Health Fatalism Does Not Predict Body Mass Index but Is Associated with Diet Quality in Healthy Adults: A Cross-Sectional Study

OBJECTIVE

Obesity as assessed by body mass index (BMI) is associated with increased risk of chronic disease. Health fatalism, defined as the belief that health outcomes are outside of one's control, is also associated with chronic disease risk. The purpose of this cross-sectional study was to understand the relationship between health fatalism and BMI in healthy adults. Secondary outcomes assessed the relationships between health fatalism and diet quality and health fatalism and physical activity.

METHOD

Healthy individuals aged 18 to 65 years were recruited via ResearchMatch, electronic mailing lists, and social media. Participants completed online questionnaires on demographic characteristics, diet quality, physical activity, and degree of health fatalism. Regression models were used to assess the primary and secondary outcomes. For the primary outcome, the model of health fatalism (predictor) and BMI (outcome) was also adjusted for diet quality, physical activity, and demographic characteristics.

RESULTS

Participants (n = 496) were 38.7 ± 14.3 years old and primarily female (76%) and White (81%), with a BMI of 25.1 ± 5.2 kg/m2. Most participants had a college or post-college education (74%), stated that they always had sufficient income to live comfortably (90%), and were moderately to highly active (91%). There was no relationship between health fatalism and BMI (p > 0.05) or health fatalism and physical activity (p > 0.05); however, there was a significant relationship between health fatalism and diet quality (beta coefficient: -0.046; 95% confidence interval, -0.086 to -0.0058; p = 0.025), such that a higher degree of fatalism predicted a slight decrease in diet quality.

CONCLUSIONS

Although health fatalism did not predict BMI in this population, fatalistic beliefs were associated with poorer diet quality.

The role of collectivism, liberty, COVID fatigue, and fatalism in public support for the zero-COVID policy and relaxing restrictions in China

BACKGROUND

China was the last country in the world to relax COVID-19 restrictions. A successful public health policy requires public support. This analysis examined the factors associated with Chinese support for zero-COVID and relaxing COVID-19 restrictions in China.

METHOD

Two online surveys were conducted among Chinese participants in mainland China on June 10-13 (N = 460) and December 2, 2022 (N = 450). These two samples were similar based on the participants' demographics.

RESULTS

The results revealed that the perceived health consequences of a COVID-19 policy, perceived norms of approving a COVID-19 policy, and hope positively predicted the participants' support for the COVID-19 policy. The results further showed that collectivism and fatalism positively predicted support for zero-COVID and negatively predicted support for relaxing restrictions. COVID fatigue was negatively associated with support for zero-COVID and positively associated with support for relaxing restrictions. Liberty positively predicted support for relaxing restrictions in June and negatively predicted zero-COVID in December 2023. It did not positively or negatively predict support for the policy adopted by the government.

CONCLUSION

Collectivism, liberty, COVID fatigue, and fatalistic beliefs are important considerations connected to public support for a COVID-19 policy. The role of liberty was more nuanced and depended on the survey's time and whether the government adopted the policy.

Fatalism tendency and health beliefs about medication use in older adults: A predictive correlational design

OBJECTIVE

This study was performed to investigate fatalism tendency and health beliefs about medication use and to identify predisposing factors of these variables among older adults.

METHODS

A predictive correlational design was used. The study was completed with 500 older adults. A personal information form, the Fatalism Tendency Scale, and the Drug Use Health Beliefs Scale were used to collect data. Univariate and multiple linear regression analysis was performed for data analysis.

RESULTS

Fatalism tendency was found to be high in older adults who used medications prescribed by the physician in different ways, used the medications more than the recommended amount, and used medications at random intervals. Older adults who used over-the-counter medications and discontinued the medications before the due date had lower health beliefs about conscious and prescription medication use.

CONCLUSIONS

The study concluded that characteristics regarding medication use predicted both fatalism tendencies and medication use health beliefs. Health perception was found to be one of the predisposing factors of medication use health beliefs, whereas education level was another predictive factor of fatalism tendency.

Vaccine Hesitancy in India: Facilitators and Inhibitors

COVID-19 is yet not completely over; however, many people are hesitant to take COVID-19 vaccines despite their availability. Vaccine hesitancy is a major roadblock to attaining normalcy and controlling the spread of the COVID-19 virus. The present research used a multitheoretical framework (Health Belief Model, 3Cs framework, fatalism, and religious fatalism) to comprehend the complexity of vaccine hesitancy. Thus, the present study aimed at exploring vaccine hesitancy in India by using key components of the Health Belief Model, 3Cs framework, fatalism, religious fatalism, and some demographics as predictors. Data were collected electronically with the help of Google Forms from 639 Indian adults following snowballing and convenience sampling techniques with standardized measures (albeit some modifications to suit the context of the study). Descriptive analysis and hierarchical regression analysis were run in SPSS (V-22) to analyze the data. Results revealed that participants of the present study scored relatively high on vaccine hesitancy. Muslims as compared with Hindus and vaccination status emerged as significant predictors of vaccine hesitancy out of the demographic factors. Fear of COVID-19, vaccine convenience, and religious fatalism also significantly predicted vaccine hesitancy. Thus, a comprehensive approach is needed to strategically use these predictors to control vaccine hesitancy.

Association of health anxiety, fatalism and medication adherence among geriatric clients: An exploratory study

OBJECTIVES

This study explored the relationship between health anxiety, fatalistic beliefs, and medication adherence among geriatric clients. Also, it determines the extent to which health anxiety and fatalism can predict the variance in medication adherence among the same population of geriatric clients.

DESIGN

A cross-sectional analytical survey on 200 eligible participants using the Arabic Version of the Short Health Anxiety Inventory, Fatalism Scale, and Morisky Medication Adherence Scale-8 items.

RESULTS

The study found a statistically significant negative relationship between the studied geriatric clients' fatalism and health anxiety and their medication adherence (r = -0.160, - 0.187, and P = 0.024, 0.008), respectively.

CONCLUSION

This study highlights the importance of considering psychological factors such as health anxiety and fatalistic beliefs in addressing medication adherence among geriatric clients. By addressing these factors, healthcare providers can develop more effective strategies to improve medication adherence and ultimately improve the health outcomes of geriatric clients.

