONCLUSION Social media informational awareness was associated with lower levels of cancer fatalism among adult social media users. College graduates with high social media informational awareness were the least likely to report cancer fatalism.
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Affiliation(s)
- Jim P Stimpson
- University of Texas Southwestern Medical Center, Peter O'Donnell Jr. School of Public Health, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.
- Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.
| | - Sungchul Park
- Department of Health Policy and Management, Korea University, Seoul, Republic of Korea
| | - Mayra Rodriguez
- Edward Via College of Osteopathic Medicine, Preventive Medicine and Public Health, Auburn, AL, USA
| | - Miguel Ángel Cano
- University of Texas Southwestern Medical Center, Peter O'Donnell Jr. School of Public Health, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - Alexander N Ortega
- University of Hawai'i at Mānoa, Thompson School of Social Work and Public Health, Honolulu, HI, USA
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Zhang L, Jiang S. Examining the Role of Information Behavior in Linking Cancer Risk Perception and Cancer Worry to Cancer Fatalism in China: Cross-Sectional Survey Study. J Med Internet Res 2024; 26:e49383. [PMID: 38819919 PMCID: PMC11179024 DOI: 10.2196/49383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 10/27/2023] [Accepted: 04/25/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Reducing cancer fatalism is essential because of its detrimental impact on cancer-related preventive behaviors. However, little is known about factors influencing individuals' cancer fatalism in China. OBJECTIVE With a general basis of the extended parallel process model, this study aims to examine how distinct cancer-related mental conditions (risk perception and worry) and different information behaviors (information seeking vs avoidance) become associated with cancer fatalism, with an additional assessment of the moderating effect of information usefulness. METHODS Data were drawn from the Health Information National Trends Survey in China, which was conducted in 2017 (N=2358). Structural equation modeling and bootstrapping methods were performed to test a moderated mediation model and hypothesized relationships. RESULTS The results showed that cancer risk perception and cancer worry were positively associated with online health information seeking. In addition, cancer worry was positively related to cancer information avoidance. Moreover, online health information seeking was found to reduce cancer fatalism, while cancer information avoidance was positively associated with cancer fatalism. The results also indicated that the perceived usefulness of cancer information moderated this dual-mediation pathway. CONCLUSIONS The national survey data indicate that cancer mental conditions should not be treated as homogeneous entities, given their varying functions and effects. Apart from disseminating useful cancer information to encourage individuals to adaptively cope with cancer threats, we advocate for health communication programs to reduce cancer information avoidance to alleviate fatalistic beliefs about cancer prevention.
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Affiliation(s)
- Lianshan Zhang
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China
| | - Shaohai Jiang
- Department of Communications and New Media, National University of Singapore, Singapore, Singapore
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Leung YW, Kwong EWY, Wong KLY, So J, Poon F, Cheng T, Chen E, Molasiotis A, Howell D. Understanding Elderly Chinese Cancer Patients in a Multicultural Clinical Setting: Embracing Mortality and Addressing Misperceptions of Vulnerability. Curr Oncol 2024; 31:2620-2635. [PMID: 38785478 PMCID: PMC11119118 DOI: 10.3390/curroncol31050197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 04/26/2024] [Accepted: 04/30/2024] [Indexed: 05/25/2024] Open
Abstract
Chinese patients face higher risks of gastrointestinal (GI) cancers and greater cancer-related deaths than Canadian-born patients. The older population encounters barriers to quality healthcare, impacting their well-being and survival. Previous studies highlighted Chinese immigrant perceptions of not requiring healthcare support. During the COVID-19 pandemic, their underutilization of healthcare services garnered attention. The present study explores the experiences of older Chinese cancer patients to improve culturally sensitive cancer care. A total of twenty interviews carried out in Cantonese and Mandarin were conducted with Chinese immigrants, aged 60 or above, diagnosed with Stage 3 or 4 GI cancer. These interviews were transcribed verbatim, translated, and subjected to qualitative descriptive analysis. Among older Chinese immigrant patients, a phenomenon termed "Premature Acceptance: Normalizing Death and Dying" was observed. This involved four key themes: 1. acceptance and letting go, 2. family first, 3. self-sufficiency, and 4. barriers to supportive care. Participants displayed an early acceptance of their own mortality, prioritizing family prosperity over their own quality of life. Older Chinese patients normalize the reality of facing death amidst cancer. They adopt a pragmatic outlook, acknowledging life-saving treatments while willingly sacrificing their own support needs to ease family burdens. Efforts to enhance health literacy require culturally sensitive programs tailored to address language barriers and differing values among this population. A strengths-based approach emphasizing family support and practical aspects of care may help build resilience and improve symptom management, thereby enhancing their engagement with healthcare services.
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Affiliation(s)
- Yvonne W. Leung
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada
- College of Professional Studies, Northeastern University, Boston, MA 02115, USA
| | - Enid W. Y. Kwong
- School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Karen Lok Yi Wong
- School of Social Work, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Jeremiah So
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Frankie Poon
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Terry Cheng
- Department of Psychiatry, University of Toronto, Toronto, ON M5S 1A1, Canada
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Eric Chen
- Department of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Alex Molasiotis
- School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Doris Howell
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada
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Wu YP, Tercyak KP, Wankier AP, Brunsgaard EK, Parsons BG, Devine KA, Stump TK, Boucher KM, Hay JL. Moderating influences on parents' fatalistic beliefs about cancer and their association with sun safety behaviors among children of melanoma survivors: Implications for treatment. J Health Psychol 2024; 29:481-491. [PMID: 37968969 DOI: 10.1177/13591053231209167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023] Open
Abstract
The purpose of this study is to examine the association between parents' fatalism about melanoma and their children's sun protection, and the potential moderating role of parent-child communication. In this observational study of N = 69 melanoma-surviving parents of children ages 8-17, parents reported on their own melanoma fatalism, as well as their children's sun safety behaviors and parent-child discussion about sun safety. Parent gender, family history of melanoma, and frequency of parent-child discussions moderated the relationship between parents' fatalism and children's sun safety behaviors. Among mothers and parents with a family history of melanoma, high fatalism was associated with lower child sunscreen use, especially when discussions were less frequent. Melanoma surviving parents' fatalistic beliefs about cancer indirectly influence their children's health behavior and are a risk factor for unsafe sun behavior. Attending to parent gender, family history, and their communications about protective behaviors as co-factors of this risk could inform future intervention targeting.
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Affiliation(s)
- Yelena P Wu
- University of Utah, USA
- Huntsman Cancer Institute, USA
| | | | | | | | | | | | - Tammy K Stump
- University of Utah, USA
- Huntsman Cancer Institute, USA
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Lai YK, Ye JF, Ao SH, Zhao X. Overcoming obstacles to mammography screening: Examining the role of offline healthcare barriers and online patient-provider communication. J Health Psychol 2024; 29:452-466. [PMID: 38411143 DOI: 10.1177/13591053241234260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024] Open
Abstract
Barriers to accessing offline healthcare may discourage patients from undergoing mammography screening. Online patient-provider communication (OPPC) offers a supplementary health resource that can complement traditional medical encounters and facilitate mammography screening. This study examines how offline healthcare barriers influence mammography screening, taking into account OPPC as an independent variable and cancer fatalism and patient activation as two mediators. Data from the 2017, 2018, and 2020 iterations of the Health Information National Trends Survey were used for this study. Results showed that OPPC was positively linked to mammography screening. Offline healthcare barriers had a negative association with patient activation and subsequent mammography behaviors. Moreover, offline healthcare barriers and OPPC were associated with mammography screening through serial mediation of cancer fatalism and patient activation. This study has important implications for encouraging mammography screening.
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Hay JL, Wu Y, Schofield E, Kaphingst K, Sussman AL, Guest DD, Hunley K, Li Y, Buller D, Berwick M. Exploring the role of cancer fatalism and engagement with skin cancer genetic information in diverse primary care patients. Psychooncology 2024; 33:e6331. [PMID: 38546209 DOI: 10.1002/pon.6331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 01/29/2024] [Accepted: 03/14/2024] [Indexed: 06/22/2024]
Abstract
OBJECTIVE To broaden the currently limited reach of genomic innovations, research is needed to understand how psychosocial and cultural factors influence reactions to genetic testing in diverse subgroups. Cancer fatalism is important in cancer prevention and deserves theoretical and empirical attention in the context of genomics and behavior change. METHODS The current study employed data from a randomized controlled trial (N = 593) offering skin cancer genetic testing (using the melanocortin-1 receptor [MC1R] gene) in primary care in Albuquerque, New Mexico, USA. We examined interrelations of cancer fatalism with demographics, general health beliefs, perceived risk, perceived control, sun protection and skin screening behaviors and cancer worry in the skin cancer context stratified across Hispanic versus non-Hispanic ethnicity, and examined cancer fatalism as a moderator of intervention effects on study primary outcomes, including 3-month sun protection, cancer worry and perceived risk. RESULTS Cancer fatalism was significantly related to the perception of control over skin cancer risk behaviors (ps ≤ 0.01) and demographics (ethnicity, education, health literacy; ps < 0.05), but not consistently related to general health beliefs or risk perception. Cancer fatalism did not moderate intervention effects on primary outcomes, except those with higher cancer fatalism randomized to intervention had higher levels of 3-month cancer worry (p = 0.019). CONCLUSIONS These findings will guide future work considering the role of cancer fatalism in use of genomic technologies in the general population. This work anticipates strategies required to address cancer fatalism as translational genomics becomes more commonly available to diverse general population subgroups.
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Affiliation(s)
- Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Yelena Wu
- Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
- Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA
| | - Elizabeth Schofield
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Kim Kaphingst
- Cancer Communication Research, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
| | - Andrew L Sussman
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - Delores D Guest
- University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico, USA
| | - Keith Hunley
- Department of Anthropology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Yuelin Li
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA
- Department of Dermatology, University of New Mexico, Albuquerque, New Mexico, USA
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Tran L, Young JL, Barton CM, Hodan R, Hanson-Kahn A, Chun N. Family health beliefs and cascade genetic testing in Asian families with hereditary cancer risk: "Okay, now what?". J Genet Couns 2024. [PMID: 38504135 DOI: 10.1002/jgc4.1891] [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: 08/07/2023] [Revised: 12/12/2023] [Accepted: 03/12/2024] [Indexed: 03/21/2024]
Abstract
The limited literature on Asian family communication of hereditary cancer risk and cascade genetic testing for pathogenic variants (PVs) in BRCA1 and BRCA2 has reported that Asian patients have selective communication of test results and lower cascade testing rates. To better understand the factors that impact communication and cascade testing in Asian families, we conducted an in-depth qualitative study guided by the Health Belief Model. Participants with heterozygous PVs in ATM, BRCA1, BRCA2, CHEK2, or PALB2, who identified their family's origins to an Asian country, were recruited from the Stanford Cancer Genetics Research Database in October-November 2021. Utilizing a constructivist approach, we conducted sixteen semi-structured interviews around family communication and cascade genetic testing. The research team analyzed the transcript data using a reflexive thematic approach. Extensive discussions between the research team resulted in three primary themes presented in this paper: (1) the role of family health beliefs in cascade genetic testing, (2) changes in communication as a result of genetic testing, and (3) genetics providers' role in supporting family discussions on cascade genetic testing. Certain health beliefs, such as perceived susceptibility to cancer and self-efficacy to take action, were co-created by family members and these shared beliefs influenced decisions about genetic testing, family communication, and family support during the cascade genetic testing process. Participants shared strategies for how genetics providers can prepare Asian patients for more effective conversations with relatives and better address potential testing barriers by tailoring information and providing anticipatory guidance. This study represents an important contribution to the literature about cascade testing among an underrepresented group. Shared family health beliefs about genetic testing may be particularly relevant for this community and these findings can inform strategies to increase cascade genetic testing in Asian families.
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Affiliation(s)
- Leena Tran
- Stanford School of Medicine, Stanford University, Stanford, California, USA
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai, Los Angeles, California, USA
| | - Jennifer L Young
- Center for Genetic Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Claire M Barton
- Stanford School of Medicine, Stanford University, Stanford, California, USA
- Department of Pediatrics, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Rachel Hodan
- Cancer Genetics, Stanford Health Care, Palo Alto, California, USA
- Department of Pediatrics (Genetics), Stanford University School of Medicine, Palo Alto, California, USA
| | - Andrea Hanson-Kahn
- Stanford School of Medicine, Stanford University, Stanford, California, USA
- Department of Pediatrics (Genetics), Stanford University School of Medicine, Palo Alto, California, USA
| | - Nicolette Chun
- Cancer Genetics, Stanford Health Care, Palo Alto, California, USA
- Department of Pediatrics (Genetics), Stanford University School of Medicine, Palo Alto, California, USA
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Baeker Bispo J, Lee H, Pal Choudhury P, Bailey Z, Jemal A, Islami F. Government Housing Assistance and Cancer Screening Among Adults With Low Income. Am J Prev Med 2024; 66:205-215. [PMID: 37943202 DOI: 10.1016/j.amepre.2023.10.005] [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: 05/11/2023] [Revised: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 11/10/2023]
Abstract
INTRODUCTION Access to affordable housing may support cancer control for adults with low income by alleviating financial barriers to preventive care. This study examines relationships between cancer screening and receipt of government housing assistance among adults with low income. METHODS Data are from the 2019 and 2021 National Health Interview Survey. Eligible respondents were classified as up-to-date or not with breast cancer (BC), cervical cancer (CVC) and colorectal cancer (CRC) screening guidelines. Multivariable logistic regression was used to model guideline-concordant screening by receipt of government housing assistance, overall and stratified by urban-rural status, race/ethnicity, and age. Analyses were performed in 2023. RESULTS Analyses for BC, CVC and CRC screening included 2,258, 3,132, and 3,233 respondents, respectively. There was no difference in CVC screening by housing assistance status, but screening for BC and CRC was higher among those who received assistance compared to those who did not (59.7% vs. 50.8%, p<0.01 for BC; 57.1% vs. 44.1%, p<0.01 for CRC). In models adjusted for sociodemographic characteristics, health status and insurance, these differences were not statistically significant for either BC or CRC screening. In stratified adjusted models, housing assistance was statistically significantly associated with increased BC screening in urban areas (aOR=1.35, 95% CI=1.00-1.82) and among Hispanic women (aOR=2.20, 95% CI=1.01-4.78) and women 45-54 years of age (aOR=2.10, 95% CI=1.17-3.75). CONCLUSIONS Policies that address housing affordability may enhance access to BC screening for some subgroups, including women in urban areas, Hispanic women, and younger women. More research on the mechanisms that link housing assistance to BC screening is needed.
