The Effect of Personal Characteristics, Perceived Threat, Efficacy and Breast Cancer Anxiety on Breast Cancer Screening Activation

Culture, community, and cancer: understandings of breast cancer from a non-lived experience among women living in Soweto

BACKGROUND

Individual perceptions, socio-cultural beliefs and health system factors are key determinants of people's health seeking behavior and are widely cited as the causes of delayed breast cancer diagnosis among women from structurally vulnerable settings. Asking: "how do women with a non-lived experience of cancer understand the disease and, what informs their health seeking behaviors?", we qualitatively explored, individual, sociocultural and health system elements from a conceptual model derived from the Socioecological, Health Belief and Cancer Stigma Frameworks, to understand perspectives of breast cancer in a South African urban community setting.

METHODS

Using a deductive approach and allowing new themes to emerge inductively, we investigated phenomenologically, breast cancer perceptions among 34 women from Soweto, Johannesburg (aged 35-74 years) in 6 Focus Group Discussions. We then conducted 20 follow-up semi-structured in-depth interviews to explore novel themes and suggestions for increasing breast cancer screening.

RESULTS

Findings revealed some awareness of breast and other cancers, but confusion and gaps in understanding of the disease, resulting in socio-culturally influenced misperceptions of risks, causes, and outcomes following treatment of breast cancer. This fueled perceptions of profound fear and stigma against people with breast and other cancers. These findings together with participant perceptions of primary healthcare providers being unwelcoming, under-resourced, and insufficiently trained to deal with breast cancer, resulted in women reporting being reluctant to participating in screening/early detection care seeking behavior. Women only accessed primary care when experiencing extreme pain or ill-health. Participants suggested as solutions for future interventions, the need for sustained community engagement, harnessing existing clinic and community stakeholders and resources to provide clear and understandable breast cancer information and encouragement for screening uptake.

CONCLUSIONS

Health literacy gaps surrounding breast cancer fuels socio-culturally influenced misperceptions, fear, stigma, and fatalism among women from Soweto. Women perceive primary care providers of having insufficient knowledge, skills, and resources to provide effective breast cancer screening services. Participants suggested the need for greater community engagement involving primary clinics and existing community stakeholders working collaboratively. Clear, understandable, and consistent information about breast cancer must be regularly disseminated and communities must be regularly encouraged to utilize breast cancer screening services.

"Oh no, they caught it!": Vicarious experience of COVID-19, protection motivation and protective behaviors

Utilizing the components of the protection motivation theory, this study investigated the role of close others' diagnosis of COVID-19 (as a vicarious experience) in individuals' adherence to protective behavior against COVID-19. Path analysis of online survey data from 3695 participants showed that the presence of a diagnosed close other was positively related to perceived vulnerability, while being negatively related to perceived response efficacy and self-efficacy. In addition, perceived severity and efficacy appraisals were positively associated with protective behavioral tendencies. Although efficacy appraisal mediated the relationship between vicarious experience and protective behavior, threat appraisal did not mediate this relationship. In sum, the results suggest that efficacy appraisal derived from vicarious experiences can be more consequential for protective behaviors than threat appraisal. Implications of these results on future large-scale health crises are discussed along with limitations and future directions.

Get Rid of Mr. Virus: The Effect of Injurant Anthropomorphism on the Intention to Engage in Protective Behavior

Injurant anthropomorphism is defined as the anthropomorphism of disease-causing agents with humanlike characteristics, emotions, intentions, or behavior. More and more health product brands and health care organizations are depicting disease causing injurants (e.g., enterovirus or PM2.5 pollutants) with human characteristics in their advertising. However, the effect of injurant anthropomorphism on consumer perceptions and decision making remains unclear. This paper investigates how consumers feel and react to injurant anthropomorphism in the context of heath product promotion. The results of four lab and field experiments show that participants will develop a higher intention to engage in protective behavior (e.g., use a PM 2.5 anti-pollution mask) when the injurant is anthropomorphized than when it is not. However, the effect disappears if the injurant triggers a high behavioral immune response (BIR), or is imbued with a crying humanlike face. In addition, the perceived threat of disease is found to mediate this effect. Briefly, the present study contributes to the health communication literature and real-world practices by systematically examining the impact of injurant anthropomorphism on the health protective response, the process through which it exerts influence, or the boundary conditions for the effect.

Factors Promoting Breast, Cervical and Colorectal Cancer Screenings participation: A Systematic Review

Objective

The present study aims at systematically reviewing research conducted on factors promoting breast, cervical and colorectal cancer screenings participation.

Methods

A literature search in MEDLINE/PubMed and PsycInfo from January 2017 to October 2021 was performed. Data extraction, researchers' full agreement and the inclusion criteria produced 102 eligible studies. Data were narratively synthesized and critically interpreted.

Results

Multiple factors favoring or hindering breast, cervical and colorectal cancer screenings were identified and summarized as factors operating at the individual level (background information, individual characteristics, emotions related to screening procedure and to cancer, knowledge and awareness), at the relational level (relationships with healthcare staff, significant others, community members), and at the healthcare system level (systems barriers/policy, lack of staff). A critical appraisal of studies revealed a fragmentation in the literature, with a compartmentalization of studies by type of cancer screening, country and specific populations of destination.

Conclusions

Overall findings indicated that greater integration of research results obtained independently for each cancer diagnosis and within the different countries/populations could foster a more comprehensive understanding of factors potentially enhancing the participation in breast, cervical and colorectal cancer screenings worldwide. This review, which is grounded in the current context of globalization and superdiversification in population, can help to enhance a better integration between research and practices, by supporting the development of more effective and inclusive evidence‐based interventions and health‐promotion campaigns worldwide. Research and practical implications are highlighted and discussed.