Religious Coping and Fatalism on Perception of Care Burden in Caregivers of Patients with Cerebral Palsy in Turkey: A Cross-Sectional and Correlational Study

Providing care to a patient with cerebral palsy can have many negative impacts upon caregivers. This study was carried out to define caregiving burden in the caregivers of cerebral palsy patients and determine the relationships between religious coping, fatalism, and burden of care. This cross-sectional and correlational study included 132 caregivers. Data were obtained using the Religious Coping Scale, the Fatalism Scale, and the Caregiver Burden Scale. It was determined that 18.9% of the participants experienced a heavy care burden. The luck and pessimism dimensions of the Fatalism Scale were positively and weakly correlated with caregiving burden (p < 0.01), while there was no correlation between caregiving burden and positive or negative religious coping styles (p > 0.05). Perception of fatalism explained 10% of the total variance in caregiving burden (R = 0.329, R² = 0.109, F = 5.195, p = 0.002). It is recommended that caregivers be supported by religious experts to strengthen positive religious coping styles and advisable fatalism perceptions.

Beliefs associated with cancer screening behaviors among African Americans and Sub-Saharan African immigrant adults: a cross-sectional study

BACKGROUND

Beliefs influence cancer screening. However, there are conflicting findings about how belief influence cancer screening among Black adults. The aim of this study was to evaluate the relationships between beliefs (religiosity, fatalism, temporal orientation, and acculturation) and cervical, breast, and colorectal cancer screening behaviors among African Americans and sub-Saharan African immigrants.

METHODS

We conducted a cross-sectional survey of 73 African American and 59 English speaking Sub-Saharan immigrant adults recruited from Lexington and surrounding cities in Kentucky. Data collected included sociodemographic variables, cancer screening behaviors, and several instruments that characterize beliefs, including religiosity, fatalism, temporal orientation, and acculturation.

RESULTS

Participants' mean age was 43.73 years (SD = 14.0), 83% were females, and 45% self-identified as sub-Saharan immigrants. Based on eligibility for each screening modality, 64% reported having ever had a Pap test, 82% reported ever having mammogram, and 71% reported ever having a colonoscopy. Higher education (OR = 2.62, 95% CI = 1.43-4.80) and being insured (OR = 4.09, 95% CI = 1.10 - 15.18) were associated with increased odds of cervical cancer screening (pap test), while cancer fatalism (OR = 0.24, 95% CI = 0.07 - 0.88) was associated with decreased odds. Increased age (OR = 1.57, 95% CI = 1.06 - 2.32) and reduced present orientation (OR = 0.42, 95% CI = 0.22 - 0.80) were associated with receipt of a mammogram. Nativity was the only factor associated with colonoscopy screening. Compared to African Americans, sub-Saharan African immigrants were 90% less likely to have had a colonoscopy (OR = 0.10, 95% CI = 0.02 - 0.66).

CONCLUSION

This study contributes to the existing literature by confirming that beliefs are important in cancer screening behaviors among African American and sub-Saharan African immigrants. These findings should inform the development of cancer control and prevention programs for Black adults.

TRIAL REGISTRATION

US National Library of Science identifier NCT04927494. Registered June 16, 2021, www.

CLINICALTRIALS

gov.

Luck perception is associated with less frequent preventive practices and a higher number of social contacts among adults during the SARS-CoV-2 pandemic

Objectives

Non-pharmaceutical interventions have been crucial to reduce transmission of the SARS-CoV-2 virus in many countries including the United Kingdom. A key research priority has been to better understand psychological and social determinants of health behaviours. We aimed to quantify the impact of luck perception on contact and preventive behaviours among adults in the UK, adjusting for key confounders.

Study design

A cross-sectional study.

Methods

Data were collected between July 28 and August 31, 2020. Luck perception, which refers to a belief whether individual's SARS-CoV-2 infection status is determined by fate or chance, was measured using Chance score, drawing on Health Locus of Control Theory. Self-reporting online questionnaires were administered to obtain participants' contact patterns and frequencies of avoiding crowds, hand washing and wearing a mask. Associations between luck perception and protective behaviours and contact patterns were quantified using regression models.

Results

Data from 233 survey respondents were analysed. Chance score was negatively associated with all protective behaviours; avoiding crowds (adjusted odds ratio (aOR) 0.46, 95% confidence interval (CI) 0.25–0.86, p = 0.02), washing hands (aOR 0.35, 95%CI 0.17–0.70, p = 0.003), and wearing masks (aOR 0.58, 95%CI 0.34–0.99, p = 0.046). For non-physical contacts (with or without distancing), a significant interaction was identified between Chance score and ethnicity. Chance score increased the number of non-physical contacts among white British, an opposite trend was observed for non-white participants.

Conclusions

Luck perception during the pandemic may affect individuals’ health protection behaviours and contact patterns. Further mechanistic understandings of human behaviours against infectious diseases are indispensable for effective response to future pandemics.

Fatalistic cancer beliefs and self-reported cancer screening behaviors among diverse urban residents

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.

Kindred fatalisms: debating science, Islam, and free will in the Darwinian era

An important aspect of the nineteenth century debate on the relationship between science and religion concerned the popularity of deterministic views among scientists. An integral part of Comte's positivism, the idea of immutable laws that determined natural and social phenomena became an increasingly prevalent component of scientific perspectives in the Darwinian era. Referring to this tendency as 'scientific fatalism,' critics likened it to Calvinist predestination, which transformed the debate into one involving polemics about different branches of Christianity as well. This paper focuses on a neglected aspect of this debate, namely, the role that references to Islam and Turks played in it. 'Mohammedan fatalism,' already a common theme in justifications of colonialism, promptly became a tool with which to condemn new scientific views. Comparing French, British, and American writings on the topic, the paper illustrates that while there emerged approaches that praised the fatalism of Muslims while making a case for scientific determinism, most scientists and thinkers resorted to condemning the fatalism of Muslims in order to distinguish their views from it. In this respect, the paper demonstrates how political and religious discourses played a significant part in the shaping of scientific discourse in the Victorian era.

Contested Minds Across Time: Perspectives from Chinese History and Culture

This essay provides an overview of the contributions by Emily Baum, Chengyang Jiang, and Sandra Teresa Hyde. Chinese history and culture provide a useful resource for thinking beyond the limits of the contemporary human sciences, such as the way that the mind operates as a contested object of knowledge across time, place, and disciplines.

Fatalism, beliefs, and behaviors during the COVID-19 pandemic

Little is known about how people's beliefs concerning the Coronavirus Disease 2019 (COVID-19) influence their behavior. To shed light on this, we conduct an online experiment ( n = 3 , 610 ) with US and UK residents. Participants are randomly allocated to a control group or to one of two treatment groups. The treatment groups are shown upper- or lower-bound expert estimates of the infectiousness of the virus. We present three main empirical findings. First, individuals dramatically overestimate the dangerousness and infectiousness of COVID-19 relative to expert opinion. Second, providing people with expert information partially corrects their beliefs about the virus. Third, the more infectious people believe that COVID-19 is, the less willing they are to take protective measures, a finding we dub the "fatalism effect". We develop a formal model that can explain the fatalism effect and discuss its implications for optimal policy during the pandemic.