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Affiliation(s)
- Jordan Baeker Bispo
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia.
| | - Hyunjung Lee
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Parichoy Pal Choudhury
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Zinzi Bailey
- University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Ahmedin Jemal
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Farhad Islami
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
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Miyawaki R, Oka K, Otsuki AK, Saito J, Yaguchi-Saito A, Kuchiba A, Fujimori M, Kreps GL, Shimazu T. Trust in Mass Media as Sources of Cancer Information: Findings from a Nationally Representative Cross-Sectional Survey in Japan. JOURNAL OF HEALTH COMMUNICATION 2024; 29:143-154. [PMID: 38126891 DOI: 10.1080/10810730.2023.2294471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Trust is a major factor in effective public dissemination and use of relevant health information to guide important health decisions. To examine mass media as a communication channel for delivering cancer information among Japanese adults, we identified the level of trust in various types of mass media as sources of cancer information, and examined factors associated with trust, including exposure to mass media, sociodemographic factors, and cancer history. Data were analyzed for 3,109 Japanese adults who responded to a nationally representative cross-sectional mail survey. Data included trust in cancer information sources, sociodemographic variables, cancer history, and exposure to mass media. Logistic regression analysis was used. The prevalence of high trust in cancer information sources was highest for physicians (94.7%). Among mass media, Internet (47.2%) was the most trusted source of cancer-related information, followed by television (44.3%), newspapers/magazines (42.7%), and radio (32.7%). The high-exposure group for newspapers (AOR = 1.28, 95%CI = 1.07-1.54) was more likely to trust newspapers. Similarly, high-exposure groups for radio (1.22, 1.02-1.45), Internet (1.21, 1.01-1.45), and television (1.30, 1.10-1.53) were positively associated with trust in each media type. Although trust in mass media was lower than trust in physicians, the study found that a large group of respondents had high levels of trust in mass media sources. Trust in cancer information from each mass media type was mainly related to the level of exposure to each mass media type. Developing health communication strategies using mass media may be effective for disseminating relevant cancer information in Japan.
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Affiliation(s)
- Rina Miyawaki
- School of Arts and Letters, Meiji University, Tokyo, Japan
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - AKi Otsuki
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
- Division of Prevention, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Junko Saito
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Akiko Yaguchi-Saito
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
- Faculty of Human Sciences, Tokiwa University, Ibaraki, Japan
| | - Aya Kuchiba
- Division of Biostatistical Research, Institution for Cancer Control/Biostatistics Division, Center for Research Administration and Support, National Cancer Center Hospital, Tokyo, Japan
- Graduate School of Health Innovation, Kanagawa University of Human Services Kanagawa Japan
| | - Maiko Fujimori
- Division of Survivorship Research, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Gary L Kreps
- Center for Health and Risk Communication, George Mason University, Fairfax, Virginia, USA
| | - Taichi Shimazu
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, Japan
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Aruma JF, Hearn M, Bernacchi V, Moss JL. Examining the roles of travel distance, medical mistrust, and cancer fatalism in the uptake of clinical cancer prevention among women in rural and urban US communities: A secondary data analysis. Prev Med Rep 2024; 38:102611. [PMID: 38375162 PMCID: PMC10874844 DOI: 10.1016/j.pmedr.2024.102611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/04/2024] [Accepted: 01/12/2024] [Indexed: 02/21/2024] Open
Abstract
Introduction Rural adults are less likely to receive cancer screening than urban adults, likely due to systematic differences in community- and individual-level factors. The purpose of this study was to analyze the relative contributions of rurality, travel time, medical mistrust, and cancer fatalism in explaining uptake of clinical cancer prevention services. Methods We conducted a secondary data analysis of 2019-2020 survey data from women, ages 45-65, in rural and urban counties in central Pennsylvania, examining rurality, travel time to a primary care provider, medical mistrust, and cancer fatalism, as well as uptake of guideline-recommended colorectal cancer screening, cervical cancer screening, and preventive check-up. Final models used multivariable logistic regression to assess the relationships among study variables, controlling for participant demographics. Results Among 474 participants, 48.9 % resided in rural counties. Most participants had received clinical cancer prevention services (colorectal cancer screening: 55.4 %; cervical cancer screening: 82.8 %; preventive check-up in the last year: 75.4 %). Uptake of services was less common among participants with higher medical mistrust (colorectal cancer screening: adjusted odds ratio [aOR] = 0.87, 95 % confidence interval [CI] = 0.76-1.00; cervical cancer screening: aOR = 0.79, 95 % CI = 0.63-1.00; last-year check-up: aOR = 0.74, 95 % CI = 0.63-0.88). Conclusions Patient attitudes, particularly medical mistrust, may contribute to rural/urban disparities in clinical cancer prevention among women. Community- and individual-level interventions are needed to improve cancer outcomes in rural areas.
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Affiliation(s)
- Jane-Frances Aruma
- Penn State College of Medicine, The Pennsylvania State University, State College, PA, USA
| | - Madison Hearn
- Penn State College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Veronica Bernacchi
- Penn State College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Jennifer L. Moss
- Penn State College of Medicine, The Pennsylvania State University, Hershey, PA, USA
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Elbarazi I, Aziz F, Ahmed LA, Abdullahi AS, Al-Maskari F. Cancer Health Literacy and Its Correlated Factors in the United Arab Emirates-A Cross Sectional Study. Cancer Control 2024; 31:10732748241248032. [PMID: 38717601 PMCID: PMC11146015 DOI: 10.1177/10732748241248032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 03/15/2024] [Accepted: 04/01/2024] [Indexed: 06/05/2024] Open
Abstract
INTRODUCTION Cancer Health literacy (CHL) is the health literacy related to cancer knowledge, prevention, treatment, screening, and access to services. It is an important indicator of people's adherence to screening and preventive measures, which helps to reduce the incidence and prevalence of cancer. The study assessed the CHL level and its association with relevant socio-demographic characteristics and sources of information among primary health care patients and visitors in the United Arab Emirates (UAE). METHODS A cross-sectional study recruited survey participants who consented to respond to an interviewer-administered questionnaire. The assessment of CHL was done by using 15 questions. CHL level was measured as a median score and also categorized as poor/inadequate, moderate, good/excellent. Nominal logistic regression was used to analyze the relationship between CHL categories and participants' sociodemographic characteristics and CHL sources of information. RESULTS Of the total 492 participants, 45.5% were young adults (30-39 years old), 32.9% were males, and 70.8% were UAE nationals. The overall median CHL score was 8.0 (IQR = 5.0-10). 33.7% of the participants had a poor/inadequate level of CHL, 49.6% had a moderate level and 16.7% had a good to excellent level of CHL. 76.9% of the participants knew the importance of early cancer screening tests, 72.7% acknowledged the metastatic capacity of cancer, and the protective factors of cancer, especially, in colon cancer (71.7%). A high proportion of participants received health information about cancer via the internet (50.7%), television (45.3%), social media (40.2%), and doctors (43.6%). Nationality other than UAE (aOR = 1.62, 95% CI = 1.03-2.56, P = .038), having university education (aOR = 2.20, 95% CI = 1.21-3.99, P = .010) compared to those with lower than high school, and having a family history of cancer (aOR = 2.42, 95% CI = 1.33-4.41, P = .004) were positively associated with CHL. Older age (aOR = .36, 95% CI = .17-.75, P = .007 for 50-59 years, and aOR = .29, 95% CI = .11-.82, P = .019) for 60-69 years, higher-income (aOR = .57, 95% CI = .33-.99, P = .047 for 10,000-19,999 AED; aOR = .53, 95% CI = .33-.88, P = .013 for ≥20,000) compared with those earning <10,000 AED were negatively associated with CHL. CONCLUSIONS CHL among the resident UAE population was moderately adequate, therefore implementation of awareness campaigns seems to be warranted. Moreover, evaluation research targeting the CHL impact on cancer prevention practices and screening is also advocated.
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Affiliation(s)
- Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Science, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Faisal Aziz
- Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Luai A. Ahmed
- Institute of Public Health, College of Medicine and Health Science, United Arab Emirates University, Al Ain, United Arab Emirates
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Aminu S. Abdullahi
- Institute of Public Health, College of Medicine and Health Science, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Fatima Al-Maskari
- Institute of Public Health, College of Medicine and Health Science, United Arab Emirates University, Al Ain, United Arab Emirates
- Zayed Center for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Rivera Rivera JN, Lacson JCA, Kim Y, Roetzheim RG, Sutton SK, Soto-Torres B, Vadaparampil ST, Kanetsky PA. Sharing and seeking information about skin cancer risk and prevention among Hispanic people from Florida and Puerto Rico. PEC INNOVATION 2023; 3:100232. [PMID: 38028436 PMCID: PMC10679524 DOI: 10.1016/j.pecinn.2023.100232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/02/2023] [Accepted: 11/11/2023] [Indexed: 12/01/2023]
Abstract
Objective To explore factors associated with communication and information-seeking after receipt of skin cancer prevention information among Hispanic individuals. Methods Multivariable logistic regression was used to analyze existing data on demographics, personal experience, salience, and beliefs variables collected from Hispanic individuals to determine independent associations with sharing and seeking information about skin cancer prevention. Results Of 578 participants, 53% reported any communication about skin cancer prevention behaviors or skin cancer genetic risk; and 31% and 21% sought additional information about preventive behaviors or genetic risk, respectively. Female sex, greater perceived severity, higher comparative chance of getting skin cancer, and lower health literacy were associated with greater communication, while having no idea of one's own skin cancer risk was related to less communication. Greater health numeracy and higher cancer worry were associated with information-seeking about prevention behaviors and genetic risk. Conclusion Up to half of participants reported communication or information-seeking, although factors associated with specific activities differed. Future studies should evaluate how to promote communication behaviors in the Hispanic community and how sharing and seeking information influence an individual's network prevention practices. Innovation Several factors related to communication behaviors among Hispanic people after obtaining skin cancer prevention information were identified.Trial registration: This trial was registered on clinicaltrials.gov (NCT03509467).
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Affiliation(s)
- Jessica N. Rivera Rivera
- Department of Health and Behavioral Outcomes, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America
- Health Care Delivery Research, MedStar Health Research Institute, Washington, DC, United States of America
| | - John Charles A. Lacson
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America
| | - Youngchul Kim
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America
| | - Richard G. Roetzheim
- Department of Family Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, United States of America
| | - Steven K. Sutton
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America
| | - Brenda Soto-Torres
- Public Health Program, Ponce Health Sciences University, Ponce, PR, United States of America
| | - Susan T. Vadaparampil
- Department of Health and Behavioral Outcomes, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America
| | - Peter A. Kanetsky
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States of America
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Zhang X, Shoben AB, Felix AS, Focht BC, Paskett ED. Differences in obesity-related health behaviors and health outcomes by rural and Appalachian residency. Cancer Causes Control 2023; 34:1113-1121. [PMID: 37498505 PMCID: PMC10547622 DOI: 10.1007/s10552-023-01741-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/21/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE Obesity and health behaviors are the major modifiable contributors to cancer and health disparities. We examined the differences in obesity-related health behaviors, and health outcomes by rural and Appalachian residency in Ohio. METHODS Cross-sectional survey data from the 2011-2019 Behavioral Risk Factor Surveillance System were obtained from the Ohio Department of Health. County-level identifiers were used to classify urban non-Appalachian, urban Appalachian, rural non-Appalachian, and rural Appalachian residency. Self-reported weight, height, health behaviors, and health conditions were used. Logistic regression was used to assess the difference in health behaviors and health outcomes by rural and Appalachian residency. All analyses incorporated with sample weights. RESULTS Among Ohio residents, compared to urban non-Appalachian residents, urban Appalachian and rural Appalachian residents had a higher prevalence of obesity, hypertension, high cholesterol, and cardiovascular diseases, as well as lower rates of healthy diet and physical activity. No difference was found in trends of obesity and obesity-related health outcomes in 2011-2019 by rural and Appalachian residency. However, rural Appalachian residents had a greater increase in obesity, hypertension, and diabetes, whereas rural non-Appalachian had favorable changes in obesity-related health behaviors. Additionally, associations between health behaviors and obesity-related health outcomes differed by rural and Appalachian residency. CONCLUSIONS Findings underscore the importance of distinguishing between urban non-Appalachian, urban Appalachian, rural non-Appalachian, and rural Appalachian populations when assessing health disparities. While the trends of obesity and obesity-related health outcomes did not differ, the association between health behaviors and obesity-related outcomes differed by rural and Appalachian residency.
