An application of an extended health belief model to the prediction of breast self-examination among women with a family history of breast cancer

The Use of the Health Belief Model in the Context of Heatwaves Research: A Rapid Review

As heatwaves increase and intensify worldwide, so has the research aimed at outlining strategies to protect individuals from their impact. Interventions that promote adaptive measures to heatwaves are encouraged, but evidence on how to develop such interventions is still scarce. Although the Health Belief Model is one of the leading frameworks guiding behavioral change interventions, the evidence of its use in heatwave research is limited. This rapid review aims to identify and describe the main themes and key findings in the literature regarding the use of the Health Belief Model in heatwaves research. It also highlights important research gaps and future research priorities. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 10 articles were included, with a geographic distribution as follows: United States (n = 1), Australia (n = 1), Pakistan (n = 1), and China (n = 1), as well as Malaysia (n = 2), Germany (n = 1), and Austria (n = 1). Results showed a lack of research using the Health Belief Model to study heatwaves induced by climate change. Half of the studies assessed heatwave risk perception, with the 2 most frequently used constructs being Perceived Susceptibility and Perceived Severity. The Self-efficacy construct was instead used less often. Most of the research was conducted in urban communities. This review underscores the need for further research using the Health Belief Model.

Investigating Media Coverage and Public Perceptions of the HPV Vaccine in China - A Content Analysis of Weibo Posts

Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. The HPV vaccination has been widely advocated around the world since the vaccine is beneficial in avoiding diseases, including some sexually transmitted diseases, brought on by HPV infections. For most Chinese, the HPV vaccine is still a relatively new concept, having only been made available to the general public in 2016. Despite the vaccine's increased prominence, there is still a lack of investigation about how the public is influencing the conversation about HPV vaccines and the public's perception of this vaccine. With the theoretical construct of the Health Belief Model, this study conducts both quantitative and qualitative content analysis to investigate the existing media narratives around HPV vaccines in China and the changes in public opinion by looking at users' contributions on Weibo, one of China's most popular social networking sites. It was found that different groups of Weibo users had contributed to diverse narratives surrounding HPV vaccination. Though the public awareness of HPV vaccination had been improved along with increasingly active communication practices and enhanced public health services, public knowledge about HPV remains inadequate. Therefore, to facilitate the popularisation of HPV related knowledge, more effort should be invested in tailoring and disseminating messages that communicate responsive and comprehensive HPV related information.

Explanations for the Cloudy Evidence That Theory Benefits Health Promotion

Persuasive arguments for using theory have been influential in health behavior and health promotion research. The use of theory is expected to improve intervention outcomes and facilitate scientific advancement. However, current empirical evaluations of the benefits of theory have not consistently demonstrated strong effects. A lack of resolution on this matter can be attributed to several features of the current body of evidence. First, the use of theory may be confounded with other features that impact health-related outcomes. Second, measurement of theory use has not been reliable. Third, the field conflates models and theories. Lastly, the evidentiary status and applicability of theories are not considered. Addressing these challenges during the execution of meta-analyses and designing original research specifically to estimate the benefits of theory could improve research and practice.

News Attention and Social-Distancing Behavior Amid COVID-19: How Media Trust and Social Norms Moderate a Mediated Relationship

Despite the fact that social distancing is an effective mean to slow the spread of COVID-19, individuals often fail to practice this behavior. Major US news media provided information to the public about social distancing after COVID-19 was declared a pandemic, potentially spurring this preventative health practice. Using data from a representative sample of US residents, this study aims to understand the relationship between news media attention and social-distancing behavior via three potential mediators: perceived effectiveness of social distancing, perceived susceptibility to COVID-19 infection, and perceived negative consequences of infection. Media trust and social norms concerning social distancing were included as potential moderators of these relationships, along with political ideology. With multiple regression and mediation analyses, we found that news media attention was positively associated with social-distancing behavior during this period. Perceived effectiveness of social distancing mediated this relationship, while perceived susceptibility and negative consequences of COVID-19 did not. Notably, media trust negatively moderated news attention's impact on the perceived effectiveness of social distancing, with the relationship being more pronounced among those who have lower trust in media. Political ideology did not moderate the relationship between news attention and perceived effectiveness. Further, social norms negatively moderated the relationship between perceived effectiveness and social-distancing behavior, with this relationship growing stronger among those uncertain about the adoption of social-distancing norms in their circle. Overall, the study found news media to have an important role in promoting social-distancing behavior when they emphasized safety measures across the ideological spectrum.

Egyptians’ Perceptions of COVID-19: Applying the Health Belief Model: A Cross-sectional Study

BACKGROUND: Many studies have found that assessing COVID-19 preventive behaviors using the health belief model (HBM) to understand both motives and fears is critical to better controlling the disease. AIM: The aim of the study was to assess the perceptions of social distancing as a preventive measure during the COVID-19 pandemic using the HBM among a sample of the Egyptian population. METHODS: An exploratory cross-sectional study was conducted using an online survey distributed through one of Egypt’s most popular social media platforms. Four hundred and seventy people responded to the survey. The survey constructed of two sections; the first section for sociodemographic data and Section 2 was for HBM constructs of self-efficacy, perceived susceptibility, and severity to COVID-19 prevention benefits and barriers. RESULTS: More than half of the participants (59.8%) were in the age range of 20–29, with an average age of 29.0 ± 6.4 years. Two hundred ninety-seven participants (63.2%) were females; 60.2% lived in the canal region; 57.9% were single; and 70% had university degrees. There were statistically significant differences regarding gender; females’ perceived higher scores in almost all model constructs (benefits, susceptibility, severity, self-efficacy, and total score). Many statistically significant differences were observed; those who were older than 30 years had higher scores in barriers, benefits, self-efficacy, and total score than younger ones. Similarly, married participants reported higher scores in barriers, benefits, self-efficacy, and total score than younger ones. Postgraduate education perceived higher scores than university in benefits, susceptibility, self-efficacy, and total score. CONCLUSION: In the present study, the majority of respondents had relatively high perceived benefits, severity, and self-efficacy, with the lower perceived self-COVID-19 susceptibility but higher for family members. Females perceived higher scores in almost all model constructs (benefits, susceptibility, severity, self-efficacy, and total score).