Demand for mitigating the risk of COVID-19 infection in public transport: The role of social trust and fatalistic beliefs

The rapid surge of COVID-19 cases worldwide drew attention to COVID-19 infection as a new source of risk in transport. The virus introduced a need for viral transmission mitigation as a major priority when selecting a mode of travel, and caused a significant drop in public transport use. The recovery of public transport use in the post-COVID period requires that the transport authorities favourably address people's demand for mitigation of the risk of COVID-19 transmission in public transport. The present study aims to explore the role of risk perception, worry and priority of COVID-19 risk reduction along with fatalistic beliefs and public trust in authorities in explaining public demand for risk mitigation. The present study is among the first to investigate the role of fatalistic beliefs, social trust and risk perception for public transport and public demand for risk mitigation. The link between priority of infection prevention and demand for risk mitigation has also been less explored in public transport research. An online survey was conducted among university students in Iran between 19th April and 16th June 2020, during the first wave of the pandemic, when the country was a major epicentre of the disease. A total of 271 out of 370 respondents whose dominant mode on university travels was public transport were included in the analysis. Results of structural equation modelling confirmed the paradox of trust, indicating that social trust is negatively associated with perceived risk of COVID-19 infection, which in turn may lead people to place less importance on COVID-19 prevention as a priority in travel mode choice, and consequently demand less risk mitigation efforts to prevent COVID-19 infection in public transport. Dissimilar to trust, however, the results revealed no relationship between fatalistic beliefs and risk perception, but a significant direct effect of fatalistic beliefs on demand for risk mitigation. To reinforce public demand for mitigating the risk of COVID-19 in public transport, the study calls on policymakers to exploit public trust resources for more effective risk communication, through disseminating the gradually accumulating evidence-based information regarding the infectivity and the virulence of COVID-19 and the scientific risk of infection. The study also underlined the potential importance of considering fatalistic beliefs when developing effective risk communication policies and practices to enhance public support for COVID-19 risk mitigation in public transport.

Peasants' Fatalistic Thinking in Chinese Communism: an Analysis of a Rural Family's Oral History

In this paper, I examine a Chinese family's oral history, which revolves around their tumultuous life transformations under the impact of China's communist movement between 1940 and 1977. Using interviews with four siblings who have distinctive personalities and life narratives, I focus on how they apply fatalistic thinking-a phenomenon popular among ordinary Chinese but is rarely analyzed by scholars-to make sense of the vicissitudes of the fates of the family members. I position the Chinese family's oral history in macro and micro contexts. In the macro context, since the land reform in 1940s, the Chinese Communist Party (CCP) had attempted to replace peasants' fatalistic thinking with class analysis to explain the roots of hardships in their lives. As the communist movement and class struggle receded, fatalistic thinking-which has never been eradicated-revived. In the micro context, fatalistic thinking is expressed through distinctive memories and narratives, which are linked to personalities and identities. I argue that fatalistic thinking is a mean of self-construction that people consciously or unconsciously resort to when facing absurdity. By using fatalistic thinking, people develop narratives about the self and create a sense of mental balance.

Exploration of Fatalism and Religiosity by Gender and Varying Levels of Engagement Among Mexican-American Adults of a Type 2 Diabetes Management Program

Objectives: Purpose of study is to explore the roles religiosity and fatalistic beliefs play in diabetes management among newly, currently, and long-term enrolled Mexican-American participants in a Type 2 diabetes mellitus (T2DM) chronic care management program.

Methods: In 2017, study participants (n = 15) completed a semi-structured interview in their preferred language (English or Spanish). Sample was stratified by amount of time individual had been enrolled as a participant of the Salud y Vida program: newly, currently, or long-term. Interviews assessed religious beliefs, beliefs concerning the cause(s) of diabetes, perceived relationship between religiosity and fatalistic beliefs with T2DM management, and the appropriateness of discussing such topics with a health professional. Interview responses were analyzed using ATLAS.ti 8.

Results: Themes identified included: perceived autonomy over diabetes prognosis, motivators for self-care, discussions of personal beliefs in the healthcare setting, and the church's role in diabetes management.

Conclusions: Among this sample, religiosity and religious fatalism played a complex role in coping with and managing diabetes. Long-term enrolled and male participants expressed beliefs of divine control over health, and a connection between religiosity and health behavior. Long-term enrolled participants felt religious and fatalistic beliefs may be suitable and beneficial to discuss in the healthcare setting.

Relationship between stressful life events and cyberbullying perpetration: Roles of fatalism and self-compassion

Few studies have documented the relationship between stressful life events and cyberbullying perpetration, and the mechanisms connecting this link are unknown. Thus, the current study tested the association of stressful life events with cyberbullying perpetration and explored this influencing mechanism further with fatalism and self-compassion tested as a mediator and a moderator respectively. A sample of 1104 Chinese adolescents (50.72% males; mean age = 13.11) volunteered for this study. The results revealed that exposure to stressful life events was positively related to cyberbullying perpetration, and fatalism played a mediation role in this relationship. The moderated mediation model revealed that stronger self-compassion weakened and even interrupted the direct associations of stressful life events with fatalism and cyberbullying perpetration, and further weakened and even interrupted the indirect relationship between stressful life events and cyberbullying perpetration via fatalism. That is, adolescents low in self-compassion were more likely to build fatalistic beliefs and engage in cyberbullying perpetration when they experienced high levels of stressful life events; whereas, stressful life events were not related to increased risk of cyberbullying perpetration among adolescents high in self-compassion.

Determination of Breast Cancer Fatalism in Women and the Investigation of the Relationship Between Women's Cervical Cancer and Pap Smear Test Health Beliefs with Religious Orientation and Fatalism

This study aims to determine breast cancer fatalism in women and investigate the relationship between women's cervical cancer and pap smear test health beliefs with religious orientation and fatalism. The study, which was conducted as a descriptive and relational screening one, was conducted in the eastern part of Turkey between July and August 2019. The study was conducted with 357 women who were not diagnosed with breast or cervical cancer, and who were not pregnant. A positive, significant relationship was found between the Religious Orientation Scale total mean score and Health Motivation and Pap smear Benefit Perception sub-scale mean score. A positive, significant relationship was found between the Fatalism Tendency Scale total mean score and Sensitivity, Importance Perception, Pap smear Benefit Perception and Pap smear Barrier Perception sub-scale mean scores (p < .05). The participating women were found to have a low level of breast cancer fatalism. Religious Orientation and Fatalism Tendency were found to have affected the Cervical Cancer and Pap Smear Test Health Beliefs. Similar studies are recommended to be conducted in larger groups and different regions.