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Affiliation(s)
- Xiaochen Zhang
- Public Health Sciences, Fred Hutchison Cancer Center, Seattle, WA, USA
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, 1590 N High Street, Suite 525, Columbus, OH, USA
| | - Abigail B Shoben
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Ashley S Felix
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Brian C Focht
- Kinesiology, Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Electra D Paskett
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, 1590 N High Street, Suite 525, Columbus, OH, USA.
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Slavik CE, Yiannakoulias N, Wilton R, Scott F. An Exploratory Study on the Impacts of Individual Skills and Health Information Exposure on Perceptions of Cancer Control and Expert Competence. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:1584-1591. [PMID: 37103679 DOI: 10.1007/s13187-023-02303-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/21/2023] [Indexed: 06/19/2023]
Abstract
People's perceptions of control over their risk of cancer, and their perceptions of health experts' abilities to manage cancer risks, shape their beliefs about the effectiveness of expert-recommended cancer-preventive behaviors and actions. The aims of this exploratory study were to investigate the impact of individual skills and sources of health information on (i) internal locus of cancer control (ILOC) and (ii) perceived expert competence. Using a cross-sectional survey (n = 172), we collected data on individual health expertise, numeracy, health literacy, amounts of health information received from various sources, ILOC for cancer prevention and perceived expert competence (i.e., believing that health experts have the knowledge to correctly estimate cancer risks). Significant associations between health expertise and ILOC, and between health literacy and ILOC, were not observed in this study (OR = 2.15, 95%CI = 0.96-5.98; OR = 1.78, 95%CI = 0.97-3.63, respectively). Participants who received more health information from the news were more likely to perceive experts as competent (OR = 1.86, 95%CI = 1.06-3.57). Logistic regression analyses suggested that higher levels of health literacy among individuals with lower numeracy may promote ILOC but discourage expert competence beliefs. Analyses by gender suggested females with low educational attainment and lower numeracy may especially benefit from educational interventions to improve health literacy and promote ILOC. Our findings build off existing literature that point to a possible interaction between numeracy and health literacy. This research, with follow up work, may have practical implications for health educators aiming to promote specific cancer beliefs that lead to the uptake of expert-recommended cancer-preventive behaviors.
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Affiliation(s)
- Catherine E Slavik
- School of Earth, Environment and Society, General Sciences Building, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
| | - Niko Yiannakoulias
- School of Earth, Environment and Society, McMaster University, Hamilton, Canada
| | - Robert Wilton
- School of Earth, Environment and Society, McMaster University, Hamilton, Canada
| | - Fran Scott
- Department of Health, Aging & Society, McMaster University, Hamilton, Canada
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Skipper TA, Weiss JE, Carlos HA, Gunn CM, Hasson RM, Peacock JL, Schiffelbein JE, Tosteson AN, Lansigan F, Rees JR. A Survey of Cancer Risk Behaviors, Beliefs, and Social Drivers of Health in New Hampshire and Vermont. CANCER RESEARCH COMMUNICATIONS 2023; 3:1678-1687. [PMID: 37649812 PMCID: PMC10464638 DOI: 10.1158/2767-9764.crc-23-0267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/28/2023] [Accepted: 07/28/2023] [Indexed: 09/01/2023]
Abstract
Compared with urban areas, rural areas have higher cancer mortality and have experienced substantially smaller declines in cancer incidence in recent years. In a New Hampshire (NH) and Vermont (VT) survey, we explored the roles of rurality and educational attainment on cancer risk behaviors, beliefs, and other social drivers of health. In February-March 2022, two survey panels in NH and VT were sent an online questionnaire. Responses were analyzed by rurality and educational attainment. Respondents (N = 1,717, 22%) mostly lived in rural areas (55%); 45% of rural and 25% of urban residents had high school education or less and this difference was statistically significant. After adjustment for rurality, lower educational attainment was associated with smoking, difficulty paying for basic necessities, greater financial difficulty during the COVID-19 pandemic, struggling to pay for gas (P < 0.01), fatalistic attitudes toward cancer prevention, and susceptibility to information overload about cancer prevention. Among the 33% of respondents who delayed getting medical care in the past year, this was more often due to lack of transportation in those with lower educational attainment (21% vs. 3%, P = 0.02 adjusted for rurality) and more often due to concerns about catching COVID-19 among urban than rural residents (52% vs. 21%; P < 0.001 adjusted for education). In conclusion, in NH/VT, smoking, financial hardship, and beliefs about cancer prevention are independently associated with lower educational attainment but not rural residence. These findings have implications for the design of interventions to address cancer risk in rural areas. Significance In NH and VT, the finding that some associations between cancer risk factors and rural residence are more closely tied to educational attainment than rurality suggest that the design of interventions to address cancer risk should take educational attainment into account.
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Affiliation(s)
- Thomas A. Skipper
- Dartmouth Cancer Center, Lebanon, New Hampshire
- Department of Molecular and Systems Biology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | | | | | - Christine M. Gunn
- Dartmouth Cancer Center, Lebanon, New Hampshire
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Rian M. Hasson
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
- Department of Surgery, Section of Thoracic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Janet L. Peacock
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | | | - Anna N.A. Tosteson
- Dartmouth Cancer Center, Lebanon, New Hampshire
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Frederick Lansigan
- Dartmouth Cancer Center, Lebanon, New Hampshire
- Department of Hematology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Judy R. Rees
- Dartmouth Cancer Center, Lebanon, New Hampshire
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
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Lin L, Zhang X, Yu M, Bernardo B, Adeyanju T, Paskett ED. The relationship between family history of cancer and cancer attitudes & beliefs within the Community Initiative Towards Improving Equity and Health Status (CITIES) cohort. PLoS One 2023; 18:e0287629. [PMID: 37368880 PMCID: PMC10298770 DOI: 10.1371/journal.pone.0287629] [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] [Received: 02/02/2022] [Accepted: 06/11/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE To determine the relationship between family history of cancer with cancer attitudes and beliefs (CABs) and cancer screening knowledge. METHODS This study used data collected for the Community Initiative Towards Improving Equity and Health Status (CITIES) project which surveyed Ohioans ages 21-74. In the current analysis, we included data on age, gender, race, marital status, education, income, financial security, health insurance, CABs, knowledge about the correct age to begin cancer screenings, and presence of a first-degree relative with cancer. Multivariable logistic regression was used to examine the association of family history of cancer with CABs and knowledge about the correct age to begin cancer screening. RESULTS Participants were predominantly over the age of 41, female, and white. Out of 603 participants, 295 (48.92%) reported not having a first-degree relative with cancer and 308 (51.08%) reported having a first-degree relative with cancer. Overall, 109 (18.08%) participants reported negative CABs, 378 (62.69%) reported moderate CABs, and 116 (19.24%) reported positive CABs. Participants who reported a first-degree relative with cancer were more likely to report positive CABs, but the association was not significant (p = .11). We observed that older, more educated, and married participants were more likely to have positive CABs (all p < 0.05). Family history of cancer was not associated with differences in knowledge about the correct age for beginning colorectal cancer screening (p = .85) and mammography (p = .88). CONCLUSIONS Having a first-degree relative with cancer was not found to be associated with CABs or knowledge about cancer screening. However, age and socioeconomic status were associated with more positive CABs and increased knowledge about cancer screening. Future research should focus on standardizing a CABs scale and expanding the generalizability of our findings.
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Affiliation(s)
- Li Lin
- College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
| | - Xiaochen Zhang
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, United States of America
| | - Mengda Yu
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, United States of America
| | - Brittany Bernardo
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, United States of America
| | - Toyin Adeyanju
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, United States of America
| | - Electra D. Paskett
- College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, United States of America
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Duru G, Topatan S. A barrier to participation in cervical cancer screenings: fatalism. Women Health 2023:1-9. [PMID: 37303197 DOI: 10.1080/03630242.2023.2223698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 04/29/2023] [Accepted: 05/18/2023] [Indexed: 06/13/2023]
Abstract
Cervical cancer is a significant disease affecting women's health in terms of its incidence and is one of the most preventable cancers. However, participation in early cervical cancer-screening programs has been unsatisfactory for various reasons. In this descriptive, relationship-seeking study, we examined the relationship between fatalism tendency, an individual barrier to participation in early cancer screening programs, and women's attitudes toward the early diagnosis of cervical cancer and undergoing the Pap smear test. Research data were collected between August 1, 2019 and December 1, 2019, in a city in northern Turkey from 602 women using a participant information form, the Attitudes Toward Early Diagnosis in Cervical Cancer Scale, and the Fatalism Tendency Scale. We found that fatalistic tendencies in women were a predictor of their attitudes toward the early diagnosis of cervical cancer (odds ratio [OR] = -0.64, β = .47, p < .001) and undergoing the Pap smear test (OR = 1.01, β = -.15, p < .001). Women with high fatalism tendencies had a more negative attitude toward the early diagnosis of cervical cancer and their participation rate in Pap smear screening programs was low. Therefore, nurses must consider women's fatalistic tendencies and attitudes toward cancer when organizing educational and informational programs that encourage participation in cervical cancer screening.
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Affiliation(s)
- Gökcem Duru
- Department of Medical Services and Techniques, Vocational School of Health Services, Gümüşhane University, Gümüşhane, Turkey
| | - Serap Topatan
- Department of Midwifery, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
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Fwelo P, Adzrago D, Adekunle AD, Adekunle TE, Akinlo A, Perkinson WB. Relationship between mental health disorder symptoms and negative cancer perceptions among U.S. adults. Cancer Causes Control 2023; 34:295-305. [PMID: 36593424 DOI: 10.1007/s10552-022-01665-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 12/20/2022] [Indexed: 01/03/2023]
Abstract
PURPOSE Although much emphasis has been placed on the impact of ambiguity on cognitive processes, the impact of mental health disorder symptoms and racial/ethnic disparities in cancer perception of fatalism and ambiguity remains less explored. This study explored the association between mental health disorder symptoms and negative cancer perceptions. Also, we assessed differences in these outcomes within mental health disorder symptoms and racial/ethnic subgroups to investigate the association between cancer perceptions and the other covariates within the aforementioned subgroups. METHODS We used the 2019-2020 Health Information National Trends Survey data (N = 9,303) to assess the perception of cancer fatalism and cancer communication ambiguity and employed weighted multivariable logistic regression to determine the effects of mental health disorder symptoms using the Patient Health Questionnaire-4 (PHQ-4) scale on these negative cancer perceptions among United States adults. RESULTS People with moderate [Adjusted Odds Ratio (AOR) = 1.58, 95% Confidence Interval (CI) = 1.09, 2.31] and severe anxiety/depression (AOR = 1.88, 95% CI = 1.12, 3.14) symptoms were more likely to have cancer fatalism perceptions than people with no anxiety/depression symptoms. People with mild (AOR = 1.33, 95% CI = 1.06, 1.69) or severe (AOR = 1.80, 95% CI = 1.03, 3.16) anxiety/depression symptoms were more likely to perceive cancer communication as ambiguous compared to people who had no anxiety/depression symptoms. CONCLUSIONS The study showed that mental health status was associated with both cancer fatalism and perceived cancer communication ambiguity. This suggests that interventions aimed at reducing mental health disorder symptoms may potentially reduce these negative perceptions, thereby improving participation in cancer prevention programs.
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Affiliation(s)
- Pierre Fwelo
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 7000 Fannin St., Suite 2052-4, Houston, TX, 77030, USA.
| | - David Adzrago
- Center for Health Promotion and Prevention Research, UTHealth School of Public Health, Houston, TX, USA
| | | | - Toluwani E Adekunle
- Department of Health Promotion and Behavioral Sciences, University of Louisville, School of Public Health and Information Sciences, Louisville, KY, USA
| | - Ambrose Akinlo
- Center for Health Promotion and Prevention Research, UTHealth School of Public Health, Houston, TX, USA
| | - William B Perkinson
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 7000 Fannin St., Suite 2052-4, Houston, TX, 77030, USA
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Espinoza‐Gutarra MR, Rawl SM, Maupome G, O'Leary HA, Valenzuela RE, Malloy C, Golzarri‐Arroyo L, Parker E, Haunert L, Haggstrom DA. Cancer-related knowledge, beliefs, and behaviors among Hispanic/Latino residents of Indiana. Cancer Med 2023; 12:7470-7484. [PMID: 36683200 PMCID: PMC10067073 DOI: 10.1002/cam4.5466] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/28/2022] [Accepted: 11/11/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Cancer is the leading cause of death for Hispanics in the USA. Screening and prevention reduce cancer morbidity and mortality. METHODS This study administered a cross-sectional web-based survey to self-identified Hispanic residents in the state of Indiana to assess their cancer-related knowledge, beliefs, and behaviors, as well as to identify what factors might be associated with cancer screening and prevention. Chi-square and Fisher's exact test were used to compare associations and logistic regression used to develop both univariate and multivariate regression models. RESULTS A total of 1520 surveys were completed, median age of respondents was 53, 52% identified as men, 50.9% completed the survey in Spanish, and 60.4% identified the USA as their country of birth. Most were not able to accurately identify ages to begin screening for breast, colorectal, or lung cancer, and there were significant differences in cancer knowledge by education level. US-born individuals with higher income and education more often believed they were likely to develop cancer and worry about getting cancer. Sixty eight percent of respondents were up-to-date with colorectal, 44% with breast, and 61% with cervical cancer screening. Multivariate models showed that higher education, lack of fatalism, older age, lower household income, and unmarried status were associated with cervical cancer screening adherence. CONCLUSIONS Among a Hispanic population in the state of Indiana, factors associated with cervical cancer screening adherence were similar to the general population, with the exceptions of income and marital status. Younger Hispanic individuals were more likely to be adherent with breast and colorectal cancer screening, and given the higher incidence of cancer among older individuals, these results should guide future research and targeted outreach.