Does Illness Behavior Contribute to the Understanding of Self-Efficacy and Quality of Life Among People With Hearing Loss? A Test of Concept

PURPOSE

The study sought to first confirm the mediating role of self-efficacy (SE) in the link between hearing loss and reduced quality of life (QOL) and introduce the construct of illness behavior (IB) as a further correlate of self-reported QOL that may itself be mediated by SE.

METHOD

Cross-sectional data were attained using a questionnaire that was completed by 61 adults with self-reported acquired hearing loss.

RESULTS

Support was provided for low SE being a barrier to QOL, with hearing loss only predictive of emotional QOL when SE was an intermediary (mediating) variable. Cognitive and affective indices of IB also predicted QOL. Those participants with elevated emotional distress and, to a lesser extent, exaggerated concerns for their health, were found to have both lower SE and poorer QOL.

CONCLUSIONS

Attempts to replicate these findings longitudinally and with larger and more diverse samples (e.g., congenital or illness-derived hearing loss) are encouraged. A more objective assessment of hearing loss may also reduce the potential for spurious associations that may arise from the use of self-reported data. Nevertheless, the analytical results provide encouragement for the continued consideration of IB in the evaluation of the well-being of individuals with hearing loss. It is proposed that IB could be a useful supplement to the study of motivation among this cohort, such as an addition to the commonly used Health Belief Model, to improve the predictive validity of appropriate health behaviors.

A Content Analysis of Social Support Messages about Environmental Breast Cancer Risk within Blogs for Mothers

Bloggers can help stimulate online conversations among their readers about a variety of health topics, including breast cancer. However, in previous studies, researchers have not specifically examined supportive messages within an online blogger community that stem from an intervention where bloggers were provided with evidence-based information about breast cancer risk that they could tailor and disseminate to their readers. In the current study, we content analyzed 282 supportive messages within online conversations from participants in blogger communities over a 2-month period immediately following an intervention where the authors provided 74 bloggers who write about motherhood issues with an infographic based on evidence-based information from the Breast Cancer and the Environment Research Program (BCERP) about environmental breast cancer risk/prevention. Bloggers who shared information about their personal breast cancer risk generated a significantly higher number of blog reader comments than bloggers who did not share information about their personal breast cancer risk. Bloggers who cited breast cancer statistics in posts were more likely to draw esteem and emotional support from their readers. Bloggers' repetition of information from blog intervention messages was more likely to elicit esteem, informational, and emotional support from readers. Disclosure of a personal breast cancer diagnosis was associated with mixed types of social support messages. The theoretical and practical implications are discussed along with key limitations of the study and future directions for research in this area.

In-vivo design feedback and perceived utility of a genetically-informed smoking risk tool among current smokers in the community

BACKGROUND

The use of genetically-informed personalized risk information for behavioral disorders, namely smoking and smoking-related behaviors, is a promising yet understudied area. The Genetics and Smoking Risk Profile, or RiskProfile, leverages genetic and environmental information to communicate one's risk for smoking-related diseases. Although prior studies have examined attitudes toward genetic results, little research has investigated these perceptions through a lens of in-vivo testing; that is, user-centered design feedback in response to personalized genetic results being returned contemporaneously. This qualitative study engaged current smokers in usability testing of the RiskProfile within the context of concurrently receiving this personalized, genetically-informed smoking cessation intervention.

METHODS

Eighty-nine participants who were current smokers responded to open-ended interview questions on perceptions of smoking-related genetic information and the content and format of the RiskProfile intervention that they had received moments before. Data were analyzed via the conventional content analysis approach in which themes were allowed to emerge throughout the analysis.

RESULTS

Participants were able to reference and offer design input on specific elements of the RiskProfile. Overall, current smokers perceived the RiskProfile to have high potential utility. Constructive feedback that current smokers offered about the tool centered around suggested improvements to optimize its usability and technical content.

CONCLUSIONS

The detailed and constructive feedback from participants highlights that in-vivo feedback offers a useful design approach that addresses concerns of rigor and relevance when returning genetic results. This unique method demonstrated perceived utility and constructive design feedback for the RiskProfile among current smokers and can play an important role in optimizing the design and implementation of personalized genetic risk interventions moving forward.

Psychological predictors of intention and avoidance of attending organized mammography screening in Norway: applying the Extended Parallel Process Model

Background

Mammography screening is the main method for early detection of breast cancer in Norway. Few studies have focused on psychological determinants of both attendance and non-attendance of publicly available mammography screening programs. The aim of the current study, guided by the Extended Parallel Process Model, was to examine how psychological factors influence defensive avoidance of breast cancer screening and intention to attend mammography.

Methods

Cross-sectional survey data from a community sample of women living in Norway aged ≥ 18 (N = 270), and without a history of breast cancer, was collected from September 2018 to June 2019 and used to investigate the relationships between the Extended Parallel Process Model (EPPM) constructs and two outcomes: defensive avoidance of breast cancer screening and intention to attend mammography within the next two years. After adjusting for confounding factors, the hierarchical multiple linear regression analyses was conducted to assess the ability of the independent variables based on the EPPM to predict the two outcome variables. Significance level was chosen at p < 0.05.

Results

Multivariate analyses showed that defensive avoidance of breast cancer screening was predicted by lower perceived susceptibility to breast cancer (β =  − 0.22, p = 0.001), lower response efficacy of mammography screening (β =  − 0.33, p = 0.001), higher breast cancer fear (β = 0.15, p = 0.014), and checking breasts for lumps (β =  − 0.23, p = 0.001). Intention to attend mammography within the next two years was predicted by higher response efficacy of mammography screening (β = 0.13, p = 0.032), having a lower educational level (β =  − 0.10, p = 0.041), and regular previous mammography attendance compared to never attending (β = 0.49, p = 0.001).