The Long Shadow of Fatalism: a Philosophical Speculation on Forster's "the Machine Stops" (1909) on the Disintegration of Technologically Advanced Societies Back Then and Today

EM Forster's short story "The Machine Stops" from 1909 is widely reread and discussed again for some ten years as it portrays a science-fiction world resting on similar technological advancements as today in the digital era. Also management literature reviewed the short story with regard to centralized decision making, rationality and totalitarianism. I argue instead, that the main theme of the short story is - in Forster's own words - the closing of a civilization in times of transition and facing major challenges. I built the argument by original quotes from Forster and by portraying the years 1906-9, when Forster developed the short story. This era before the Great War starting in 1914 was characterized by euphoric 'futurism' based on groundbreaking innovations like 'long distance messaging', 'penny post', 'animated films', Ford's assembly line, 'Olivetti typewriter', 'feature film', 'large ships' and 'air transportation' - the ingredients of the short story as I argue. At the same time these acquitted years were characterized by increasing disintegration, instability, rebellions and a financial crisis with bailout programs. Based on the analogy and as part of speculative philosophy I reconstruct the current great challenges with Forster' shadow of fatalism and arrive at the urgency to put more effort in addressing and researching pathways out of the crisis and towards stabilization of business and society.

Determination of health fatalism and the factors affecting health fatalism in patients with epilepsy in the North of Turkey

OBJECTIVE

In individuals with epilepsy, health fatalism can affect their perceptions of health and their responses to solutions offered, both positively and negatively. This study aimed to investigate health fatalism in people with epilepsy in Turkey and the factors that influence their health fatalism.

METHOD

This descriptive and cross-sectional study was conducted between December 2019 and April 2020 with 100 epilepsy patients who were referred to a neurology outpatient clinic in the North of Turkey. The data for the study were collected using a descriptive information form and the Health Fatalism Scale (HES).

RESULTS

The total mean score on the Health Fatalism Scale for the study participants was found to be 56,16 ± 15,71. Significant association was found between health fatalism and educational status (p < 0,05), polytherapy (p < 0,05), and frequency of seizures (p < 0,001).

CONCLUSION

In this study, individuals with epilepsy expressed high levels of fatalism in their health beliefs. It was found that illiterate individuals with epilepsy held more fatalistic beliefs. In addition, it was found that participants who used polytherapy and those who had frequent seizures also had higher levels of fatalistic health beliefs.

The relationship between cancer fatalism and education

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.

Psychological profile of multi drug resistance TB patients: A qualitative study from a Tertiary care Centre of Kolkata

INTRODUCTION

There has been a new challenge to the already existing threat of tuberculosis (TB) and that is drug resistance TB (DR-TB). The causal relationships between mental disorders and TB are complicated and relatively unexplored. For this reason a qualitative study was done on DR-TB patients attending R G Kar Medical College.

MATERIALS AND METHODS

The study population consisted of the patients who are registered for the DR-TB regimen are followed up four times with General Health Questionnaire (GHQ). Those scoring poorly were sent for expert evaluation by psychologist, who counselled them, and followed them up after in-depth interviews. These records of in-depth interview were analysed as qualitative research inputs.

RESULTS

In our study out of 165 patients, (4.8%) needed interventions. The domains emerging from the study are worried about future and as well as family, disbelief about the diagnosis, embarrassment regarding the diagnosis, fear of death, blaming fate for the disease, stigma, suicidal ideation.

CONCLUSION

This study finds out the important domains of psychogical problems among the patients and also advocates a psychologist to remain at DR-TB centres.

Fatalism and Depressive Symptoms: Active and Passive Forms of Fatalism Differentially Predict Depression

Classic fatalism is the belief that regardless of actions, events are predestined to occur (Straughan and Seow 1998). Researchers have found that fatalism is positively correlated with depression symptoms and higher endorsement of an external locus of control. Although fatalism is thought to be a unitary construct, based on the current literature, we hypothesized fatalism may take on other forms. We defined active fatalism as the belief in a predestined personal and global future, combined with the belief that one must do their part to bring this predestined future into fruition. Therefore, we predicted that active fatalism will be negatively correlated with depression symptoms, external locus of control, and negative coping skills. We recruited a sample of religious participants online (n = 282; 49.3% female) who completed self-report scales measuring depression symptoms, classic fatalism, active fatalism, coping skills, and locus of control. We found that while classic fatalism was significantly and positively associated with depression and negative coping, active fatalism was positively correlated with positive coping skills, and negatively correlated with depression and external locus of control. Finally, the present study found that active fatalism explained variance in both depression and anxiety symptoms above and beyond the classic form of fatalism. This confirmed our hypotheses and suggested that there may be several forms of fatalism, each differentially predicting mental health processes and outcomes. The significant positive correlation of positive coping and negative correlations of depression and external locus of control with active fatalism offer evidence in support of the notion that this form of fatalism may in fact be associated with protective mechanisms against depression. Differential assessment of these varying concepts may be appropriate for assessment and psychotherapy.

Psychological Constructs Related to Seat Belt Use: A Nationally Representative Survey Study

Seat belt use can significantly reduce fatalities in motor vehicle crashes (Kahane, 2000). Nevertheless, the current U.S. seat belt use rate of 89.6% (Enriquez & Pickrell, 2019) indicates that a relatively small but pervasive portion of the population does not wear seat belts on a full-time basis. Whereas much is known about the demographic predictors of seat belt use, far less is understood about psychological factors that predict individual proclivities toward using or not using a seat belt. In this study, we examined some of these potential psychological predictors. A probability-based web survey was conducted with 6,038 U.S. residents aged 16 or older who reported having driven or ridden in a car in the past year. We measured self-reported seat belt use and 18 psychological constructs and found that delay of gratification, life satisfaction, risk aversion, risk perception, and resistance to peer influence were positively associated with belt use. Impulsivity and social resistance orientation were negatively associated with belt use. Prior research has shown that psychological factors like delay of gratification, risk aversion/perception, and impulsivity predict other health behaviors (e.g., cigarette smoking, sunscreen use); our results extend this literature to seat belts and can aid the development of traffic safety programs targeted at non-users who-due to such factors-may be resistant to more traditional countermeasures such as legislation and enforcement.

Assessing preventive health behaviors from COVID-19: a cross sectional study with health belief model in Golestan Province, Northern of Iran

Background

Coronavirus disease 2019 (COVID-19) is a new viral disease that has caused a pandemic in the world. Due to the lack of vaccines and definitive treatment, preventive behaviors are the only way to overcome the disease. Therefore, the present study aimed to determine the preventive behaviors from the disease based on constructs of the health belief model.