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Affiliation(s)
- Manuel R. Espinoza‐Gutarra
- Division of Hematology and Oncology, Department of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Susan M. Rawl
- Indiana University Melvin and Bren Simon Comprehensive Cancer CenterIndianapolisIndianaUSA
- Indiana University School of NursingIndianapolisIndianaUSA
| | - Gerardo Maupome
- Indiana University Purdue University Indianapolis, Richard M. Fairbanks School of Public HealthIndianapolisIndianaUSA
| | | | | | - Caeli Malloy
- Indiana University School of NursingIndianapolisIndianaUSA
| | | | - Erik Parker
- School of Public HealthIndiana University BloomingtonBloomingtonIndianaUSA
| | - Laura Haunert
- Indiana University School of NursingIndianapolisIndianaUSA
- Indiana University School of MedicineIndianapolisIndianaUSA
| | - David A. Haggstrom
- Center for Health Services ResearchRegenstrief InstituteIndianapolisIndianaUSA
- VA HSR&D Center for Health Information and CommunicationRichard L. Roudebush Veterans Affairs Medical CenterIndianapolisIndianaUSA
- Division of General Internal Medicine and GeriatricsIndiana University School of MedicineIndianapolisIndianaUSA
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Haynes D, Hughes KD, Okafor A. PEARL: A Guide for Developing Community-Engaging and Culturally-Sensitive Education Materials. J Immigr Minor Health 2022; 25:666-673. [PMID: 36266493 PMCID: PMC9584241 DOI: 10.1007/s10903-022-01418-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2022] [Indexed: 12/02/2022]
Abstract
Community outreach and engagement has been a regular activity of the National Cancer Institute at its designated Cancer Centers. However, in 2016, community outreach and engagement became a required activity for all cancer centers. Yet there is a gap in the literature that provides guidelines for developing materials that resonate with communities. We developed the PEARL rubric to fulfill that gap from our work developing culturally sensitive breast cancer education materials for African American and Immigrant African women. We conducted a targeted literature review to understand the approaches that have been used for developing education materials for communities. We reviewed the literature and distilled key elements into our PEARL guide for creating culturally appropriate education materials. PEARL consists of five elements: Plain language and understandability, Explicit data, statistics, and graphs, Affirmative framing, Representative content, and Local connection. PEARL is a modern comprehensive guide that researchers can use for creating culturally sensitive materials. It is designed to guide researchers develop educational materials who have little to no experience in community engagement.
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Affiliation(s)
- David Haynes
- Institute for Health Informatics, University of Minnesota, Suite 8-100, 516 Delaware Street SE, Minneapolis, MN 55455 USA
| | - Kelly D. Hughes
- Minnesota Department of Health, Sage Program, 85 7Th Place E, St. Paul, MN 55101 USA
| | - Annette Okafor
- College of Letters and Sciences, University of Wisconsin-Madison, 1055 Bascom Mall, Madison, WI 53706 USA
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22
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Lu L, Liu J, Yuan YC. Cultural Differences in Cancer Information Acquisition: Cancer Risk Perceptions, Fatalistic Beliefs, and Worry as Predictors of Cancer Information Seeking and Avoidance in the U.S. and China. HEALTH COMMUNICATION 2022; 37:1442-1451. [PMID: 33752516 DOI: 10.1080/10410236.2021.1901422] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Cancer is one of the most common causes of death in China and the United States. Past studies found that cancer risk perceptions, fatalistic beliefs, and worry were prominent predictors of health-related behaviors. Perceived cancer risks, fatalistic beliefs, and worry were associated with cancer information acquisition in the United States. However, little is known about whether these factors played comparable roles in China. This study investigates the psychological antecedents of cancer information acquisition using data from Health Information National Trends Surveys (HINTS) in both countries. Results showed that cancer worry was negatively related to cancer information avoidance in the U.S. but positively related to information avoidance in China. Also, whereas cancer fatalistic beliefs were negatively associated with cancer information seeking in the U.S., the relationships between fatalistic beliefs and cancer information seeking exhibited more complex patterns in China. Implications for cancer communication in different cultures are discussed.
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Affiliation(s)
- Linqi Lu
- College of Media and International Culture, Zhejiang University, Hangzhou, Zhejiang, China
- Department of Communication, Cornell University, Ithaca, New York, USA
| | - Jiawei Liu
- Department of Communication, Cornell University, Ithaca, New York, USA
| | - Y Connie Yuan
- Department of Communication, Cornell University, Ithaca, New York, USA
- Department of Global Development, Cornell University, Ithaca, New York, USA
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Pinheiro LC, Soroka O, Razon DT, Antoine F, Rothman J, Kanis MJ, Khan U, Tamimi RM, Nanus D, Phillips E. Fatalistic cancer beliefs and self-reported cancer screening behaviors among diverse urban residents. J Behav Med 2022; 45:954-961. [PMID: 36083412 DOI: 10.1007/s10865-022-00358-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/15/2022] [Indexed: 10/14/2022]
Abstract
Cancer fatalism-the belief that death is inevitable when cancer is present-has been identified as a barrier to cancer screening, detection, and treatment. Our study examined the relationship between self-reported cancer fatalism and adherence to cancer screening guidelines of the breasts, cervix, colon, and prostate among a diverse sample of urban-dwelling adults in Brooklyn, New York. Between May 2019 and August 2020, we conducted a cross-sectional survey of adults 40 + years of age (n = 2,341) residing in Brooklyn neighborhoods with high cancer mortality. Multivariable logistic regression models were used to assess the odds of reporting cancer screening completion across three fatalistic cancer belief categories (low, med, high). Participants' median age was 61 (IQR 51, 71) years, 61% were women, 49% self-identified as non-Hispanic black, 11% Hispanic, 4% Asian, and 6% more than one race. There were no statistically significant differences in the proportion of low, some, or high fatalistic beliefs identified among male respondents compared to women. Among women, we observed that high fatalistic cancer beliefs were associated with higher odds (OR 2.01; 95% CI 1.10-3.65) of completing breast but not cervical (1.04; CI 0.55-1.99) or colon (1.54; CI 0.88-2.69) cancer screening. Men with high fatalistic cancer beliefs had a trend towards lower odds of prostate screening (OR 0.53: 95% CI 0.18-1.57) compared to men with low fatalistic beliefs, but neither was statistically significant. Findings suggest that high fatalistic cancer beliefs may be an important factor in cancer screening utilization among women. Further examination in longitudinal cohorts with a larger sample of men may be needed in order to identify any significant effect.
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Affiliation(s)
- Laura C Pinheiro
- Division of General Internal Medicine, Weill Cornell Medicine, 338 East 66thStreet, Box #46, New York, NY, 10021, USA.,Sandra and Edward Meyer Cancer Center, NewYork-Presbyterian Weill Cornell, New York, New York, NY, USA.,Department of Population Health Sciences, Weill Cornell Medicine, NY, New York, USA
| | - Orysya Soroka
- Division of General Internal Medicine, Weill Cornell Medicine, 338 East 66thStreet, Box #46, New York, NY, 10021, USA
| | - Dominic T Razon
- Division of General Internal Medicine, Weill Cornell Medicine, 338 East 66thStreet, Box #46, New York, NY, 10021, USA.,Sandra and Edward Meyer Cancer Center, NewYork-Presbyterian Weill Cornell, New York, New York, NY, USA
| | - Francesse Antoine
- Division of General Internal Medicine, Weill Cornell Medicine, 338 East 66thStreet, Box #46, New York, NY, 10021, USA.,Sandra and Edward Meyer Cancer Center, NewYork-Presbyterian Weill Cornell, New York, New York, NY, USA
| | - Julia Rothman
- College of Human Ecology, Cornell University - Martha Van Rensselaer Hall, Ithaca, NY, USA
| | - Margaux J Kanis
- Division of Gynecological Oncology, NewYork-Presbyterian Brooklyn Methodist Hospital, NY, Brooklyn, USA
| | - Uqba Khan
- Division of Hematology and Oncology, Department of Medicine, NewYork-Presbyterian Brooklyn Methodist Hospital, NY, Brooklyn, USA
| | - Rulla M Tamimi
- Sandra and Edward Meyer Cancer Center, NewYork-Presbyterian Weill Cornell, New York, New York, NY, USA.,Department of Population Health Sciences, Weill Cornell Medicine, NY, New York, USA
| | - David Nanus
- Sandra and Edward Meyer Cancer Center, NewYork-Presbyterian Weill Cornell, New York, New York, NY, USA.,Division of Hematology and Oncology, Department of Medicine, NewYork-Presbyterian Weill Cornell Medicine, NY, New York, USA
| | - Erica Phillips
- Division of General Internal Medicine, Weill Cornell Medicine, 338 East 66thStreet, Box #46, New York, NY, 10021, USA. .,Sandra and Edward Meyer Cancer Center, NewYork-Presbyterian Weill Cornell, New York, New York, NY, USA.
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24
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Selvi A, Kaya H. The Relationship Between Learning Needs and Fatalism Tendency in Women Who Have a Relative with Breast Cancer. JOURNAL OF RELIGION AND HEALTH 2022; 61:1333-1350. [PMID: 34350540 DOI: 10.1007/s10943-021-01339-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/03/2021] [Indexed: 06/13/2023]
Abstract
The aim of this study was to determine the information-support needs and level of meeting these needs, the tendency of fatalism trend, and the relationship between these parameters in women having a relative with breast cancer. The research was carried out with 400 women who were the primary relatives of patients treated within oncology units. Participants completed an information form, the information support needs questionnaire and the fatalism tendency scale. There was found to be a high, negative and weak significant relationship between the mean of needs for information-support and the mean of fatalism tendency scale (r = - 343; p < .001) and high, negative and average significant relationship with fulfilling their needs. There was also a negative relationship between the importance for information-support needs, fulfilling their needs and fatalism tendency in women who have relatives with breast cancer.
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Affiliation(s)
- Aşkın Selvi
- Clinical Nurse Educator and Infection Control Nurse, Beykent University Hospital, Büyükçekmece, Istanbul, Turkey.
| | - Hülya Kaya
- Nursing Education Department, Florence Nightingale Faculty of Nursing, Istanbul University- Cerrahpaşa, 34381, Şişli, İstanbul, Turkey
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25
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Hamshari S, Nazzal Z, Altell M, Nanaa I, Jbara R, Sabri R. Mammogram uptake and barriers among Palestinian women attending primary health care in North Palestine. Eur J Gen Pract 2021; 27:264-270. [PMID: 34633262 PMCID: PMC8510586 DOI: 10.1080/13814788.2021.1985996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Breast cancer affects women's lives worldwide, yet early detection is an effective strategy for reducing mortality. The participation of women in mammography screening is linked to their knowledge, attitudes and perceived barriers. Objectives Our study aims to assess mammography screening uptake and barriers among women attending primary healthcare centres (PHCs) in northern Palestine. Methods Using an interviewer administered questionnaire, we used a cross-sectional study design to determine mammography screening uptake, knowledge and barriers among 357 women attending PHCs in Northern Palestine between December 2018 and March 2019. Results The mean age was 50 years. The majority (69.2%) were considered to have adequate knowledge about breast cancer and mammography screening. Mammography screening uptake among the participants was 37%. Almost 85% of the women had a positive attitude towards breastfeeding as a prophylaxis factor against breast cancer, while the most frequent barrier to mammography screening was that the participants believed they did not have any symptoms (28.6%), followed by 22.1% of them who did not want to know if they had breast cancer. Conclusion The findings of this study highlighted the low mammography uptake among Palestinian women despite the adequate knowledge of those women and the fully accessible and free screening programme. Hence, interventional strategies should be implemented at several levels to enhance mammogram uptake.
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Affiliation(s)
- Suha Hamshari
- Family and Community Medicine Department, An-Najah National University, Nablus, Palestine
| | - Zaher Nazzal
- Family and Community Medicine Department, An-Najah National University, Nablus, Palestine
| | - Mariam Altell
- Department of Public Health, Faculty of Medicine and Health Sciences, Nablus, Palestine
| | - Israa Nanaa
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Rawan Jbara
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Ruba Sabri
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Moss JL, Popalis M, Ramirez SI, Reedy-Cooper A, Ruffin MT. Disparities in Cancer Screening: The Role of County-Level Metropolitan Status and Racial Residential Segregation. J Community Health 2021; 47:168-178. [PMID: 34550504 DOI: 10.1007/s10900-021-01035-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2021] [Indexed: 12/21/2022]
Abstract
Mortality from cervical and colorectal cancers can be reduced through routine screening, which can often be accessed through primary care. However, uptake of screening in the US remains suboptimal, with disparities observed across geographic characteristics, such as metropolitan status or level of racial residential segregation. Little is known about the interaction of metropolitan status and segregation in their relationship with cancer screening. We conducted a quantitative survey of 474 women aged 45-65 in central Pennsylvania. The survey collected county-level characteristics and participant-level demographics, beliefs, cancer screening barriers, and cervical and colorectal cancer screening. We used bivariate and multivariable logistic regression to analyze relationships between metropolitan status and segregation with screening. For cervical cancer screening, 82.8% of participants were up-to-date, which did not differ by county type in the final analysis. Higher healthcare trust, higher cancer fatalism, and reporting cost as a barrier were associated with cervical cancer screening. For colorectal cancer screening, 55.4% of participants were up-to-date, which differed by county type. In metropolitan counties, segregation was not associated with colorectal cancer screening, but in non-metropolitan counties, segregation was associated with greater colorectal cancer screening. The relationship between metropolitan status and being up-to-date with colorectal, but not cervical, cancer screening varied by segregation. Other important beliefs and barriers to screening varied by county type. This research can guide future cancer screening interventions in primary care settings in underserved communities.