Conclusions

The study revealed that defensive avoidance of breast cancer screening and intention to attend mammography were not predicted by the same pattern of psychological factors. Our findings suggest future health promotion campaigns need to focus not only on the psychological factors that encourage women’s decision to attend the screening, but also to counter factors that contribute to women’s decision to avoid it.

Four Actionable Bottlenecks and Potential Solutions to Translating Psychiatric Genetics Research: An Expert Review

BACKGROUND

Psychiatric genetics has had limited success in translational efforts. A thorough understanding of the present state of translation in this field will be useful in the facilitation and assessment of future translational progress.

PURPOSE

A narrative literature review was conducted. Combinations of 3 groups of terms were searched in EBSCOhost, Google Scholar, and PubMed. The review occurred in multiple steps, including abstract collection, inclusion/exclusion criteria review, coding, and analysis of included papers.

RESULTS

One hundred and fourteen articles were analyzed for the narrative review. Across those, 4 bottlenecks were noted that, if addressed, may provide insights and help improve and increase translation in the field of psychiatric genetics. These 4 bottlenecks are emphasizing linear translational frameworks, relying on molecular genomic findings, prioritizing certain psychiatric disorders, and publishing more reviews than experiments.

CONCLUSIONS

These entwined bottlenecks are examined with one another. Awareness of these bottlenecks can inform stakeholders who work to translate and/or utilize psychiatric genetic information. Potential solutions include utilizing nonlinear translational frameworks as well as a wider array of psychiatric genetic information (e.g., family history and gene-environment interplay) in this area of research, expanding which psychiatric disorders are considered for translation, and when possible, conducting original research. Researchers are urged to consider how their research is translational in the context of the frameworks, genetic information, and psychiatric disorders discussed in this review. At a broader level, these efforts should be supported with translational efforts in funding and policy shifts.

Assessing Stakeholder Perceptions of the Utility of Genetic Information for the Clinical Care of Mental Health Disorders: We Have a Will but Need to See the Way

Academic stakeholders' (primarily mental health researchers and clinicians) practices and attitudes related to the translation of genetic information into mental health care were assessed. A three-part survey was administered at two large, urban universities. Response frequencies were calculated. Participants (N = 64) reported moderate levels of translational practice, adequate levels of genetic knowledge, and variable levels of genetic competence. They held positive attitudes toward translating genetic information about mental health broadly but negative attitudes about the impact that such information would have on specific aspects of care. The current study lays the groundwork for further inquiry into translating genetic information to mental health care.

Credibility of self-reported health parameters in elderly population

AIM

Examining the credibility of self-reported height, weight, and blood pressure by the elderly population using a tablet in a retirement residence, and examining the influence of health beliefs on the self-reporting credibility.

BACKGROUND

Obesity is a major problem with rising prevalence in the western world. Hypertension is also a significant risk factor for cardiovascular diseases. Self-report, remotely from the clinic, becomes even more essential when patients are encouraged to avoid visiting the clinic as during the COVID-19 pandemic. Self-reporting of height and weight is suspected of leading to underestimation of obesity prevalence in the population; however, it has not been well studied in the elderly population.The Health Belief Model tries to predict and explain decision making of patients based on the patient's health beliefs.

METHODS

Residents of a retirement home network filled a questionnaire about their health beliefs regarding hypertension and obesity and self-reported their height, weight, and blood pressure. Blood pressure, height, and weight were then measured and compared to the patients' self-reporting.

FINDINGS

Ninety residents, aged 84.90 ± 5.88, filled the questionnaire. From a clinical perspective, the overall gap between the measured and the self-reported BMI (M = 1.43, SD = 2.72), which represents an absolute gap of 0.74 kilograms and 2.95 centimeters, is expected to have only a mild influence on the physician's clinical evaluation of the patient's medical condition. This can allow the physician to estimate their patient's BMI status before the medical consultation and physical examination upon the patient's self-reporting. Patients' dichotomous (normal/abnormal) self-report of their blood pressure condition was relatively credible: positive predictive value (PPV) of 77.78% for normal blood pressure (BP) and 78.57% for abnormal BP. The relatively high PPV of BP self-reporting demonstrates an option for the physician to recognize patients at risk. Regression analysis found no correlation between the anthropometric parameters and the Health Belief Model.

Consumer acceptance of edible insect foods: an application of the extended theory of planned behavior

BACKGROUND/OBJECTIVES

The purpose of this study was to measure consumer acceptance of edible insect foods (EIFs) while applying the extended theory of planned behavior (ETPB). Insects as food have attracted interest as potential possible sources of nutrition for the future. This study investigated consumers' perception toward insect food and future purchase behaviors.

SUBJECTS/METHODS

A survey was conducted among citizens of Korea. About two thirds of respondents had tried an EIF previously, and the mean value for food neophobia was 3.1 on a 5-point Likert scale. Respondents were divided into 2 groups of those experienced with EIFs and those not and by level of food neophobia. An independent t-test, multiple regression and descriptive analyses were conducted on the data.

RESULTS

The primary reason for not eating EIFs was that their insect form induced disgust. Comparisons of ETPB attributes by experience with EIFs showed significant differences between groups for food neophobia, subjective norm, attitude, and behavioral intention. In addition, significant differences were found for subjective norm, perceived behavioral control, attitude, and behavioral intention between 2 neophobia groups. Finally, the results of measuring the relationships between ETPB attributes and behavioral intention showed only subjective norm and attitude affected behavioral intention.

CONCLUSIONS

These results suggest that enhanced subjective norms producing a publicly accepted EIFs environment would help encourage the purchase of EIFs. The results of this study can help the development of EIF products for future food markets.