Methods

In the present cross-sectional study during March 11–16, 2020, 750 individuals in Golestan Province of Iran were included in the study using the convenience sampling and they completed the questionnaires through cyberspace. Factor scores were calculated using the confirmatory factor analysis. The effects of different factors were separately investigated using the univariate analyses, including students sample t-test, ANOVA, and simple linear regression. Finally, the effective factors were examined by the multiple regression analysis at a significant level of 0.05 and through Mplus 7 and SPSS 16.

Results

The participants’ mean age was 33.9 ± 9.45 years; and 57.1% of them had associate and bachelor's degrees. Multiple regression indicated that the mean score of preventive behavior from COVID-19 was higher in females than males, and greater in urban dwellers than rural dwellers. Furthermore, one unit increase in the standard deviation of factor scores of self-efficacy and perceived benefits increased the scores of preventive behavior from COVID-19 by 0.22 and 0.17 units respectively. On the contrary, one unit increase in the standard deviation of factor score of perceived barriers and fatalistic beliefs decreased the scores of the preventive behavior from COVID-19 by 0.36 and 0.19 units respectively.

Conclusions

Results of the present study indicated that female gender, perceived barriers, perceived self-efficacy, fatalistic beliefs, perceived interests, and living in city had the greatest preventive behaviors from COVID-19 respectively. Preventive interventions were necessary among males and villagers.

Fatalism in the context of COVID-19: Perceiving coronavirus as a death sentence predicts reluctance to perform recommended preventive behaviors

To manage the spread of coronavirus, health entities have urged the public to take preventive measures such as social distancing and handwashing. Yet, many appear reluctant to take these measures. Research is needed to understand factors underlying such reluctance, with the aim of developing targeted health interventions. We identify associating coronavirus with death as one such factor. 590 participants completed surveys in mid-March 2020, which included attitudes toward coronavirus, preventive behavioral intentions, and sociodemographic factors. Associating coronavirus with death negatively predicted intentions to perform preventive behaviors. Further, associating coronavirus with death was not evenly distributed throughout the sample and was related with a number of sociodemographic factors including age, race, and availability of sick leave. Following recommended preventive measures to slow the spread of coronavirus appears to relate to the degree to which people associate coronavirus with death. These findings can be used by public health researchers and practitioners to identify those for whom targeted health communication and interventions would be most beneficial, as well as to frame health messaging in ways that combat fatalism.

Fatalistic Beliefs and Migration Behaviors: A Study of Ideational Demography in Nepal

We investigate influences of fatalistic beliefs on domestic and international migration in Nepal, positing that fatalistic beliefs may affect decisions to migrate and where to locate. Fatalism is the belief that human outcomes are preordained by forces outside of one's power and control. Because of its relationship with effort and innovation, fatalism may be an important factor in people's decision to migrate and destination choice. We expect that fatalistic beliefs encourage or discourage migration depending upon societal expectations to migrate and the relative ease of migration to different destinations. Our empirical analysis relies on migration histories of respondents from the Chitwan Valley Family Study. Results from multinomial logistic regression models provide evidence that fatalistic beliefs increase overall migration propensity and has both positive and negative destination-specific effects. Fatalistic beliefs increase Nepalis' odds of migrating to destinations that are, relatively speaking, easier to access, but decrease the odds of migrating to destinations with higher barriers to entry.

Psychosocial, education, economic factors, decision-making ability, and caries status of mothers of children younger than 6 years in suburban Nigeria

Background

Little information is available on the relationship between mothers’ psychosocial profile and caries status, and less information is available on the oral health status and psychosocial status of mothers of young children in Africa. This study examined the association between the psychosocial profile of mothers in Nigeria and their prevalence of caries.

Methods

The prevalence of caries and severe caries (DMFT > 3) in mothers with children 71 months old and younger recruited through a household survey in Ile-Ife, Nigeria, was estimated through clinical examination. The explanatory variables were maternal education, income, decision-making status, and psychosocial status (dental anxiety, general anxiety, depressive symptoms, parenting stress, executive dysfunction, sense of coherence, fatalism and social support). The risk indicators for maternal caries were analyzed with logistic regression.

Results

The prevalence of caries was 3.3%. Twenty (39.2%) of the 51 women with caries had DMFT > 3. Most study participants were 25–34 years old (59.3%), had secondary level education (63.1%), earned N18,000 ($49)-N30000 ($84) per month (42.9%), and can make autonomous decisions about their health care, household purchases, or visits to family/relatives (68.8%). Most women had normal general anxiety (79.9%), low dental anxiety (90.4%), and normal stress (76.4%) levels. Most also had high fatalism (56.6%), perceived moderate social support (81.6%), had normal depressive symptoms (75.9%), low executive dysfunction (55.9%), and high sense of coherence (53.8%). Mothers who had clinically significant levels of stress were twice more likely to have caries than were those whose level of stress was normal (AOR: 2.26; 95%CI: 1.04–4.89; P = 0.039). Also, mothers who had high fatalism were less likely to have caries than were those with low fatalism (AOR: 0.40; 95%CI: 0.21–0.75; P = 0.004).

Conclusion

High levels of parenting stress was a risk indicator for caries while high fatalism was protective from caries in mothers of children younger than 6-years. Maternal education, income and decision-making ability were not associated with maternal caries. Though the caries prevalence for women with young children was low, the prevalence of severe caries was high and this because of the possible negative effect on their health and wellbeing.

How do fatalistic beliefs affect the attitudes and pedestrian behaviours of road users in different countries? A cross-cultural study

This paper reports on an exploratory investigation of the influence of five different fatalistic belief constructs (divine control, luck, helplessness, internality, and general fatalism) on three classes of self-reported pedestrian behaviours (memory and attention errors, rule violations, and aggressive behaviours) and on respondents' general attitudes to road safety, and how relationships between constructs differ across countries. A survey of over 3400 respondents across Bangladesh, China, Kenya, Thailand, the UK, and Vietnam revealed a similar pattern for most of the relationships assessed, in most countries; those who reported higher fatalistic beliefs or more external attributions of causality also reported performing riskier pedestrian behaviours and holding more dangerous attitudes to road safety. The strengths of relationships between constructs did, however, differ by country, behaviour type, and aspect of fatalism. One particularly notable country difference was that in Bangladesh and, to a lesser extent, in Kenya, a stronger belief in divine influence over one's life was associated with safer attitudes and behaviours, whereas where significant relationships existed in the other countries the opposite was true. In some cases, the effect of fatalistic beliefs on self-reported behaviours was mediated through attitudes, in other cases the effect was direct. Results are discussed in terms of the need to consider the effect of locus of control and attributions of causality on attitudes and behaviours, and the need to understand the differences between countries therein.