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Affiliation(s)
- Jennifer L Moss
- Penn State College of Medicine, The Pennsylvania State University, Hershey, PA, USA.
- Department of Family and Community Medicine, Department of Public Health Sciences, Penn State College of Medicine, The Pennsylvania State University, 134 Sipe Ave., #205, MC HS72, P.O. Box 850, Hershey, PA, 17033, USA.
| | - Madyson Popalis
- Penn State College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Sarah I Ramirez
- Penn State College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Alexis Reedy-Cooper
- Penn State College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Mack T Ruffin
- Penn State College of Medicine, The Pennsylvania State University, Hershey, PA, USA
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27
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Link E, Baumann E. Explaining cancer information avoidance comparing people with and without cancer experience in the family. Psychooncology 2021; 31:442-449. [PMID: 34549858 DOI: 10.1002/pon.5826] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Cancer information avoidance (CIA) serves as a barrier to preventive efforts. To learn how to combat this barrier, we aim to examine predictors of CIA in populations with and without cancer experience in the family, which are addressed differently in cancer prevention, according to specific informational barriers. METHODS A subsample of people with and without cancer in the family (n = 2,757) of an online survey with a sample stratified for the German population by age, gender, education, and region was conducted via an online access panel. The survey instrument was adapted from the Health Information National Trends Survey. Separate stepwise regression analyses were conducted. RESULTS Only a comparatively small proportion of the variance in CIA was explained by the predictors, ranging from R2 = .148 for people without cancer experience to R2 = .180 for participants with cancer experience in their family. Across the groups, the findings showed that people who were fatalistic about the risk of cancer, less health literate, who perceived less social pressure to be informed, and were less trusting in information sources more often avoided cancer information. CONCLUSIONS Our findings identify relevant target groups to be addressed and barriers to be removed for cancer communication efforts. Adequate information provision can be supported by programs for fostering health literacy and social network diffusion strategies.
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Affiliation(s)
- Elena Link
- Department of Journalism and Communication Research, Hanover University of Music, Drama and Media, Hanover, Germany
| | - Eva Baumann
- Department of Journalism and Communication Research, Hanover University of Music, Drama and Media, Hanover, Germany
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28
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Yu L, Zheng F, Xiong J, Wu X. Relationship of patient-centered communication and cancer risk information avoidance: A social cognitive perspective. PATIENT EDUCATION AND COUNSELING 2021; 104:2371-2377. [PMID: 33583647 DOI: 10.1016/j.pec.2021.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/11/2021] [Accepted: 02/03/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE We examined the relationship between patient-centered communication and cancer risk information avoidance and estimated the mediating role of self-efficacy in this relationship. METHODS Using nationally representative cross-sectional data from the U.S. Health Information National Trends Survey (N = 2033), this study aims to provide a comprehensive understanding of the relationship between patient-centered communication and cancer risk information avoidance via correlation analysis, stepwise regression models, and mediation analysis. RESULTS Patient-centered communication was significantly negatively associated with cancer risk information avoidance (β= -0.09, p < 0.01) after controlling for gender, income, education, and cancer risk perception. Self-efficacy fully mediated the relationship of patient-centered communication with cancer risk information avoidance. CONCLUSION Patient-centered communication can improve patients' self-efficacy, thereby preventing them from avoiding cancer risk information. PRACTICE IMPLICATIONS The negative relationship between patient-centered communication and cancer risk information avoidance substantiates that improving patient-centered communication is a promising approach to support caregivers in their activities, reduce patients' subjective cancer burden, and even improve their health. To address cancer-related issues, policymakers can consider interventions from the external environment and internal personal cognition perspectives.
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Affiliation(s)
- Lei Yu
- School of Medicine and Health Management, Huazhong University of Science and Technology, 430030 Wuhan, China.
| | - Feiyang Zheng
- School of Medicine and Health Management, Huazhong University of Science and Technology, 430030 Wuhan, China.
| | - Jie Xiong
- Department of Strategy, Entrepreneurship & International Business, ESSCA School of Management, 49003 Angers, France.
| | - Xiang Wu
- School of Medicine and Health Management, Huazhong University of Science and Technology, 430030 Wuhan, China.
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29
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Guo Y, Szurek SM, Bian J, Braithwaite D, Licht JD, Shenkman EA. The role of sex and rurality in cancer fatalistic beliefs and cancer screening utilization in Florida. Cancer Med 2021; 10:6048-6057. [PMID: 34254469 PMCID: PMC8419763 DOI: 10.1002/cam4.4122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND People's fatalistic beliefs about cancer can influence their cancer prevention behaviors. We examined the association between fatalistic beliefs and breast and colorectal cancer screening among residents of north-central Florida and tested whether there exists any sex or rural-non-rural disparities in the association. METHODS We conducted a cross-sectional, random digit dialing telephone survey of 895 adults residing in north-central Florida in 2017. Using weighted logistic models, we examined the association between (1) respondents' sociodemographic characteristics and cancer fatalistic beliefs and (2) cancer fatalistic beliefs and cancer screening utilization among screening eligible populations. We tested a series of sex and rurality by fatalistic belief interactions. RESULTS Controlling for sociodemographics, we found the agreement with "It seems like everything causes cancer" was associated with a higher likelihood of having a mammogram (odds ratio [OR]: 3.34; 95% confidence interval [CI]: 1.17-9.51), while the agreement with "Cancer is most often caused by a person's behavior or lifestyle" was associated with a higher likelihood of having a blood stool test (OR: 1.85; 95% CI: 1.12-3.05) or a sigmoidoscopy or colonoscopy among women (OR: 2.65; 95% CI: 1.09-6.44). We did not observe any rural-non-rural disparity in the association between fatalistic beliefs and cancer screening utilization. CONCLUSIONS Some, but not all, cancer fatalistic beliefs are associated with getting breast and colorectal cancer screening in north-central Florida. Our study highlights the need for more research to better understand the social and cultural factors associated with cancer screening utilization.
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Affiliation(s)
- Yi Guo
- Department of Health Outcomes and Biomedical InformaticsCollege of MedicineUniversity of FloridaGainesvilleFLUSA
- University of Florida Health Cancer CenterGainesvilleFLUSA
| | - Sarah M. Szurek
- Department of Health Outcomes and Biomedical InformaticsCollege of MedicineUniversity of FloridaGainesvilleFLUSA
- University of Florida Health Cancer CenterGainesvilleFLUSA
| | - Jiang Bian
- Department of Health Outcomes and Biomedical InformaticsCollege of MedicineUniversity of FloridaGainesvilleFLUSA
- University of Florida Health Cancer CenterGainesvilleFLUSA
| | - Dejana Braithwaite
- University of Florida Health Cancer CenterGainesvilleFLUSA
- Department of Aging and Geriatric ResearchCollege of MedicineUniversity of FloridaGainesvilleFLUSA
- Department of EpidemiologyCollege of Public Health and Health Professions and College of MedicineUniversity of FloridaGainesvilleFLUSA
| | - Jonathan D. Licht
- University of Florida Health Cancer CenterGainesvilleFLUSA
- Division of Hematology and OncologyDepartment of MedicineCollege of MedicineUniversity of FloridaGainesvilleFLUSA
| | - Elizabeth A. Shenkman
- Department of Health Outcomes and Biomedical InformaticsCollege of MedicineUniversity of FloridaGainesvilleFLUSA
- University of Florida Health Cancer CenterGainesvilleFLUSA
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Francis DB, Zelaya CM. Cancer Fatalism and Cancer Information Seeking Among Black Women: Examining the Impact of Aretha Franklin's Death on Cancer Communication Outcomes. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:763-768. [PMID: 32020521 DOI: 10.1007/s13187-020-01701-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Information seeking is often heightened following news coverage of cancer announcements from prominent celebrities or public figures. While scholars have sought to explicate the mechanisms influencing cancer information seeking following celebrity health announcements, the focus has primarily been on cognitive and emotional factors. Other influences such as sociocultural constructs have largely been ignored in this domain. Additionally, few studies have examined the health communication behaviors of minority individuals. The purpose of this study was to examine Black women's information seeking behaviors as a response to the death of the singer Aretha Franklin from pancreatic cancer and the role of fatalistic beliefs about cancer in the information seeking process. Using a survey conducted a few weeks after Franklin's death (N = 164), we found moderate amounts of pancreatic cancer information seeking, with almost 30% of women looking for information. Younger Black women were much more likely to search for information after Franklin's death than older women. Moreover, while we found fatalistic beliefs to be associated with pancreatic cancer information seeking, the findings were driven by younger women. In particular, younger women were more likely to seek pancreatic cancer information regardless of their beliefs about cancer. This study advances the understanding of cancer information seeking among Black women. Implications for cancer communication with Black women are discussed.
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Affiliation(s)
- Diane B Francis
- Department of Communication, University of Kentucky, Lexington, KY, 40506, USA.
| | - Carina M Zelaya
- College of Communication and Information, University of Kentucky, Lexington, KY, USA
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Russell CA, Régnier Denois V, Rouèche E, Simon V, Chauvin F. Empowerment Through Participation in a Cancer Prevention Exhibit: Evidence from the Hygée Lab Intervention. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:519-531. [PMID: 31808052 DOI: 10.1007/s13187-019-01658-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
While many countries have launched cancer prevention initiatives to improve the public's understanding of risk and protective factors, few are systematically evaluated. Hygée Lab, a living lab in a socioeconomically deprived area of France, is designed to interactively communicate evidence-based information about cancer prevention and treatment with the goal to improve visitors' understanding of cancer risk and prevention factors, reduce fatalism in regard to cancer, and increase feelings of empowerment. Pre- and post-visit data were collected during the first 18 months of the exhibit's opening from two segments of the population: adolescents from local schools (N = 134) and the general public (N = 112). Adolescents from the same schools who did not participate in the visit comprised the control group (N = 94). A further 232 general public visitors completed post-surveys only. Pre-post-visit comparisons reveal significant changes in both adolescent and general public visitors: cancer understanding improves, fatalism in regard to cancer is reduced, and feelings of empowerment increase. This systematic evaluation of Hygée Lab offers promise for how interactive exhibits may be used for cancer prevention amongst low health literacy populations.
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Affiliation(s)
- Cristel Antonia Russell
- Graziadio School of Business, Pepperdine University, 24255 Pacific Coast Highway, Malibu, CA, 90263, USA.
| | | | - Emilie Rouèche
- Institut de Cancérologie de la Loire, St Etienne, France
| | - Valérie Simon
- Institut de Cancérologie de la Loire, St Etienne, France
| | - Franck Chauvin
- Institut de Cancérologie de la Loire, Université Jean Monnet - UDL, St Etienne, France
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Harris MTH, Bagley SM, Maschke A, Schoenberger SF, Sampath S, Walley AY, Gunn CM. Competing risks of women and men who use fentanyl: "The number one thing I worry about would be my safety and number two would be overdose". J Subst Abuse Treat 2021; 125:108313. [PMID: 34016300 PMCID: PMC8140193 DOI: 10.1016/j.jsat.2021.108313] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/16/2020] [Accepted: 01/22/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Standard public health approaches to risk communication do not address the gendered dynamics of drug use. The aim of this study was to explore perceptions of fentanyl-related risks among women and men to inform future risk communication approaches. METHODS We conducted a qualitative study, purposively sampling English-speaking women and men, aged 18-25 or 35+ years, with past 12-month illicitly manufactured fentanyl use. In-depth individual interviews explored experiences of women and men related to overdose and fentanyl use. We conducted a grounded content analysis examining specific codes related to overdose and other health or social risks attributed to drug use. Using a constant comparison technique, we explored commonalities and differences in themes between women and men. RESULTS The study enrolled twenty-one participants, 10 women and 11 men. All participants had personal overdose experiences. Both women and men described overdosing as a "chronic" condition and expressed de-sensitization to the risk of overdose. Women and men described other risks around health, safety, and state services that often superseded their fear of overdose. Women feared physical and sexual violence and prioritized caring for children and maintaining relations with child protective services, while men feared violence arising from obtaining and using street drugs and incarceration. Only women reported that fear of violence prevented their utilization of harm reduction services. CONCLUSIONS Experiences with overdose and risk communication among people who use fentanyl-containing opioids varied by gender. The development of gender-responsive programs that address targeted concerns may be an avenue to enhance engagement with harm reduction and treatment services and create safe spaces for women not currently accessing available services.