Parental Attitudes Towards Prenatal Genetic Testing For Sickle Cell Disease

Uptake of prenatal genetic testing (PGT) is low among those with sickle cell disease (SCD). This study evaluated the association of knowledge and attitudes towards prenatal genetic counseling (PGC), awareness of posttesting intervention options and omission bias with attitudes towards PGT. In addition, we explored changes among knowledge, attitudes, and awareness of options following exposure to an educational, clinical vignette among parents of children with SCD. Parents (n=44) completed a questionnaire and an educational, clinical vignette presenting a detailed account of a pregnant woman with sickle cell trait seeking PGT and PGC was read to each participant. t Tests, Spearman correlations, multivariable regressions, and moderation/mediation analyses were used. More positive attitudes towards PGC (P=0.01), lesser tendency of omission bias (P<0.01) and private insurance (P=0.04) were significant correlates of more positive attitudes towards PGT. Omission bias mediated the relationship of attitudes towards PGC and attitudes towards PGT (95% confidence interval: 0.13, 3.03). Awareness of options (P=0.02), knowledge of PGC (P=0.01) and knowledge of PGT (P=0.01) significantly improved after exposure to the clinical vignette. Patients and families with SCD can benefit from education about the importance of prenatal diagnosis to improve attitudes, address omission bias and promote more informed decisions of PGT.

Moderating Role of Demographic Characteristics in Breast Cancer Awareness and the Behavioural Disposition of Women in Ogun State, Nigeria

BACKGROUND

Breast cancer incidence is fast increasing, posing a significant threat to the health of women of all races globally. In Nigeria, breast cancer causes the most cancer-related deaths among women each year as a result of inadequate awareness.

AIM

This study is aimed at examining the moderating role of demographic characteristics in facilitating breast cancer awareness among women, and how it relates to their behavioural disposition to the disease.

METHODS

The study adopted the descriptive (survey) and cross-sectional research designs to elicit information from women of adult age selected across five Local Government Areas in Ogun state. The data, collected through questionnaire were analysed through the use of a variance-based SEM Partial Least Square (PLS).

RESULTS

The result shows that demographic characteristics (age and education) has a significant positive effect and jointly explain 74.9% of the variance in the breast cancer awareness and behavioural disposition among women in the study area. The findings revealed that a significant number of women with breast cancer had not acquired useful knowledge that could potentially be used to diagnose, prevent, and manage the disease. Unfortunately, the practice of Breast Self-Examination is grossly low among Nigerian women, as a consequence, only 20-30% of the women in study areas, including professionals, are aware of the benefits of BSE and only a smaller percentage practice BSE.

CONCLUSION

There is, therefore, a need to educate women on the benefits of this simple life-saving procedure through the consistent use of media platforms.

A national cross-sectional study of adherence to timely mammography use in Malta

BACKGROUND

Routine mammography improves survival. To achieve health benefits, women must attend breast screening regularly at recommended time intervals. Maltese women are routinely invited to undergo mammography at three-year intervals at an organized breast screening programme (MBSP) or can opt to attend a private clinic. Previous research shows that health beliefs, particularly perceived barriers, were the most significant predictors of uptake to the first MBSP invitation. Whether these beliefs and other factors are predictive of adherence with recommended time intervals for mammography at organized or private screening in Malta is unknown. For the first time, this paper explores the predictors for Maltese women screened within or exceeding the recommended three-year frequency in organized or private screening in Malta.

METHODS

Information was obtained from a cross-sectional survey of 404 women, aged 50 to 60 years at the time of their first MBSP invitation, where women's characteristics, knowledge, health beliefs and illness perceptions were compared. The main variable of interest was women's mammography attendance within a three-year interval (ADHERENT) or exceeding three years (NON-ADHERENT). Data were analysed using descriptive statistics, chi-square test, Mann Whitney test, Independent Samples t-test and Shapiro Wilk test.

RESULTS

At the time of the survey, 80.2% (n = 324) had been screened within three years (ADHERENT), 5.9% (n = 24) had exceeded the three-year frequency (NON-ADHERENT) while 13.9% (n = 56) never had a mammogram. No significant associations were found between ADHERENT or NON-ADHERENT women in relation to sociodemographic or health status variables (p > 0.05). Knowledge of screening frequency was significantly associated with women's mammography adherence (χ2 = 5.5, p = 0.020). Health beliefs were the strongest significant predictors to describe the variance between ADHERENT and NON-ADHERENT screeners. When Mann Whitney test and Independent Samples t-test were applied on mammography adherence, perceived barriers and cues to action were found to be the most important predictors (p = 0.000, p = 0.039 respectively).

CONCLUSIONS

To increase routine and timely mammography practices, women who are non-adherent to recommended time frequency guidelines should be targeted, together with their health beliefs, predominantly perceived barriers and cues to action.

Influences on anticipated time to ovarian cancer symptom presentation in women at increased risk compared to population risk of ovarian cancer

Background

In the absence of routine ovarian cancer screening, promoting help-seeking in response to ovarian symptoms is a potential route to early diagnosis. The factors influencing women’s anticipated time to presentation with potential ovarian cancer symptoms were examined.

Methods

Cross-sectional questionnaires were completed by a sample of women at increased familial risk (n = 283) and population risk (n = 1043) for ovarian cancer. Measures included demographic characteristics, symptom knowledge, anticipated time to symptom presentation, and health beliefs (perceived susceptibility, worry, perceived threat, confidence in symptom detection, benefits and barriers to presentation). Structural equation modelling was used to identify determinants of anticipated time to symptomatic presentation in both groups.

Results

Associations between health beliefs and anticipated symptom presentation differed according to risk group. In increased risk women, high perceived susceptibility (r = .35***), ovarian cancer worry (r = .98**), perceived threat (r = −.18**), confidence (r = .16**) and perceiving more benefits than barriers to presentation (r = −.34**), were statistically significant in determining earlier anticipated presentation. The pattern was the same for population risk women, except ovarian cancer worry (r = .36) and perceived threat (r = −.03) were not statistically significant determinants.

Conclusions

Associations between underlying health beliefs and anticipated presentation differed according to risk group. Women at population risk had higher symptom knowledge and anticipated presenting in shorter time frames than the increased risk sample. The cancer worry component of perceived threat was a unique predictor in the increased risk group. In increased risk women, the worry component of perceived threat may be more influential than susceptibility aspects in influencing early presentation behaviour, highlighting the need for ovarian symptom awareness interventions with tailored content to minimise cancer-related worry in this population.

Electronic supplementary material

The online version of this article (10.1186/s12885-017-3835-y) contains supplementary material, which is available to authorized users.