The Reliability and Validity of the Religious Health Fatalism Scale in Turkish Language

This study aimed to conduct the reliability and validity study of the Religious Health Fatalism Scale in Turkish language. The study carried out in methodological type and consisted of 500 individuals. The basic component analysis was applied to the 17-item scale, and it was decided that the Turkish version of the scale would have one sub-dimension. Factor loads were over 0.30 for all items, and the explained variance of the scale was found 42.70%. The Cronbach's α coefficient was determined to be 0.91. Consequently, it was determined that the Religious Health Fatalism Scale had one dimension in the Turkish language, and it was a highly valid and reliable tool. It was determined that the elderly, females, housewives, illiterate, people with no health insurance, married individuals, those with low income, and people with chronic diseases had higher health fatalism scores.

The influence of stressful life events on depression among Chinese university students: Multiple mediating roles of fatalism and core self-evaluations

BACKGROUND

Previous studies have investigated the role of cognitive factors in the relationship between stressful life events and depression; however, few studies comprehensively considered cognitive and personality factors. Therefore, this study investigated the multiple mediating roles of fatalism and core self-evaluations in the relationship between stressful life events and depression.

METHODS

A cross-sectional survey was conducted with 537 Chinese university students (M_age = 20.20, SD = 1.38) at two universities in Guizhou and Sichuan provinces. The independent variable was stressful life events; mediating variables were fatalism and core self-evaluations; and the dependent variable was extent of depression. Multiple mediation analysis was performed using the PROCESS macro in SPSS.

RESULTS

Significant positive correlations were found among stressful life events, fatalism, and depression, while core self-evaluations were significantly negatively correlated with stressful life events, fatalism, and depression. After adjusting for demographic variables, stressful life events directly and positively influenced depression (β = 0.370, 95% CI = 0.292-0.448). Fatalism and core self-evaluations played multiple mediating roles in the relationship between stressful life events and depression, with stressful life events influencing depression through three mediation pathways (total mediation effect = 0.199, 95% CI = 0.145-0.254), which accounted for 53.85% of the total effect.

LIMITATIONS

The data used in this study were self-reported by university students and measureed via cross-sectional designs.

CONCLUSIONS

Stressful life events can influence depression either directly or indirectly by simultaneously increasing fatalism and lowering core self-evaluations (parallel mediation) or decreasing core self-evaluations through increasing the level of fatalism (serial mediation).

The Relationship Between Health Literacy, Cancer Prevention Beliefs, and Cancer Prevention Behaviors

While cancer prevention behaviors have been clearly defined, many people do not engage in these risk-reduction behaviors. Factors such as cancer prevention beliefs and limited health literacy may undermine cancer prevention behavior recommendations. This study explored the relationships between cancer prevention beliefs, health literacy, and cancer prevention behaviors. Data were analyzed from the 2013 Health Information National Trends Survey (n = 1675). Regression analyses for four cancer prevention belief (prevention is not possible, cancer is fatal, there are too many recommendations for prevention, everything causes cancer) statements were modeled, including health literacy and sociodemographic variables as predictors. In addition, separate regression analyses predicted four cancer prevention behaviors (fruit and vegetable consumption, physical activity, cigarette smoking) from cancer prevention beliefs, health literacy, and sociodemographic variables. Participants with low health literacy were more likely to hold fatalistic cancer prevention beliefs than those with higher health literacy. Cancer prevention beliefs were related to less fruit and vegetable consumption, fewer days of physical activity, and with being a nonsmoker after controlling for sociodemographic variables. Health literacy was not a significant predictor of cancer prevention behaviors. Given the relationship between health literacy and cancer prevention beliefs, research is needed to ascertain how to empower patients with low health literacy to have a more realistic understanding of cancer.

Fatalism in breast cancer and performing mammography on women with or without a family history of breast cancer

Background

Breast cancer is the most prevalent cancer in women, and in those with a positive family history, it is important to perform mammography. One of the probable barriers in doing mammography is fatalism.

Methods

This is a descriptive/cross-sectional study conducted on 400 women residing in Isfahan, Iran, randomly selected in 2017. Sampling was done randomly among the enrolled women in Health Integrity System. The data collection tool was a questionnaire regarding the demographic-fertility information and fatalism. The data analysis was done by SPSS software. A P-value < 0.05 was considered statistically significant.

Results

The results showed that the mean rate of fatalism was 59.5 ± 23.2 in women with the experience of mammography, and 65.9±18.7 in women without the experience. Moreover, the mean rate of fatalism was 73.1±15.2 in subjects with a family history of breast cancer, and 59.3 ± 22.5 in those no family history related to this condition. Accordingly, fatalism was statistically significant associated (P < 0.001) with a family history of breast cancer and experience of mammography. There was no significant relationship between demographic information and fatalism (P > 0.05).

Conclusion

The results indicated that fatalism in women with no experience of mammography was higher than in those with a positive history. Regarding the necessity of mammography in women with a family history of breast cancer, the required interventions seem to be essential to changing the viewpoints of women regarding the importance and effect of mammography as a screening method for breast cancer.

Electronic supplementary material

The online version of this article (10.1186/s12905-019-0810-6) contains supplementary material, which is available to authorized users.

Cancer fatalism and adherence to national cancer screening guidelines: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

BACKGROUND

Sociocultural factors, such as health insurance status, income, education, and acculturation, predict cancer screening among U.S. Hispanics/Latinos. However, these factors can be difficult to modify. More research is needed to identify individual-level modifiable factors that may improve screening and subsequent cancer outcomes in this population. The aim of this study was to examine cancer fatalism (i.e., the belief that there is little or nothing one can do to lower his/her risk of developing cancer) as a determinant of adherence to national screening guidelines for colorectal, breast, prostate, and cervical cancer among Hispanics/Latinos.

METHODS

Participants were from the multi-site Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sociocultural Ancillary Study (N = 5313). The National Cancer Institute (NCI) Health Interview National Trends Survey was used to assess cancer fatalism and receipt of cancer screening. Adherence was defined as following screening guidelines from United States Preventive Services Task Force and the American Cancer Society during the study period.

RESULTS

Adjusting for well-established determinants of cancer screening and covariates (health insurance status, income, education, acculturation, age, Hispanic/Latino background), lower cancer fatalism was marginally associated with greater adherence to screening for colorectal (OR 1.13, 95% CI [.99-1.30], p = .07), breast (OR 1.16, 95% CI [.99-1.36], p = .08) and prostate cancer (OR 1.18, 95% CI [.97-1.43], p = .10), but not cervical cancer.