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Affiliation(s)
- Miriam T H Harris
- Boston University School of Medicine/Boston Medical Center, Department of Medicine, Section of General Internal Medicine, 801 Massachusetts Ave, Second Floor, Boston, MA 02118, United States of America; Clinical Addiction Research and Education Unit, Grayken Center for Addiction, 801 Massachusetts Ave, Second Floor, Boston, MA 02118, United States of America.
| | - Sarah M Bagley
- Boston University School of Medicine/Boston Medical Center, Department of Medicine, Section of General Internal Medicine, 801 Massachusetts Ave, Second Floor, Boston, MA 02118, United States of America; Clinical Addiction Research and Education Unit, Grayken Center for Addiction, 801 Massachusetts Ave, Second Floor, Boston, MA 02118, United States of America; Boston University School of Medicine, Department of Pediatrics, Division of General Academic Pediatrics, 801 Massachusetts Ave, Second Floor, Boston, MA 02118, United States of America.
| | - Ariel Maschke
- Boston University School of Medicine, Department of Medicine, Section of General Internal Medicine, Women's Health Unit, 801 Massachusetts Ave, First Floor, Boston, MA 02118, United States of America.
| | - Samantha F Schoenberger
- Boston University School of Medicine/Boston Medical Center, Department of Medicine, Section of General Internal Medicine, 801 Massachusetts Ave, Second Floor, Boston, MA 02118, United States of America.
| | - Spoorthi Sampath
- Boston University School of Medicine, Department of Medicine, Section of General Internal Medicine, Women's Health Unit, 801 Massachusetts Ave, First Floor, Boston, MA 02118, United States of America.
| | - Alexander Y Walley
- Boston University School of Medicine/Boston Medical Center, Department of Medicine, Section of General Internal Medicine, 801 Massachusetts Ave, Second Floor, Boston, MA 02118, United States of America; Clinical Addiction Research and Education Unit, Grayken Center for Addiction, 801 Massachusetts Ave, Second Floor, Boston, MA 02118, United States of America.
| | - Christine M Gunn
- Boston University School of Medicine, Department of Medicine, Section of General Internal Medicine, Women's Health Unit, 801 Massachusetts Ave, First Floor, Boston, MA 02118, United States of America; Boston University School of Public Health, Department of Health Law, Policy, and Management, 715 Albany Street, Boston, MA 02118, United States of America.
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Aguirre-Camacho A, Hidalgo B, González-Cuevas G. Fear of breast cancer among young Spanish women: Factor structure and psychometric properties of the Champion breast cancer fear scale. PLoS One 2021; 16:e0249562. [PMID: 33819298 PMCID: PMC8021158 DOI: 10.1371/journal.pone.0249562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 03/21/2021] [Indexed: 11/18/2022] Open
Abstract
Heightened fear of breast cancer (FBC) has been linked to increased distress following breast cancer diagnosis and to avoidance of mammography screening. To our knowledge, however, no studies have examined the nature of FBC exclusively among young females, even though they are overrepresented in media stories of breast cancer. Given that no instruments are available to assess FBC in the Spanish language, we sought to 1) evaluate the psychometric properties and factor structure of the Champion Breast Cancer Fear Scale (CBCFS), and 2) offer preliminary data on the nature of FBC among young women. Participants (N = 442, mean age = 21.17, range 17-35) completed the translated CBCFS (CBCFS-es) and the Spanish version of the Short Health Anxiety Inventory. The CBCFS-es demonstrated good concurrent validity, internal consistency, and test-retest reliability. Confirmatory factor analysis showed adequate fit to a one-factor solution. The majority of participants reported considerably high levels of FBC, as 25.34% and 59.73% of them scored above the moderate- and high-FBC cut-offs, respectively. Moreover, FBC could not be explained by general concerns regarding health and illness, given that levels of health anxiety were low. Implications for health education, research, and clinical practice are discussed.
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Affiliation(s)
- Aldo Aguirre-Camacho
- Department of Psychology, School of Biomedical Sciences, European University of Madrid, Madrid, Spain
| | - Beatriz Hidalgo
- Department of Psychology, School of Biomedical Sciences, European University of Madrid, Madrid, Spain
- Department of Psychology, Autonomous University of Madrid, Madrid, Spain
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Clarke N, Kearney PM, Gallagher P, McNamara D, O'Morain CA, Sharp L. Negative emotions and cancer fatalism are independently associated with uptake of Faecal Immunochemical Test-based colorectal cancer screening: Results from a population-based study. Prev Med 2021; 145:106430. [PMID: 33482227 DOI: 10.1016/j.ypmed.2021.106430] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 01/13/2021] [Accepted: 01/16/2021] [Indexed: 12/24/2022]
Abstract
Although systematic colorectal cancer screening is efficacious, many programmes suffer from low uptake. Few behavioural or attitudinal factors have been identified as being associated with participation in colorectal cancer screening. We explored knowledge, beliefs about cancer, subjective health literacy, emotional attitudes to screening, and social influences among individuals invited to a population-based screening programme. Regression modelling of a cross-sectional survey of 2299 individuals (users and non-users) of a population-based Faecal Immunochemical Test (FIT) screening programme in Dublin was conducted. Questions were derived from previous theoretically-informed qualitative work and assessed using previously used and validated measures. The primary outcome variable was uptake status (User/Participation or Non-User/Non-participation); multivariable logistic regression was used to estimate the odds ratios (OR) for screening participation. Stronger fatalistic beliefs independently predicted lower uptake (OR = 0.94; 95% CI 0.90-0.98; P = 0.003). Those aged <65 who disagreed that "cancer can often be cured" also had lower uptake (OR = 0.43; 95% CI 0.22-0.82: P = 0.017). Agreement that the test was disgusting and tempting fate predicted lower uptake (OR = 0.16: 95% CI 0.10-0.27: p < 0.001), while the influence of a partner on decision to be screened was associated with higher uptake (OR = 1.32; 95% CI 1.15-1.50: P < 0.001). Negative cancer-related and screening-related beliefs and emotions are associated with non-participation in FIT (-based screening). Research is warranted to explore if these negative beliefs and emotions are modifiable and, if so, whether this would improve screening uptake. The association between the influence of a partner and screening participation present a challenge around improving uptake among those not in co-habiting relationships.
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Affiliation(s)
| | | | | | - Deirdre McNamara
- Department of Clinical Medicine, Trinity Centre for Health Sciences, Adelaide and Meath Hospital, Dublin, Ireland.
| | - Colm A O'Morain
- Faculty of Health Science, Trinity College Dublin, Dublin, Ireland.
| | - Linda Sharp
- Newcastle University Centre for Cancer, Population Health Sciences Institute, Newcastle University, England, UK.
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Preferences in trust regarding the provision of cancer information among adults. J Natl Med Assoc 2021; 113:457-464. [PMID: 33814180 DOI: 10.1016/j.jnma.2021.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/10/2021] [Accepted: 03/01/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Disparities associated with trust in health information exist warranting a need for research assessing this relationship among adults. Therefore, the aim of this study was to assess trust of cancer information among U.S. adults. METHODS A weighted sample of 237,670,167 adults from the Health Information National Trends Survey (HINTS) from 2011-2014 was used for the analyses. Dependent variables were dichotomized answers to whether individuals trusted information from family/friends, the internet, or a doctor. Independent variables included age, sex, region, race/ethnicity, and cancer diagnosis to investigate associations between demographic factors and differences in trust. Logistic regression was run using R survey package. RESULTS There were statistically significant differences in trust based on race/ethnicity, age, and cancer diagnosis. Minorities were less likely to trust information from a doctor, with Hispanics more likely to trust information from the internet (OR=1.8 (95% CI 1.36,2.43)), and Non-Hispanic Blacks trusting information from family and friends (OR=1.5 (95% CI 1.06, 2.13)). Adults ≥45 years of age were less likely to trust the doctor 'a lot' (45-64 years: OR=0.6 (95% CI 0.50, 0.83); 65+ years (OR=0.7 (95% CI 0.54, 0.92)), but more likely to not trust information from family and friends or the internet. Patients with cancer were more likely to trust information from a doctor 'a lot' (78%; p=0.01). DISCUSSION Significant differences in preferences regarding trust in cancer information occurred based on sociodemographic characteristics. CONCLUSION These finding suggest targeting specific population subgroups for information from sources they trust could be helpful in reducing disparities in trust.
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Disparities in access to health care system as determinant of survival for patients with pancreatic cancer in the State of São Paulo, Brazil. Sci Rep 2021; 11:6346. [PMID: 33737639 PMCID: PMC7973503 DOI: 10.1038/s41598-021-85759-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 02/19/2021] [Indexed: 12/19/2022] Open
Abstract
Little is known about the features and outcomes of Brazilian patients with pancreatic cancer. We sought to describe the socio-economic characteristics, patterns of health care access, and survival of patients diagnosed with malignant pancreatic tumors from 2000 to 2014 in São Paulo, Brazil. We included patients with malignant exocrine and non-classified pancreatic tumors according to the International Classifications of Disease (ICD)-O-2 and -O-3, diagnosed from 2000 to 2014, who were registered in the FOSP database. Prognostic factors for overall survival (OS) in the subgroup of patients with ductal or non-specified (adeno)carcinoma were evaluated using Cox proportional hazard model. The study population consists of 6855 patients. Median time from the first visit to diagnosis and treatment were 13 (Interquartile range [IQR] 4-30) and 24 (IQR 8-55) days, respectively. Both intervals were longer for patients treated in the public setting. Median OS was 4.9 months (95% confidence interval [95% CI] 4.7-5.2). Increasing age, male gender, lower educational level, treatment in the public setting, absence of treatment, advanced stage, and treatment from 2000 to 2004 were associated with inferior OS. From 2000-2004 to 2010-2014, no improvement in OS was seen for patients treated in the public setting. Survival of patients with malignant pancreatic tumors remains dismal. Socioeconomical variables, especially health care funding, are major determinants of survival. Further work is necessary to decrease inequalities in access to medical care for patients with pancreatic cancer in Brazil.
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He R, Li Y. Media Exposure, Cancer Beliefs, and Cancer-Related Information-Seeking or Avoidance Behavior Patterns in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3130. [PMID: 33803594 PMCID: PMC8002949 DOI: 10.3390/ijerph18063130] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/12/2021] [Accepted: 03/14/2021] [Indexed: 12/09/2022]
Abstract
This study explored the relationships between media exposure, cancer beliefs, and cancer information-seeking or information-avoidance behaviors. Based on the planned risk information-seeking model and its extended framework, two predictive models were constructed: one for cancer information seeking and the other for cancer information avoidance. A structural equation modeling strategy was applied to survey data from China HINTS 2017 (n = 3090) to compare the impact of traditional mass media and social media exposure to cancer-related information on cancer information-seeking and information-avoidance behaviors. The study findings suggest that health-related information exposure through different media channels may generate distinctive information-seeking or information-avoidance behaviors based on various cancer beliefs. Additionally, the findings indicate that social media exposure to health-related and cancer curability beliefs does not lead to cancer information avoidance; both mass media and social media exposure encourage people to seek cancer-related information. Cancer fatalism is positively associated with cancer information-seeking and avoiding intentions, suggesting that negative cancer beliefs predict seemingly contradictory yet psychologically coherent information intentions and behaviors.
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Affiliation(s)
- Rui He
- Department of Journalism, School of Humanities, Shanghai University of Finance and Economics, 100 Wudong RD, Yangpu District, Shanghai 200433, China;
| | - Yungeng Li
- School of Media and Communication, Shanghai Jiao Tong University, 800 Dongchuan RD, Minhang District, Shanghai 200240, China
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Emami L, Ghahramanian A, Rahmani A, Mirza Aghazadeh A, Onyeka TC, Nabighadim A. Beliefs, fear and awareness of women about breast cancer: Effects on mammography screening practices. Nurs Open 2021; 8:890-899. [PMID: 33570277 PMCID: PMC7877223 DOI: 10.1002/nop2.696] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/28/2020] [Accepted: 10/29/2020] [Indexed: 12/26/2022] Open
Abstract
AIM This study sought to investigate the beliefs, fear and awareness about breast cancer and mammography screening practices of women in Iran. METHODS This descriptive-correlational study was conducted at Tabriz, East Azerbaijan Province, northwest of Iran from February-July 2017. One hundred and fifty-two women aged 40 years and older, who were referred to 12 health centres for health services were selected via clustering sampling. Associations between variables and mammography screening practices were examined using bivariate and multivariate logistic regression analyses. Participants who had a mammogram within the last 24 months were compared with those who had none. Sociodemographic questionnaire, Champion's Breast Cancer Fear Scale, Champion's Health Belief Model Scale for Mammography Screening, Breast Cancer Awareness Scale and Powe Fatalism Inventory were the tools used for data gathering. RESULTS Just 38.2% of women reported having a mammogram within the last 24 months. Self-efficacy (OR = 5.36, B = 1.68, p < .001), susceptibility (OR = 2.83, B = 1.04, p < .001), motivation (OR = 2.11, B = 0.75, p = .024) and lower perceived barriers (OR = 0.25, B = -1.37, p < .001) were associated with being screened. Neither fatalistic belief nor awareness towards breast cancer was significant.