Beliefs and Perception About HIV/AIDS, Self-Efficacy, and HIV Sexual Risk Behaviors Among Young Thai Men Who Have Sex With Men

This study examined the relationships of HIV/AIDS beliefs, self-efficacy for AIDS preventive behaviors, perception of HIV as a chronic disease, and HIV risk behaviors among young Thai men who have sex with men. Participants were recruited for a self-administered anonymous survey through Facebook. Logistic regression analysis was used to identify factors associated with each of four HIV risk behavior outcomes. Factors associated with sexual risk behaviors included age (18 and 21 years), having a current regular male partner, self-efficacy for AIDS preventive behaviors (self-efficacy in refusing sexual intercourse, self-efficacy in questioning potential sex partners, and self-efficacy in condom use), AIDS health belief (perceived susceptibility to HIV/AIDS, perceived severity of HIV/AIDS, perceived barriers to condom use, and cues to action for HIV/AIDS prevention), and perception of HIV/AIDS as a chronic disease (perceived HIV sero-status disclosure). Knowledge generated from this study has the potential to inform prevention messages for young Thai MSM.

Prevalence of Known Risk Factors in Women Diagnosed with Breast Cancer at Inmol Hospital, Lahore, Punjab

BACKGROUND

Breast cancer is the most prevalent cancer in women worldwide and its frequency is increasing gradually in many countries. Over the last three decades an increase in the breast cancer has been witnessed in the earlier low-risk Asian countries including Pakistan.

PURPOSE

The objective of the current study was to assess the prevalence of known risk factors like early menarche, late menopause, socio economic, reproductive and demographic factors, among women diagnosed with breast cancer at INMOL hospital, Lahore, Punjab, as little information exists in this regard.

MATERIALS AND METHODS

A survey study was conducted on 200 women diagnosed with breast cancer who were seen at Institute of Nuclear Medicine and Oncology (INMOL) hospital, Lahore. A structured questionnaire was administered to these patients regarding the known risk factors through face to face interviews after obtaining appropriate consent.

RESULTS

Regarding non-modifiable risk factors, our study showed that majority of the breast cancer patients were diagnosed at 35-45 years (32.5%) or at older age (≤46) and experienced menarche at 12 years or older (66 %). Likewise, a large number of patients reached menopause at the age of 45 years (60%), had no family and personal history of breast cancer (80%) and hence fell in a low risk category. Regarding modifiable risk factors in women diagnosed with breast cancer, most of the patients fell in low risk strata as the majority were married (98%) at young age, breastfed their children for 12 months or more (88%) and bore two to three children (80%). Considering income criteria, the majority of the patients had a low risk profile as they belonged to middle class (70%), urban area (60%) and were house wives (80%). However, it was noted that a considerable number of women (34%) diagnosed with breast cancer experienced menarche at an early age (<12) and reached menopause after the age of 45 years. This situation is further augmented by environmental changes and dietary habits and places them in a high risk category.

Exploring breast health practices of post-menopausal women: Implications to informed consent

In light of the contention surrounding breast health practices, the research aimed to explore post-menopausal women's experiences of such practices. Semi-structured interviews were conducted in July and August 2015 with 13 Australian women aged 54-74 years. Data were analysed thematically. Participants deemed their engagement with breast health practices as the 'right' thing. However, engaging in these 'right' practices appeared to be fostered by misconceptions. The findings suggest that women may not be making evidence-informed decisions to engage in breast screening; identify contemporary barriers to promoting informed decisions; and may inform information pertinent to breast screening policy, campaigns and decision aid designs.

The double-edged sword of ovarian cancer information for women at increased risk who have previously taken part in screening

BACKGROUND

Women at increased risk who decide not to have, or to delay, risk-reducing salpingo-oophorectomy have to rely on early diagnosis through symptom awareness and presenting to primary care as soon as possible in the absence of screening. However, little is known about the acceptability to women of this strategy. We aimed to gain an in-depth understanding of women's perceptions and previous experiences of ovarian cancer symptom management, and the influences on ovarian cancer awareness and anticipated symptom presentation.

METHOD

Qualitative interviews were conducted with eight women at increased risk of ovarian cancer who had previously taken part in ovarian cancer screening and analysed using interpretative phenomenological analysis (IPA).

RESULTS

Familial experience of ovarian cancer and perceived personal risk shaped women's perceptions and behavioural responses to disease threat. Ovarian cancer information was perceived to be a double-edged sword, regarded as either useful for increasing knowledge and confidence in discussing symptom concerns with health professionals or to be avoided due to fears about cancer.

CONCLUSION

Women may be cautious about searching for information independently and in the absence of routine ovarian screening.

PRACTICE IMPLICATIONS

Thought needs to be given to how best to create and disseminate credible ovarian cancer symptom information materials.

Health information seeking and scanning among US adults aged 50–75 years: Testing a key postulate of the information overload model

Past research has found that older US adults (aged 50–75 years) exhibit high levels of cancer information overload and cancer worry; however, no study to date has examined whether these perceptions are related to information seeking/scanning. To explore this relationship, older adults ( N = 209, Mage = 55.56, SD = 4.24) were recruited to complete a survey measuring seeking, scanning, cancer information overload, and cancer worry. Most participants were high-scan/seekers (40.2%) followed by low-scan/seekers (21.1%), high-scan/no seekers (19.6%), and low-scan/no seekers (19.1%). Low-scan/no seekers had significantly higher cancer information overload compared to all other groups, consistent with the postulate that overload and seeking/scanning are negatively related. Low-scan/no seekers and high-scan/seekers both exhibited higher cancer worry severity, consistent with past research suggesting that cancer worry explains high levels of activity/inactivity.

The role of television viewing and direct experience in predicting adolescents' beliefs about the health risks of fast-food consumption

BACKGROUND

Fast-food advertising abounds on television (TV), and programs targeting youth often display fast-food consumption but rarely with any negative consequences. Cultivation research maintains that cumulative exposure to TV influences audiences' views of and beliefs about the real world. Thus, the amount of TV adolescents watch is likely to bias their views of the consequences of eating fast food. This research posits that this relationship varies as a function of adolescents' actual experience with fast food.