CONCLUSIONS

The associations of cancer fatalism were small and marginal, underlining that sociocultural factors are more robust determinants of cancer screening adherence among Hispanics/Latinos.

"Seatbelts don't save lives": Discovering and targeting the attitudes and behaviors of young Arab male drivers

The paper presents a two-part study that discovered then targeted beliefs and attitudes towards seatbelt use in young Arab men. The purpose of part one was to discover their safe driving beliefs, attitudes and behaviors as well as their responses to safe driving campaigns to ascertain message elements that could incite reactance. Part two targeted selected beliefs and attitudes in a message that was designed based on the results from part one to both address relevant beliefs and attitudes as well as avoid reactance. One belief, that seatbelts are not necessary in the back seat, and two attitudes, avoidance of wearing the seatbelt to prevent clothing from being wrinkled and to avoid friends' derision, were targeted. Because the participants reported reactance to common safe driving campaigns, the options for the message were quite limited. Using fear appeals, shocking content or depicting the consequences of accidents was deemed likely to be ineffective, rather a novel approach was called for. Utilizing the collectivist and masculine nature of the culture, the resulting message featured a group of young Arab men who are convinced by a personified Seatbelt to wear their seatbelts after an adventure. The message succeeded in eliciting statistically reliable belief and attitudinal change on all three dependent variables after one exposure, suggesting that tailored messages that avoid triggering reactance and are culturally contextualized while aimed at specific beliefs and attitudes can be persuasive. Although risk taking behavior can result from group pressure, our message used culturally specific group pressure but depicted it as being against the risky behavior and positively reinforced the less risky behavior, demonstrating that such approaches can be effective. The film was not a typical safe driving message, utilized social norms from the target audience and was carefully matched to their attitudes and beliefs while not being an overtly persuasive. We argue that message campaigners can utilize both the method and results for subsequent campaigns aimed at young Arab men.

Beyond fatalism: Information overload as a mechanism to understand health disparities

BACKGROUND

Fatalism - beliefs about the causes and controllability of disease - has been negatively associated with prevention behaviors. Fatalism has been suggested as a mechanism for health disparities because ethnic minorities are especially likely to hold fatalistic beliefs. However, the construct has been criticized: Fatalism fails to account for structural barriers to health faced by vulnerable populations that also score highly on measures of fatalism. Another critique suggests that operationalizations of fatalism expose communication failures: "Fatalism" rather reflects information overload from an environment riddled with misinformation and contradictions. This study aimed to expand understanding of one mechanism through which communication may contribute to disparities by considering the context of nutrition among bicultural Latinas, who face increased risk from dietary acculturation.

METHOD

Mixed-methods (semi-structured in-depth interview, survey) with Mexican-American women ages 18-29 (n = 24) in rural California.

RESULTS

Contrary to previous studies, the majority of this sample of Mexican-American women did not endorse fatalistic beliefs; most demonstrated clear understanding of the link between diet and risk of diseases: Diabetes and heart disease were understood to result from behaviors within one's control. Yet despite articulating links between diet and disease, participants felt overloaded and confused about conflicting information from public and interpersonal sources. Moreover, despite reporting feeling inundated with information, participants noted critical information gaps, distinguishing between information available and information needed.

CONCLUSIONS

We found minimal support for fatalistic beliefs among a sample of Mexican-American women, but considerable information overload and confusion, together with a desire for specific knowledge and skills. Results extend understanding of how communication may influence disparities: Information overload may be conflated with fatalism, challenging the notion that fatalism is a cultural belief. Moreover, inequalities in access to and ability to process information compound overload effects. We discuss opportunities to improve the clarity of communication about nutrition science and dietary recommendations.

Is pregnancy fatalism normal? An attitudinal assessment among women trying to get pregnant and those not using contraception

OBJECTIVES

To assess factors associated with pregnancy fatalism among U.S. adult women.

STUDY DESIGN

I used data from the Change and Consistency in Contraceptive Use study, which collected information from a national sample of 4634 U.S. women aged 18-39 at baseline (59% response rate). I assessed pregnancy fatalism based on agreement with the statement: "It doesn't matter whether I use birth control, when it is my time to get pregnant, it will happen." I compared fatalism among all respondents to fatalism among respondents who were trying to get pregnant and those who did not want to get pregnant but were not using contraception. I used logistic regression to assess associations between nonuse of contraception and pregnancy fatalism at baseline and whether respondents were trying to get pregnant 6 months later.

RESULTS

Overall, 36% of the sample expressed some degree of pregnancy fatalism, and proportions were higher for respondents trying to get pregnant (55%) and those not using contraception (57%). The association between pregnancy fatalism and trying to get pregnant was maintained after controlling for other characteristics [odds ratio (OR) 1.4, p=.01], as was the association for nonuse of contraception (OR 2.08, p<.001). Contraceptive nonusers at baseline were more likely than users to be trying to get pregnant 6 months later, especially if they expressed a fatalistic outlook at baseline.

CONCLUSIONS

Pregnancy fatalism may be a common outlook among women who are trying to get pregnant. Associations between fatalism and nonuse of contraception may be more complex than previously recognized.

IMPLICATIONS

Gaining a better understanding of the dynamics of pregnancy planning might inform our understanding of why some women do not use contraception.

Fatalism and educational disparities in beliefs about the curability of advanced cancer

OBJECTIVE

Understanding socioeconomic disparities in the care of patients with incurable cancer is a high priority. We hypothesized that patients without a high school education are more likely to believe that they could be cured and we explored the role of fatalism.

METHODS

We studied 977 patients with advanced, incurable cancer. Two logistic regression analyses were conducted. Model One examined the effect of education on beliefs about curability. Model Two added fatalism.

RESULTS

The significant association between having less than a high school education and the belief that advanced cancer can be cured (OR=2.55; 95% CI: 1.09-5.96) in Model One was attenuated by 39% and rendered nonsignificant in Model Two. Fatalism was associated with the belief that advanced cancer can be cured. Whites were less likely to believe they could be cured than Blacks and Asians/Pacific Islanders. Beliefs about curability were not associated with income or insurance status.

CONCLUSIONS

People who do not complete high school are more likely to believe that their advanced cancer is curable, in part because they are more likely to hold fatalistic worldviews.

PRACTICE IMPLICATIONS

Interventions to help oncologists care for patients with fatalistic beliefs could mitigate socioeconomic disparities in end-of-life care.

Cultural factors associated with the intent to be screened for prostate cancer among adult men in a rural Kenyan community

Background

The aim of this study was to determine cultural factors associated with prostate cancer screening intent among adult Kenyan African men.