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Affiliation(s)
- Lida Emami
- Medical Surgical Department, Nursing and Midwifery FacultyIslamic Azad UniversityBonab BranchBonabIran
| | - Akram Ghahramanian
- Medical and Surgical Department, Nursing and Midwifery Faculty, Hematology and Oncology Research CenterTabriz University of Medical SciencesTabrizIran
| | - Azad Rahmani
- Medical Surgical Department, Nursing and Midwifery FacultyTabriz University of Medical SciencesTabrizIran
| | - Ahmad Mirza Aghazadeh
- Department of Basic sciencesParamedical FacultyTabriz University of Medical SciencesTabrizIran
| | - Tonia C. Onyeka
- Department of Anaesthesia/Pain & Palliative Care UnitMultidisciplinary Oncology CentreCollege of MedicineUniversity of NigeriaItuku‐Ozalla CampusEnuguNigeria
| | - Amirreza Nabighadim
- Department of UrologyUro‐Oncology Research CenterTehran University of Medical SciencesTehranIran
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Peng W, Carcioppolo N, Occa A, Ali K, Yang Q, Yang F. Feel Worried, Overloaded, or Fatalistic? The Determinants of Cancer Uncertainty Management Preferences. HEALTH COMMUNICATION 2021; 36:347-360. [PMID: 31760812 DOI: 10.1080/10410236.2019.1692489] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Uncertainty in the context of cancer involves a complex and conflicting decision-making process. Individual preferences of seeking or avoiding information in the decisions of maintaining, reducing, or increasing uncertainty often depend on key cancer-related beliefs. The present study investigates whether cancer worry (CW), information overload (CIO), or fatalism (CF) can predict four constructs of uncertainty management preferences - avoid to maintain hope, avoid insufficient information, seek to increase uncertainty, and seek to reduce uncertainty. A hybrid model with structural and measurement components was specified and tested. The model analysis shows that cancer-related beliefs influenced individuals' needs and preferences for uncertainty management through seeking or avoiding information. CW was positively related to all but avoiding insufficient information. CIO was positively associated with all four preferences. CF was only associated with avoiding to maintain uncertainty. Theoretical and practical implications were discussed.
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Affiliation(s)
- Wei Peng
- School of Communication, University of Miami
| | | | - Aurora Occa
- Department of Communication, University of Kentucky
| | | | - Qinghua Yang
- Bob Schieffer College of Communication, Texas Christian University
| | - Fan Yang
- Department of Communication Studies, University of Alabama at Birmingham
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Keller KG, Toriola AT, Schneider JK. The relationship between cancer fatalism and education. Cancer Causes Control 2021; 32:109-118. [PMID: 33151430 PMCID: PMC8284073 DOI: 10.1007/s10552-020-01363-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 10/24/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE Fatalism is defined by feelings of pessimism, hopelessness, and powerlessness regarding cancer outcomes. Early researchers reported associations between race and cancer fatalism. Yet current evidence suggests that social determinants of health are better predictors of cancer fatalism than race. Therefore, the aim of this study was to examine the association between age, race, education, and cancer fatalism. METHODS Three hundred ninety (n = 390) women who attended a screening mammogram at the Joanne Knight Breast Health Center at Siteman Cancer Center at Washington University School of Medicine (St. Louis, MO) completed the Powe Fatalism Inventory (PFI), a 15-item self-report instrument used to operationalize cancer fatalism. We used Pearson's correlation, independent samples t-tests, one-way ANOVA with post hoc tests, and linear regression to analyze the relationships between PFI total scores and age, race, and education. RESULTS There were no differences between the mean PFI scores for Non-Hispanic Whites (1.89, SD 0.55) and African Americans (2.02, SD 0.76, p = 0.092, 95% CI 0.27 to 0.02). We found significant differences between the mean PFI scores across levels of education. Women who attained a high school degree or less (n = 72) reported higher PFI scores (2.24, SD 0.77) than women who attended some college or post-high school vocational training (n = 111; 1.95, SD 0.61) and women with a college or postgraduate degree (n = 206; 1.83, SD 0.57). When PFI score was regressed onto age, race, and education, only education significantly explained fatalism (B = -0.19, p < 0.001). CONCLUSIONS In this study, cancer fatalism did not differ between Non-Hispanic White and African American women attending a screening mammogram. However, lower educational levels were associated with higher cancer fatalism. The previously observed associations between race and cancer fatalism may be explained by racial disparities in social determinants of health, such as education. Importantly, study findings indicate that the people with the greatest need for cancer fatalism interventions are those with lower educational levels.
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Paige SR, Alpert JM, Bylund CL. Fatalistic Cancer Beliefs Across Generations and Geographic Classifications: Examining the Role of Health Information Seeking Challenges and Confidence. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:3-9. [PMID: 32648238 PMCID: PMC7794083 DOI: 10.1007/s13187-020-01820-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Information seeking is an active health behavior that influences cancer fatalism; however, people commonly experience challenges in accessing high-quality and actionable health information that is personally relevant. This is especially common among older and rural adults who have a high cancer risk. The purpose of this study was to examine the theoretical assumption that enhancing perceived confidence to overcome health information seeking challenges will alleviate cancer fatalism. In 2017, 895 adults from a large southeastern medical university's cancer catchment area participated in a random digit dial survey. Participants were Millennials (18-35; 19%), Generation X (36-51; 23%), Baby Boomers (52-70; 40%), and Silent Generation (71-95; 16.9%) who had equal representation across metro (78.9%) and nonmetro (21.1%) counties. Younger generations (Millennials and Generation X) held stronger fatalistic cancer beliefs ("It seems like everything causes cancer," "When I think about cancer, I automatically think about death") than older generations. Most participants believed that precautionary efforts exist to reduce their chances of getting cancer, which was strongest among individuals residing in metro counties. In controlling for generation and geographic residence, individuals who experienced challenges in the process of accessing health information had stronger fatalistic beliefs about cancer prevention; however, this relationship was most pronounced among individuals with confidence to ultimately obtain information that they needed. This study contributes to evidence for health information equity in combatting fatalistic cancer beliefs. Findings have important implications for the optimized dissemination of culturally adapted cancer education and skill-based training to efficiently access and evaluate relevant cancer education.
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Affiliation(s)
- Samantha R Paige
- STEM Translational Communication Center, University of Florida, Gainesville, FL, USA.
| | - Jordan M Alpert
- Department of Advertising, College of Journalism and Communications, University of Florida, Gainesville, FL, USA
| | - Carma L Bylund
- Division of Hematology & Oncology, College of Medicine, University of Florida, Gainesville, FL, USA
- Department of Public Relations, College of Journalism and Communications, University of Florida, Gainesville, FL, USA
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Guo XM, Tom L, Leung I, O'Brian C, Zumpf K, Simon M. Associations between Fatalistic Cancer Beliefs and Cancer-Screening Behaviors in Chinese American Immigrant Women. J Immigr Minor Health 2021; 23:699-706. [PMID: 33515161 DOI: 10.1007/s10903-021-01144-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2021] [Indexed: 11/25/2022]
Abstract
Chinese Americans have among the lowest rates of up-to-date cancer screening in the United States. Fatalistic health beliefs are also common in this population and can lead to decreased healthcare utilization. We sought to understand how these fatalistic beliefs are associated with cancer screening behaviors in this underserved population. A cross-sectional survey was conducted with 732 Chinese women from the greater Chinatown area of Chicago, Illinois. Surveyed questions included sociodemographic information, self-reported healthcare utilization and cancer screening behaviors. The majority of respondents were older than 50, spoke Chinese, had less than a college education, public or no medical insurance, and an annual income < $20,000. Approximately 20% had never received Papanicolaou or mammogram screening. Fatalistic beliefs were common and associated with increased health-seeking behaviors and appropriate Pap and mammogram screening. In this cohort of Chinese American immigrant women in an urban Chinatown community, fatalistic cancer beliefs were prevalent and associated with increased health-seeking and positive cancer screening behaviors. This previously unreported relationship could be leveraged in improving health outcomes of an underserved population.
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Affiliation(s)
- Xiaoyue Mona Guo
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, 250 E. Superior St., Suite 5-2177, Chicago, IL, 60611, USA. .,, 2020 Zonal Ave, IRD, Room 220, Los Angeles, CA, 90033, USA.
| | - Laura Tom
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, 250 E. Superior St., Suite 5-2177, Chicago, IL, 60611, USA.,Center for Health Equity Transformation, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Ivy Leung
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, 250 E. Superior St., Suite 5-2177, Chicago, IL, 60611, USA.,Center for Health Equity Transformation, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Catherine O'Brian
- Center for Health Equity Transformation, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Katelyn Zumpf
- Biostatistics Collaboration Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Melissa Simon
- Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, 250 E. Superior St., Suite 5-2177, Chicago, IL, 60611, USA.,Center for Health Equity Transformation, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Department of General/Preventive Medicine and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Kabukye JK, Ilozumba O, Broerse JEW, de Keizer N, Cornet R. Implementation of an Interactive Voice Response System for Cancer Awareness in Uganda: Mixed Methods Study. JMIR Mhealth Uhealth 2021; 9:e22061. [PMID: 33496672 PMCID: PMC7872833 DOI: 10.2196/22061] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/11/2020] [Accepted: 11/15/2020] [Indexed: 12/23/2022] Open
Abstract
Background Cancer awareness is crucial for cancer care and prevention. However, cancer awareness in Uganda is low, and access to cancer information is limited. Objective This study aims to (1) understand the cancer awareness situation in Uganda (perceptions, beliefs, information needs, and challenges to accessing cancer information) and opinions about interactive voice response (IVR) systems; (2) develop cancer awareness messages and implement them in an IVR system; and (3) evaluate user acceptance and use of the IVR system. Methods A participatory design approach was adopted. To understand cancer awareness needs and challenges, 3 interviews and 7 focus group discussions (FGDs) were conducted with cancer health care providers, patients with cancer, caregivers and survivors, administrators, and lay citizens (n=73). On the basis of the resulting qualitative data, audio messages addressing cancer information needs were developed and implemented in an IVR system. The system and messages were tested with users (n=12) during 2 co-design workshops before final rollout. Finally, the system was evaluated over 6 months after going live, using call records and user feedback from telephone interviews with callers (n=40). Results The cancer information needs included general topics such as what cancer is, what causes it, cancer screening and diagnosis, cancer treatment, and practical information on what to expect during cancer care. There were also myths and misconceptions that need to be addressed, such as that cancer is due to witchcraft and has no treatment. Information on COVID-19 was also sought after following the outbreak. We developed 20 audio cancer messages (approximately 2 minutes each) in English and Luganda, along with 14 IVR navigation instructions. These were implemented in an IVR system with 24/7 availability from all over Uganda via a toll-free multi-channel telephone number. The total number of calls made to the IVR system 6 months after going live was 3820. Of these, 2437 (63.8%) lasted at least 30 seconds and were made from 1230 unique telephone numbers. There were 191 voice messages and 760 calls to live agents, most of which (681/951, 71.6%) were in Luganda. Call volumes peaked following advertisement of the system and lockdowns due to COVID-19. Participants were generally familiar with IVR technology, and caller feedback was largely positive. Cited benefits included convenience, toll-free access, and detailed information. Recommendations for improvement of the system included adding live agents and marketing of the system to target users. Conclusions IVR technology provides an acceptable and accessible method for providing cancer information to patients and the general public in Uganda. However, a need remains for health system reforms to provide additional cancer information sources and improve cancer care services in general.
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Affiliation(s)
- Johnblack K Kabukye
- Uganda Cancer Institute, Kampala, Uganda.,Department of Medical Informatics, Amsterdam Public Health research institute, Amsterdam UMC - Location AMC, Amsterdam, Netherlands
| | - Onaedo Ilozumba
- Athena Institute, Faculty of Science, Vrije Universiteit, Amsterdam, Netherlands
| | | | - Nicolette de Keizer
- Department of Medical Informatics, Amsterdam Public Health research institute, Amsterdam UMC - Location AMC, Amsterdam, Netherlands
| | - Ronald Cornet
- Department of Medical Informatics, Amsterdam Public Health research institute, Amsterdam UMC - Location AMC, Amsterdam, Netherlands
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Schulz PJ, Pessina A, Hartung U, Petrocchi S. Effects of Objective and Subjective Health Literacy on Patients' Accurate Judgment of Health Information and Decision-Making Ability: Survey Study. J Med Internet Res 2021; 23:e20457. [PMID: 33475519 PMCID: PMC7861996 DOI: 10.2196/20457] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/24/2020] [Accepted: 11/03/2020] [Indexed: 11/25/2022] Open
Abstract
Background Interpreting health information and acquiring health knowledge have become more important with the accumulation of scientific medical knowledge and ideals of patient autonomy. Health literacy and its tremendous success as a concept can be considered an admission that not all is well in the distribution of health knowledge. The internet makes health information much more easily accessible than ever, but it introduces its own problems, of which health disinformation is a major one. Objective The objective of this study was to determine whether objective and subjective health literacy are independent concepts and to test which of the two was associated more strongly with accurate judgments of the quality of a medical website and with behavioral intentions beneficial to health. Methods A survey on depression and its treatments was conducted online (n=362). The Newest Vital Sign was employed to measure objective, performance-based health literacy, and the eHealth Literacy Scale was used to measure subjective, perception-based health literacy. Correlations, comparisons of means, linear and binary logistic regression, and mediation models were used to determine the associations. Results Objective and subjective health literacy were weakly associated with one another (r=0.06, P=.24). High objective health literacy levels were associated with an inclination to behave in ways that are beneficial to one’s own or others’ health (Exp[B]=2.068, P=.004) and an ability to recognize low-quality online sources of health information (β=–.4698, P=.005). The recognition also improved participants’ choice of treatment (β=–.3345, P<.001). Objective health literacy helped people to recognize misinformation on health websites and improved their judgment on their treatment for depression. Conclusions Self-reported, perception-based health literacy should be treated as a separate concept from objective, performance-based health literacy. Only objective health literacy appears to have the potential to prevent people from becoming victims of health disinformation.