METHOD

Two cross-sectional surveys conducted in the cultivation research tradition assess the relationship between the amount of adolescents' regular exposure to TV and their beliefs about the risks and benefits of eating fast food. Teenage children of members of online panels reported hours of TV viewing, beliefs about the consequences of eating fast food, and their frequency of fast-food consumption.

RESULTS

In both studies, beliefs about health risks of fast-food consumption vary as a function of the amount of TV watched. Heavy TV viewers have less negative and more positive beliefs about the consequences of fast-food consumption than light viewers. As direct experience with fast food increases, the relationship between TV viewing and risk perceptions weakens, but the relationship between TV viewing and positive perceptions strengthens. These moderated relationships remain when we control for physical activity (Study 1) and the density of fast-food restaurants in respondents' geographical area (Study 2).

CONCLUSION

Given the role of TV viewing in biasing perceptions of the consequences of eating fast food, public health researchers and practitioners should carefully monitor and perhaps regulate the amount of fast-food advertising on TV and the content of TV programs.

Toward the Development of the Cerebrovascular Attitudes and Beliefs Scale (CABS): A Measure of Stroke-Related Health Beliefs

PURPOSE

To develop a measure of stroke-related health beliefs, derived from the Health Belief Model (HBM) and a measure of stroke risk factor behavior change.

METHOD

The Cerebrovascular Attitudes and Beliefs Scale (CABS) was devised to assess survivors' beliefs and attitudes about their susceptibility to future stroke, the perceived seriousness of stroke, and the likely benefits and barriers associated with undertaking behaviors to reduce stroke risk. A second measure, the Stroke Behavior Change Inventory (SBCI), as well as a version developed for relatives (SBCI-R), was devised to assess participants' pre- and poststroke risk factor behavior.

RESULTS

Forty-two stroke/transient ischemic attack (TIA) survivors accurately described behavior changes they had undertaken poststroke, when compared to relatives' reports of such behavior (n = 7). Most survivors changed at least some behaviors poststroke to reduce their stroke risk. Further analysis to determine the role of health beliefs in predicting behavior change poststroke was undertaken, focusing on those behaviors that were changed in a large enough proportion of the sample. The beliefs most predictive of behavior change related to perceived stroke seriousness and severity, but the combination of beliefs from the HBM was not predictive of behavior change.

CONCLUSION

After stroke or TIA, most survivors change their behavior in ways that would contribute to stroke risk reduction. Such effects can be demonstrated using survivor self-report or relatives' report of survivors' behaviors. Using the CABS, partial support for health belief variables as predictors of such behavior change was also identified, suggesting that further investigation of these variables is warranted.

Awareness levels about breast cancer risk factors, early warning signs, and screening and therapeutic approaches among Iranian adult women: a large population based study using latent class analysis

BACKGROUND AND OBJECTIVE

Breast cancer (BC) continues to be a major cause of morbidity and mortality among women throughout the world and in Iran. Lack of awareness and early detection program in developing country is a main reason for escalating the mortality. The present research was conducted to assess the Iranian women's level of knowledge about breast cancer risk factors, early warning signs, and therapeutic and screening approaches, and their correlated determinants.

METHODS

In a cross-sectional study, 2250 women before participating at a community based screening and public educational program in an institute of cancer research in Isfahan, Iran, in 2012 were investigated using a self-administered questionnaire about risk factors, early warning signs, and therapeutic and screening approaches of BC. Latent class regression as a comprehensive statistical method was used for evaluating the level of knowledge and its correlated determinants.

RESULTS

Only 33.2%, 31.9%, 26.7%, and 35.8% of study participants had high awareness levels about screening approaches, risk factors, early warning signs and therapeutic modalities of breast cancer, respectively, and majority had poor to moderate knowledge levels. Most effective predictors of high level of awareness were higher educational qualifications, attending in screening and public educational programs, personal problem, and family history of BC, respectively.

CONCLUSION

Results of current study indicated that the levels of awareness among study population about key elements of BC are low. These findings reenforce the continuing need for more BC education through conducting public and professional programs that are intended to raise awareness among younger, single women and those with low educational attainments and without family history.

Functional status, anxiety, cardiac self-efficacy, and health beliefs of patients with coronary heart disease

BACKGROUND

Beliefs and emotions could effect on functional status, quality of life, and mortality amongst patients who are suffering coronary heart disease (CHD). Current study examined the role of anxiety: trait/ state, self-efficacy, health beliefs, and functional status among patient with history of CHD.

METHOD

In this correlational study, 105 hospitalized and outpatients patients suffering CHD in Tehran Heart Center Hospital participated by using convenience sampling method in 2012. Cardiac self-efficacy, Seattle Angina, and research-designed health beliefs questionnaires were used to gather data.

RESULTS

The functional status in CHD patients showed significant relationships with gender, job, and type of medical insurance of the participants (All ps<0.05). In addition , perceived vulnerability to face again cardiac attack in the future, per-ceived severity of next cardiac attack, anxiety, state anxiety and trait anxiety (All ps<0.05) had significant and negative relationships with functional status. Con-versely, the cardiac self-efficacy had a positive and significant relationship (P<0.001) with functional status.

CONCLUSION

Psychological factors have important role in functional status and quality of life of patients who suffering CHD. Therefore, it is necessary to emphasize on supportive and complementary programs to promote Cardiac Reha-bilita-tion Programs.

Evaluation of breast self-examination (BSE) application in first and second degree relatives of patients with breast cancer

BACKGROUND

The aim of this study was to determine beliefs concerning breast self-examination in first- and second-degree relatives of patients with breast cancer and evaluate their breast self-examination (BSE) application.

MATERIALS AND METHODS

A survey study was conducted in an oncology polyclinic and general surgery clinic of a hospital in Ankara, the capital of Turkey with a sample of 140 women.

