Recalling and Intending to Enact Health Recommendations: Optimal Number of Prescribed Behaviors in Multibehavior Messages

Predictors of correct recall of genetic risk information among Hispanic individuals in Florida and Puerto Rico

OBJECTIVE

To identify predictors of genetic risk recall and examine whether recall influences adoption of skin cancer preventive behaviors among Hispanic individuals.

METHODS

Hispanic participants randomized to intervention arms (n = 463) of a precision prevention trial were provided MC1R risk information (average, higher) and asked to recall their risk after 3 and 9 months. Predictors of recall (correct versus did not recall/misremembered) were determined by backwards stepwise logistic regression. Intervention effects on preventive behaviors were estimated within strata of 3-month recall.

RESULTS

Age inversely predicted correct recall in both risk groups (average: OR3-months(3)= 0.97, 95%CI:0.94-1.01, OR9-months(9)= 0.96, 95%CI:0.93-0.99; higher: OR3 = 0.98, 95%CI:0.95-1.01, OR9 = 0.98, 95%CI:0.95-1.00). Education positively predicted recall among participants at average risk (OR3 =1.64, 95%CI:1.06-2.63, OR9 =1.73, 95%CI:1.12-2.81). Darker untanned skin color inversely predicted recall among participants at higher risk (OR3 =0.68, 95%CI:0.45-0.99, OR9 =0.74, 95%CI:0.50-1.09). Intervention effects for routine sunscreen use and undergoing a clinical skin exam were stronger among participants at higher risk who correctly recalled at 3 months than those who did not recall/misremembered.

CONCLUSIONS

Younger age, higher education, and lighter untanned skin color predicted correct recall. Better recall may improve skin cancer prevention outcomes.

PRACTICE IMPLICATIONS

Additional strategies are needed to boost recall among Hispanic individuals who are older, less educated, and darker-skinned.

Predictors of genetic risk recall among the participants of a randomized controlled precision prevention trial against melanoma

PURPOSE

Inherited variation in MC1R imparts low to moderate risk of melanoma. Research on genetic risk recall, factors predicting recall, and whether recall influences adoption of preventive behaviors is limited.

METHODS

Participants (n = 447) enrolled in a melanoma precision prevention trial were provided with MC1R risk information (average or higher) and after 6 and 12 months, were asked to recall their genetic risk. Predictors of recall were identified using backward stepwise selection. Intervention effects were reassessed after stratifying by recall.

RESULTS

Participants at higher risk were 2 to 3 times more likely to misremember or not recall than participants with average risk. Misremembering was almost exclusively observed among participants at higher risk. Among the participants with average risk, lower health numeracy and not completing the telephone follow-up were associated with not recalling or misremembering. Among the participants at higher risk, lower education was associated with not recalling and lower perceived comparative chance of developing melanoma was associated with misremembering. In general, participants at higher risk who correctly recalled had modestly stronger intervention effects on sun protection behaviors than those who misremembered or did not recall.

CONCLUSION

Future studies should examine different strategies to increase genetic risk recall, which may result in improved behavioral outcomes, especially among participants with lower education and health numeracy.

Supportive Care Needs: Perspectives of Cancer Patients and Healthcare Providers

This descriptive qualitative study was conducted to understand supportive care needs from the perspectives of cancer patients and their healthcare providers (HCPs). Data collected from a purposive sample of 15 individuals (eight cancer patients and seven HCPs) using individual semi-structured interviews (60-90 minutes) were analyzed using thematic analysis. Four themes emerged from interview data in both patients and their HCPs: (1) information and resources, (2) peer support groups, (3) support for caregivers, and (4) tailored care. These four themes were discussed with subtle differences between groups. In addition, communication with and among HCPs was discussed by patients, while survivorship was mentioned by HCPs. Findings from this study indicate that nurses and other HCPs should provide supportive care congruent with the needs, preferences, and priorities of cancer patients through active and bidirectional communication with patients as well as interdisciplinary collaboration, which may optimize patient outcomes and use of resources.

Testing General Versus Specific Behavioral Focus in Messaging for the Promotion of Sun Protection Behaviors

BACKGROUND

Recommendations for skin cancer prevention include behaviors such as using sunscreen, seeking shade, and wearing a shirt with sleeves, but the best way to persuasively communicate this information to the public is not clear.

PURPOSE

To test whether a messaging strategy using videos that focus on one specific behavior at a time versus a more general or multibehavior sun protection message is effective at changing attitudinal beliefs and intention with regard to sun protection behaviors.

METHODS

Online experiment among non-Hispanic white 18-49 year old adults in the USA. Participants were randomly assigned to one of four conditions, each one with health messages on a different sun protection prevention behavior: "using sunscreen" (Condition 1, n = 259), "seeking shade" (Condition 2, n = 245), or "covering up" (Condition 3, n = 289). Condition 4 (the control, n = 251) is a multibehavior message that equally promotes sunscreen, seeking shade, and covering up and features a general message on sun safety.

RESULTS

ANOVA and path analysis results suggest that messages which emphasize a single sun protection behavior compared with general sun safety messaging could potentially be a promising approach. The effectiveness of the videos in influencing attitudinal beliefs varied by behavior, with some gender and age moderation. There was an indirect effect on intention to use sunscreen.

CONCLUSIONS

This study advances our understanding of strategies for skin cancer prevention campaigns. Specifically, it suggests that focusing on a single sun protection behavior with targeted beliefs may be valuable as a first step in encouraging sun safety.

Action and inaction in multi-behaviour recommendations: a meta-analysis of lifestyle interventions

This meta-analysis examined theoretical predictions about the effects of different combinations of action (e.g., start an exercise regime) and of inaction (e.g., reduce screen time, rest in between weight lifting series) recommendations in smoking, diet, and physical activity multiple-domain interventions. The synthesis included 150 research reports of interventions promoting multiple behaviour domain change and measuring change at the most immediate follow-up. The main outcome measure was an indicator of overall change that combined behavioural and clinical effects. There were two main findings. First, as predicted, interventions produced the highest level of change when they included a predominance of recommendations along one behavioural dimension (i.e., predominantly inaction or predominantly action). Unexpectedly, within interventions with predominant action or inaction recommendations, those including predominantly inaction recommendations had greater efficacy than those including predominantly action recommendations. This effect, however, was limited to interventions in the diet and exercise domains, but reversed (greater efficacy for interventions with predominant action vs. inaction recommendations) in the smoking domain. These findings provide important insights on how to best combine recommendations when interventions target clusters of health behaviours.