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Affiliation(s)
- Peter Johannes Schulz
- Institute of Communication and Health, Università della Svizzera italiana, Lugano, Switzerland
| | - Annalisa Pessina
- Institute of Communication and Health, Università della Svizzera italiana, Lugano, Switzerland
| | - Uwe Hartung
- Università della Svizzera italiana, Lugano, Switzerland
| | - Serena Petrocchi
- Institute of Communication and Health, Università della Svizzera italiana, Lugano, Switzerland
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Moser RP, Arndt J, Jimenez T, Liu B, Hesse BW. Perceptions of cancer as a death sentence: Tracking trends in public perceptions from 2008 to 2017. Psychooncology 2020; 30:511-519. [PMID: 33205560 DOI: 10.1002/pon.5596] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 10/26/2020] [Accepted: 11/03/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE There has been steady progress in reducing cancer mortality in the United States; however, this progress hasn't been evenly distributed across regions. This paper assesses trends in cancer mortality salience (CMS), that is, agreeing that getting cancer is a death sentence, over time in the United States and examines correlates of CMS. METHODS Data from three administrations of the Health Information National Trends Survey (HINTS), gathered in 2008, 2013, and 2017, were merged, resulting in a total sample of 10,063 respondents. Trends in changes in CMS over time were examined as well as maps of the distribution of CMS in the United States. A logistic regression model was conducted, regressing CMS on a set of sociodemographic, psychological, health-related, and environmental predictors. RESULTS The aggregated percentage of US adults who agreed with the CMS statement changed over time and was modified by age. Geographic distribution of agreement with CMS was inconsistent across the United States. In the adjusted logistic model, perceived health (worse health), cancer prevention, fatalism, and confusion, and cancer status (no cancer) were all significantly associated with CMS. There was also a significant interaction between survey year and age. CONCLUSION Despite recent information that cancer mortality rates are decreasing, most US adults still see cancer as a death sentence and this is especially an issue in certain subgroups. These findings have ramifications for groups of people who may be at risk for developing cancer given their attitudes and beliefs that there isn't much they can do to prevent or control it.
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Affiliation(s)
- Richard P Moser
- Behavioral Research Program, National Cancer Institute, Rockville, Maryland, USA
| | - Jamie Arndt
- Department of Psychology, University of Missouri, Columbia, Missouri, USA
| | - Tyler Jimenez
- Department of Psychology, University of Missouri, Columbia, Missouri, USA
| | - Benmei Liu
- Surveillance Research Program, National Cancer Institute, Rockville, Maryland, USA
| | - Bradford W Hesse
- Behavioral Research Program, National Cancer Institute (Retired), Honolulu, Hawaii, USA
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A national survey of oncology survivors examining nutrition attitudes, problems and behaviours, and access to dietetic care throughout the cancer journey. Clin Nutr ESPEN 2020; 41:331-339. [PMID: 33487286 DOI: 10.1016/j.clnesp.2020.10.023] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/23/2020] [Accepted: 10/30/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Attitudes of cancer survivors to nutrition and nutrition care have rarely been captured. A better understanding of their needs based on a review of their experiences would give voice to this patient group (which has rarely been captured) and allow for better planning of nutritional care. AIMS To conduct a national survey to determine: (1) survivors' experience in relation to nutrition and diet-related problems, (2) perceived importance of the role of nutrition to cancer survivors, (3) the experience of accessing dietetic support, (4) the sources where survivors get nutrition information, and (5) their use of alternative dietary strategies. METHODS Survivors (any adult ever diagnosed with cancer) who had been diagnosed with or treated for cancer in Ireland within the past 5 years, were asked to complete a 25-item paper-based survey at one of 20 different hospital sites in Ireland. The survey was also hosted online on the websites of major cancer charities. Descriptive statistics were used to examine quantitative data. RESULTS In total, 1073 valid responses were received (63% female, mean age 57 years (range 18-88)). Breast cancer was the most common (n = 362), followed by colorectal (n = 121). One third of respondents had metastatic disease. Diet-related problems were reported by 45%. Weight loss was experienced by 44% and amongst those, 42% reported they were 'unhappy or worried' by this, while 27% reportedbeing 'delighted/happy' with their weight loss. Muscle loss was noted by 52%, with 20% reporting they had noticed 'a lot' of muscle loss. Nutrition was rated as 'very/extremely' important to cancer care by 89% of respondents, yet 58% reported being asked about dietary issues by their medical team only 'sometimes', 'rarely' or 'never'. Only 39% had been assessed/treated by a registered dietitian (RD) and 74% rated their advice/care as 'very/extremely' helpful. Worryingly, 39% of survivors with involuntary weight loss, and 29% of survivors on a texture modified diet had not received nutritional care from an RD. Overall, 57% of those who did not see an RD said they wanted more dietetic support (access to a helpline/dietitian/additional reliable information). Of concern, 37% of survivors were following or had tried alternative, unproven dietary strategies (e.g. restrictive diets, herbal remedies, juicing or detoxes), and 32% reported avoiding specific foods, e.g. processed meat or dairy. A majority (56%) felt confused by the often conflicting nutrition information available in the media and offered by people around them. CONCLUSIONS While nutrition is considered highly important by cancer survivors and a high proportion experience potentially serious diet-related problems including weight and muscle loss, fewer than half surveyed had access to a dietitian. Over a third had used at least one alternative dietary strategy, and over half felt confused about nutrition. Comprehensive nutritional screening and referral programmes to oncology dietitians need to be implemented in the ambulatory setting in order to identify and facilitate early management of the nutritional concerns of cancer survivors.
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Sarma EA, Quaife SL, Rendle KA, Kobrin SC. Negative cancer beliefs: Socioeconomic differences from the awareness and beliefs about cancer survey. Psychooncology 2020; 30:471-477. [PMID: 33064857 DOI: 10.1002/pon.5573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/09/2020] [Accepted: 10/14/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Socioeconomic gaps in cancer mortality may be driven partially by poorer uptake of early detection behaviors among lower socioeconomic status (SES) groups. Lower SES groups may hold both fewer positive and more negative cancer beliefs that discourage these behaviors. We examined SES differences in positive and negative cancer beliefs in US adults. METHODS We conducted telephone interviews with a population-representative sample, aged 50+, using the Awareness and Beliefs about Cancer instrument (N = 1425). Cancer beliefs were measured using three positively and three negatively framed items. We used multivariable logistic regression models to examine associations between beliefs and education, which served as a marker of individual-level SES. RESULTS Agreement with positive statements was high (>80%) and did not vary with education, while agreement with negative statements varied. Relative to adults with a bachelor's degree, adults with a high school degree or less were more likely to agree that "treatment is worse than cancer" (45.2% vs. 68.2%; adjusted odds ratio (aOR) = 2.43, 99% CI = 1.50-3.94), cancer is "a death sentence" (17.4% vs. 33.2%; aOR = 2.51, 99% CI = 1.45-4.37), and they "would not want to know if I have cancer" (15.7% vs. 31.6%; aOR = 2.88, 99% CI = 1.54-5.36). CONCLUSIONS Positive cancer statements were generally endorsed, but negative statements were more frequently endorsed by lower SES groups. Additional work is needed to understand how negative beliefs develop and coexist alongside positive beliefs. Interventions to improve detection behaviors targeting lower SES groups may benefit from focusing on reducing negative beliefs, rather than increasing positive beliefs.
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Affiliation(s)
- Elizabeth A Sarma
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, USA.,Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland, USA
| | - Samantha L Quaife
- Department of Behavioral Science and Health, University College London, London, England
| | - Katharine A Rendle
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sarah C Kobrin
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, USA
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Jun J. Cancer/health communication and breast/cervical cancer screening among Asian Americans and five Asian ethnic groups. ETHNICITY & HEALTH 2020; 25:960-981. [PMID: 29792075 DOI: 10.1080/13557858.2018.1478952] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Accepted: 05/03/2018] [Indexed: 06/08/2023]
Abstract
Objectives: This paper is an examination of cancer/health communication factors (i.e. cancer/health information seeking, patient-provider communication (PPC), cancer screening information from providers) and screening for breast and cervical cancer among Asian Americans and five Asian ethnic groups (Chinese, Filipinos, Japanese, Koreans, Vietnamese) in comparison to Whites. Additionally, the relationship between cancer/health communication disparity and cancer screening gaps between Asian Americans and Whites was investigated. Design: Data comes from a nationally representative sample of 2011-2014 Health Information National Trends Surveys (HINTS). Results: Asian Americans and most Asian ethnic-groups reported significantly lower rates of cancer/health information seeking and lower evaluations for PPC as compared to Whites, though differences within Asian ethnic groups were observed (Koreans' greater cancer/health information seeking, Japanese' higher PPC evaluation). When the cancer/health communication factors were controlled, Asian Americans' odds of cancer screening were increased. Especially, Asian Americans' odds of adhering to the breast cancer screening guideline became nearly 1.4 times greater than Whites. Conclusion: This research demonstrates that health organizations, providers, and Asian American patients' collaborative efforts to increase the access to quality cancer information, to make culturally competent but straightforward screening recommendations, and to practice effective communication in medical encounters will contribute to diminishing cancer disparities among Asian Americans.
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Affiliation(s)
- Jungmi Jun
- The School of Journalism and Mass Communications, University of South Carolina, Columbia, SC, USA
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Xie J, Xie S, Cheng Y, He Z. Beliefs and Information Seeking in Patients With Cancer in Southwest China: Survey Study. JMIR Cancer 2020; 6:e16138. [PMID: 32821061 PMCID: PMC7474411 DOI: 10.2196/16138] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 01/01/2020] [Accepted: 06/03/2020] [Indexed: 12/16/2022] Open
Abstract
Background Although previous studies have reported the cancer information-seeking behaviors among patients in high-income countries, the cancer information-seeking practices of patients living in low- and middle-income areas are less known. Objective This study investigated the beliefs and information-seeking patterns of cancer patients in southwest China. Methods A questionnaire was designed, and data were collected in two hospitals (N=285) in southwest China. Statistical analyses included bivariate analyses and regressions. Results Patients’ attitudes towards cancer fatalism were significantly influenced by marital status (P<.001), education (P<.001), and household income (P<.001). Moreover, endorsing fatalistic belief was positively associated with age (r=0.35, P<.001). The regression model showed that younger patients (odds ratio [OR] 0.96, 95% CI 0.93-0.99) and those with higher education (OR 1.75, 95% CI 1.09-2.81) were more likely to seek information. Additionally, patients who were less confident in getting information were more likely to find information (OR 1.70, 95% CI 1.15-2.52), while fatalism belief was not significant in the regression (OR 0.65, 95% CI 0.22-1.95). Conclusions This study explored the information-seeking patterns of cancer patients in southwest China. It was found that many Chinese people endorsed cancer fatalism. These pessimistic beliefs about the potential to prevent and to cure cancer correlate with rather than cause cancer-related information seeking. However, self-efficacy about the confidence in finding needed cancer information was a significant predictor of information-seeking.
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Affiliation(s)
- Juan Xie
- School of Information Management, Nanjing University, Nanjing, China
| | - Shi Xie
- Jinling College, Nanjing University, Nanjing, China
| | - Ying Cheng
- School of Information Management, Nanjing University, Nanjing, China
| | - Zhe He
- School of Information, College of Communication and Information, Florida State University, Tallahassee, FL, United States
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Gedefaw A, Yilma TM, Endehabtu BF. Information Seeking Behavior About Cancer and Associated Factors Among University Students, Ethiopia: A Cross-Sectional Study. Cancer Manag Res 2020; 12:4829-4839. [PMID: 32606972 PMCID: PMC7319524 DOI: 10.2147/cmar.s259849] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 06/12/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction Cancer is among the leading cause of death in sub-Saharan Africa over the last few years, putting a tremendous physical, emotional, and financial strain on individuals, families, and health systems. Many health systems in sub-Saharan Africa are least prepared to manage this burden, and a large number of individuals do not have access to quality cancer-related information to prevent and manage cancer. Understanding the information seeking behavior of individuals, especially university students who are more likely to seek health information than other people, can be seen as an opportunity to provide resources to improve lifestyle or prevent possible health-threatening behaviors of individuals. Objective This study aimed to assess cancer information seeking behavior (CISB) and its associated factors among students in Debre Tabor University, Ethiopia. Methods An institution-based cross-sectional study design was conducted among students at Debre Tabor University from March 01 to March 30, 2019. A total of 844 students were selected using a multistage stratified sampling technique. Data were collected using a structured and pre-tested questionnaire by trained data collectors. Data entry and analyses were performed using Epi info version 7.2 and SPSS version 20, respectively. Descriptive and inferential statistics were used to explore the socio-demographic information and cancer information seeking behavior. Binary logistic regression was used to identify factors associated with cancer information seeking. Results The proportion of cancer information seeking by students in the past 12 months was 30.1%. Their preferred source of information about cancer was health-care providers (48%) followed by the Internet (27.6%). Year of study, Internet access (AOR=6.07, 95% CI= 4.05, 9.10), health literacy level (AOR=1.8, 95% CI=1.21, 2.68), self-reported health condition (AOR=1.85, 95% CI=1.25, 2.73), perceived susceptibility to cancer (AOR=2.48, 95% CI=1.47, 4.2), and perceived severity of cancer (AOR=3.33, 95% CI=1.85, 6.0) were the factors associated with cancer information seeking. Conclusion The proportion of cancer information seeking among university students was low. Being 3rd- and 4th-year student, internet access, being healthy, adequate health literacy level, concerning about cancer, and higher perceived severity of cancer were significantly associated with cancer information seeking. Increase health literacy and awareness creation about cancer for students will help to seek cancer information.
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Affiliation(s)
- Adugna Gedefaw
- Department of Health Informatics, Debre Tabor Health Science College, Gondar, Ethiopia
| | - Tesfahun Melese Yilma
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Berhanu Fikadie Endehabtu
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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