RESULTS

It was determined that 60.7% of the participants had conducted BSE and 48.1% had undergone a clinical breast examination. Perceived self- efficacy of the women who performed BSE were significantly higher compared with women who did not practice BSE (p<0.001) Furthermore, perceived barriers were lower among those who had performed BSE (p<0.001). Logistic regression analysis indicated that women who perceived higher self-efficacy (OR: 1.119, 95% CI: 1.056- 1.185, p<0.001) and had regular CBE (OR: 8.250, 95% CI: 3.140-21.884, p<0.001) and educational status (OR: 5.287, 95% CI: 1.480-18.880, p<0.01) were more likely to perform BSE.

CONCLUSIONS

Findings from this study indicated that perceived barriers, perceived self-efficacy, and educational status could be predictors of BSE behavior among the first- and second-degree relatives of patients with breast cancer. Therefore, BSE training programs that emphasize self-efficacy and address perceived barriers are recommended.

Determination of information and support needs of first degree relatives of women with breast cancer

BACKGROUND

Breast cancer is the most frequent type of cancer among women in the world and the most common cause of deaths from cancer in females. In Turkey, breast cancer comes first in the list of the most frequent ten cancer types seen in women. As the incidence rate of breast cancer is high, many women having breast cancer in the family experience the breast cancer at secondhand. This study was carried out in an attempt to determine the information and support needs of women whose first-degree relatives have breast cancer and to what extent these needs are met.

METHODS

The research sample consisted of 156 women. Questionnaire Form and Information and Support Needs Questionnaires were used as the data collection tools.

RESULTS

Information need score averages (x?:3.72±0.19) of women included in the research sampling were found to be higher than their score averages of support needs (x?:3.24±0.41).

CONCLUSION

Information needs which were indicated by women as very important were related to treatment, symptoms of breast cancer and breast self examination (BSE), while support needs which were indicated by women as very important were learning how to perform BSE, women's anxiety for themselves and their relatives regarding breast cancer and having their breasts examined by a health professional. It is recommended that nurses and other medical staff should give information to women whose first-degree relatives have breast cancer about the disease, its etiology, scanning, diagnosis, treatment options and protection as well as prevention.

Applying Psychological Theories to Promote Healthy Lifestyles

Over the past few decades, researchers have been developing and refining psychological theories and models to provide solid behavioral frameworks for evidence-based research. Each year new theories and models are created; however, a select few appear to have withstood the test of time and continue to be frequently utilized in present-day research. The objectives of this review are to highlight these psychological theories and models and describe their application to various public health issues and behaviors. Descriptions and example applications of the following theories and models are described in this review: health belief model, theory of reasoned action/planned behavior, social cognitive theory, transtheoretical model, and socioecological model.

Health beliefs and practice of breast self-examination among young Cypriot women

PURPOSE

Breast cancer is the leading form of cancer affecting Cypriot women. This study is aimed at examining the factors influencing the choice of Cypriot women to perform breast self-examination (BSE).

DESIGN

A cross-sectional, descriptive, and correlational study, with a sample of 94 young Cypriot women, was conducted.

METHOD

The Greek version of Champion's Health Belief Model was used. Various statistical tests were implemented.

FINDINGS

Almost all women (91.5%) had heard about BSE, and 71.3% had performed it sometime in the past. The susceptibility factor was significant in influencing women's behavior, while barriers and self-confidence were associated with practicing BSE. Knowledge on BSE and a high level of education were positively related with the frequency of practicing BSE.

CONCLUSIONS

Proper education on BSE is important in shaping young women's attitudes. Any related health strategy should consider the concepts of Health Belief Model, especially the factors that make a female susceptible to breast cancer.

Towards an effective health interventions design: an extension of the health belief model

INTRODUCTION

The recent years have witnessed a continuous increase in lifestyle related health challenges around the world. As a result, researchers and health practitioners have focused on promoting healthy behavior using various behavior change interventions. The designs of most of these interventions are informed by health behavior models and theories adapted from various disciplines. Several health behavior theories have been used to inform health intervention designs, such as the Theory of Planned Behavior, the Transtheoretical Model, and the Health Belief Model (HBM). However, the Health Belief Model (HBM), developed in the 1950s to investigate why people fail to undertake preventive health measures, remains one of the most widely employed theories of health behavior. However, the effectiveness of this model is limited. The first limitation is the low predictive capacity (R(2) < 0.21 on average) of existing HBM's variables coupled with the small effect size of individual variables. The second is lack of clear rules of combination and relationship between the individual variables. In this paper, we propose a solution that aims at addressing these limitations as follows: (1) we extended the Health Belief Model by introducing four new variables: Self-identity, Perceived Importance, Consideration of Future Consequences, and Concern for Appearance as possible determinants of healthy behavior. (2) We exhaustively explored the relationships/interactions between the HBM variables and their effect size. (3) We tested the validity of both our proposed extended model and the original HBM on healthy eating behavior. Finally, we compared the predictive capacity of the original HBM model and our extended model.

METHODS

To achieve the objective of this paper, we conducted a quantitative study of 576 participants' eating behavior. Data for this study were collected over a period of one year (from August 2011 to August 2012). The questionnaire consisted of validated scales assessing the HBM determinants - perceived benefit, barrier, susceptibility, severity, cue to action, and self-efficacy - using 7-point Likert scale. We also assessed other health determinants such as consideration of future consequences, self-identity, concern for appearance and perceived importance. To analyses our data, we employed factor analysis and Partial Least Square Structural Equation Model (PLS-SEM) to exhaustively explore the interaction/relationship between the determinants and healthy eating behavior. We tested for the validity of both our proposed extended model and the original HBM on healthy eating behavior. Finally, we compared the predictive capacity of the original HBM model and our extended model and investigated possible mediating effects.

RESULTS

The results show that the three newly added determinants are better predictors of healthy behavior. Our extended HBM model lead to approximately 78% increase (from 40 to 71%) in predictive capacity compared to the old model. This shows the suitability of our extended HBM for use in predicting healthy behavior and in informing health intervention design. The results from examining possible relationships between the determinants in our model lead to an interesting discovery of some mediating relationships between the HBM's determinants, therefore, shedding light on some possible combinations of determinants that could be employed by intervention designers to increase the effectiveness of their design.

CONCLUSION

Consideration of future consequences, self-identity, concern for appearance, perceived importance, self-efficacy, perceived susceptibility are significant determinants of healthy eating behavior that can be manipulated by healthy eating intervention design. Most importantly, the result from our model established the existence of some mediating relationships among the determinants. The knowledge of both the direct and indirect relationships sheds some light on the possible combination rules.

Effect of a school-based oral health-education program on Iranian children: results from a group randomized trial

Parents and school staff play important roles in promoting children's oral health. Our study goals were to investigate whether an intervention targeting parents and school staff can improve the oral-health behavior and oral-health status of schoolchildren. Three-hundred and ninety-two schoolchildren in six schools in Tehran participated in a group randomized trial from September 2010 to March 2011. Schools were randomly allocated into three groups: comprehensive, student, and control. Intervention in the comprehensive group consisted of strategies to encourage children, their parents, and school staff to increase the frequency of toothbrushing and flossing. In the student group, the intervention targeted only children. The control group received no intervention. The primary outcome was change in oral-health behaviors (brushing and flossing), while the secondary outcomes were changes in oral hygiene and Community Periodontal indices and in Health Belief Model components. Multilevel modeling was employed for data analyses. Students who were in the comprehensive intervention group brushed and flossed significantly more frequently compared with those in the student intervention group. Although students' gingival health improved significantly in the comprehensive intervention group, such significant improvement was not seen in the student group. In conclusion, promising results are seen when the oral-health education targets both school and home settings.

Attitudes and health beliefs associated with breast cancer screening behaviors among Turkish women

PROBLEM

This research was undertaken to determine the attitudes and health beliefs of a sample of Turkish women about breast self-examination (BSE), clinical breast examination, and mammography.

DESIGN

Data were collected by means of a researcher-designed questionnaire and the Champion Health Belief Model Scale. A total of 1,342 women participated in this study.

RESULTS

It was found that 10.1% of the women practiced BSE once a month, 19.8% of the women had had a clinical breast examination, and 15.0% had had a mammogram. Age and marital status were significant variables that influenced whether the women used only one or multiple methods for early detection of breast cancer. Participants who had higher levels of confidence for BSE and lower perceptions of barriers to BSE were more likely to perform BSE. Participants who perceived higher levels of confidence to perform BSE were more likely to be using all three early detection methods.

IMPLICATIONS FOR PRACTICE

Interventions and strategies that help women develop confidence in their abilities to perform early breast cancer detection methods are likely to encourage them to engage in regular screening for breast cancer.

Using the Extended Health Belief Model to understand siblings' perceptions of risk for hereditary hemochromatosis

OBJECTIVE

this research focuses on individuals' reactions to news that a sibling has been diagnosed with hereditary hemochromatosis (HH). We used the Extended Health Belief Model (EHBM) to frame our analysis of siblings' perceptions of risk for HH and decision of whether to obtain diagnostic testing.

METHOD

60 patient and 25 sibling interviews were transcribed and thematically analyzed for the six components of the EHBM.

RESULTS

patient and sibling reports of siblings' perceptions were categorized into the six components of the EHBM: susceptibility, severity, benefits, barriers, cue to action, and self-efficacy.

CONCLUSION

In the case of HH, siblings' perceptions of HH are varied and include a range of motivators and barriers that may impact family-based detection. Family-based detection can often play an important part of effective public health strategies to address inherited risk of disease. Further research should examine the EHBM with other genetic conditions.

PRACTICE IMPLICATIONS

this analysis using the EHBM suggests areas of importance for message development for both medical personnel and HH patients to promote diagnostic testing of at-risk siblings.

The effects of an educational program on knowledge of breast cancer, early detection practices and health beliefs of nurses and midwives

AIM

To determine the effectiveness of an educational program concerning knowledge of breast cancer, early detection practices and health beliefs of nurses and midwives.

BACKGROUND

Educational programs play an important role in breast cancer preventive behaviour.

DESIGN

The study was designed as an experimental post-test only, control group design. The educational program was applied only to the experimental group. The study group included 157,134 nurses and midwives respectively in the experimental and the control group.

METHODS

Participants in the experimental group received an educational program on the breast cancer. One year after the educational program was delivered, data were collected from the two groups using a personal data form and the Turkish version of Champion's Health Belief Model Scale. Descriptive statistics, paired samples t-test, chi-square test and Fisher's exact test were conducted in the course of the data analyses.

RESULTS

The mean total knowledge score was significantly higher in the experimental group than in the control group. The application percentage of mammography and clinical breast examination was higher in the experimental group. There were no significant differences between two groups in performing breast self-examination. The experimental group was significantly more likely to feel confident and motivated, and their total score on the health belief scale was much better than that of the control group.

CONCLUSIONS

The results of this study showed that educational intervention had a positive impact on knowledge of breast cancer, on practices related to breast cancer, on early detection and on the health beliefs in the experimental group.

RELEVANCE TO CLINICAL PRACTICE

The educational programs, including techniques to increase the motivation and skills for early detection of breast cancer, should be made widespread in nursing and midwifery. Health beliefs should be considered in planning educational programs about breast cancer. Interventions should be designed to enhance nurses' and midwives' confidence and motivation.

An exploration of rural and urban Kenyan women's knowledge and attitudes regarding breast cancer and breast cancer early detection measures

Many women in Kenya with breast cancer symptoms do not seek medical attention until their cancer is very advanced, leading to high mortality rates and a heavy cancer burden on the nation. In this study we employed eight focus groups with low- and middle-income rural and urban Kenyan women to explore their knowledge, attitudes, and behaviors concerning breast cancer and its early detection measures. Topics for discussion were derived from the components of the Health Belief Model (HBM). Findings revealed a huge divide between urban middle-income women and all other groups with respect to knowledge of breast cancer and early detection measures. In addition, women viewed breast cancer as a highly severe disease. Perceived benefits of early detection measures centered around preparing themselves for what was assumed to be inevitable death.