Methods

A cross-sectional quantitative study with an analytic design was carried out in a randomly selected sample of 155 adult men aged 25–98 years living in a rural community in Kenya. Constructs from the Theory of Planned Behaviour were used to guide this study. A 5 -point Likert scale was used to assess fatalistic beliefs, fear, perceived benefits, and family influence. A structured questionnaire was used to collect quantitative data at the household level.

Results

Only 2.4% of the study participants had been screened for prostate cancer. About 2/3rd (64%) of the participants felt that they were at risk of getting prostate cancer; 44% intended to be screened within the following 6 months. Mean scores on a 5-point Likert scale indicated: strong beliefs in the benefits of prostate screening (4.2 (±SD .8), men aged over 40 were not perceived to be at risk of getting prostate cancer (1.3 ± .6), relatively high fatalistic beliefs of prostate cancer screening (3.6 (±SD .8), high degree of fear or apprehension of prostate cancer screening (3.2 (±SD 1.2), and a high level of influence of family members in prostate cancer screening (3.9 (±SD 1.0). The Wald criterion demonstrated that only family influence made a significant contribution to the intent to screen for prostate cancer (p = 0.031). Age, education, marital status, fatalism, fear, and benefit of screening were not associated with the intent to screen for prostate cancer.

Conclusions

Strong beliefs of the benefits of prostate screening tended to be surpassed by relatively high fatalistic beliefs and fear or apprehension in prostate cancer screening. The family plays an important role in influencing decision making related to prostate cancer screening in Africans.

Fatalism and exposure to health information from the media: examining the evidence for causal influence

Fatalistic attitudes have a negative impact on a broad variety of health behaviors and behavioral determinants of health. A growing body of research has documented an association between media exposure and fatalism; however, scholarship has not been able to ascertain the causal direction. This review synthesizes the current state of the literature. A major finding is that most studies purporting to assess the relationship between media exposure and fatalism use conflated measures of fatalism. Among those that use an appropriate measure, there is some evidence that increased exposure to media increases fatalism. Although there is a substantive theoretical rationale for such effects, more research is needed to make a definitive claim and to explain the mechanism for such effects.

The Reliability and Validity of Prostate Cancer Fatalism Inventory in Turkish Language

This study aimed to conduct the reliability and validity study of the Prostate Cancer Fatalism Inventory in Turkish language. The study carried out in methodological type and consisted of 171 men. The ages of the participants ranged between 40 and 82. The content validity index was determined to be 0.80, Kaiser-Meyer-Olkin value 0.825, Bartlett's test X ² = 750.779 and p = 0.000. Then the principal component analysis was applied to the 15-item inventory. The inventory consisted of one dimension, and the load factors were over 0.30 for all items. The explained variance of the inventory was found 33.3 %. The Kuder-Richardson-20 coefficient was determined to be 0.849 and the item-total correlations ranged between 0.335 and 0.627. The Prostate Cancer Fatalism Inventory was a reliable and valid measurement tool in Turkish language. Integrating psychological strategies for prostate cancer screening may be required to strengthen the positive effects of nursing education.

Heart disease versus cancer: understanding perceptions of population prevalence and personal risk

Although the gap is narrowing, Americans are more likely to be diagnosed with and die from heart disease than cancer, and yet many believe cancer is more common and their personal risk of cancer is higher than their heart disease risk. Using nationally representative 2013 Health Information National Trends Survey data, we assessed such beliefs and examined sociodemographic and psychological factors and health behaviors associated with these beliefs. 42.8% of participants rated cancer as more common and 78.5% rated their own cancer risk as equal to or exceeding their heart disease risk. These misperceptions were only modestly correlated. Beliefs about relative population risk were associated with various psychological factors, whereas beliefs about relative personal risk were not. Both beliefs were inconsistently associated with health behaviors. Accuracy in beliefs about cancer and heart disease relative risk and prevalence is low and future research should explore antecedents and consequences of these beliefs.

"How the other half live": Lay perspectives on health inequalities in an age of austerity

This paper examines how people living in two socially contrasting areas of Stockton on Tees, North East England experience, explain, and understand the stark health inequalities in their town. Participants displayed opinions that fluctuated between a variety of converging and contrasting explanations. Three years of ethnographic observation in both areas (2014-2017) generated explanations which initially focused closely on behavioural and individualised factors, whilst 118 qualitative interviews subsequently revealed more nuanced justifications, which prioritised more structural, material and psychosocial influences. Findings indicate that inequalities in healthcare, including access, the importance of judgemental attitudes, and perceived place stigma, would then be offered as explanations for the stark gap in spatial inequalities in the area. Notions of fatalism, linked to (a lack of) choice, control, and fear of the future, were common reasons given for inequalities across all participants. We conclude by arguing for a prioritisation of listening to, and working to understand, the experiences of communities experiencing the brunt of health inequalities; especially important at a time of austerity.

Health Behaviors and their Relationship with Disease Control in People Attending Genetic Clinics with a Family History of Breast or Colorectal Cancer

The current work aimed to assess health behaviors, perceived risk and control over breast/colorectal cancer risk and views on lifestyle advice amongst attendees at cancer family history clinics. Participants attending the East of Scotland Genetics Service were invited to complete a questionnaire (demographic data, weight and height, health behaviors and psycho-social measures of risk and perceived control) and to participate in an in-depth interview. The questionnaire was completed by 237 (49 %) of attendees, ranging from 18 to 77 years (mean age 46 (±10) years). Reported smoking rates (11 %) were modest, most (54 %) had a BMI > 25 kg/m2, 55 % had low levels of physical activity, 58 % reported inappropriate alcohol intakes and 90 % had fiber intakes indicative of a low plant diet. Regression analysis indicated that belief in health professional control was associated with higher, and belief in fatalism with poorer health behavior. Qualitative findings highlighted doubts about the link between lifestyle and cancer, and few were familiar with the current evidence. Whilst lifestyle advice was considered interesting in general there was little appetite for non-tailored guidance. In conclusion, current health behaviors are incongruent with cancer risk reduction guidance amongst patients who have actively sought advice on disease risk. There are some indications that lifestyle advice would be welcomed but endorsement requires a sensitive and flexible approach, and the acceptability of lifestyle interventions remains to be explored.

Pathways for the relationship between diabetes distress, depression, fatalism and glycemic control in adults with type 2 diabetes

BACKGROUND

The aim of this study was to examine the mechanism by which depressive symptoms, diabetes distress, and diabetes fatalism together influence diabetes outcomes using structured equation modeling.

METHODS

615 adults with type 2 diabetes were recruited from two primary care clinics in the southeastern United States. Psychosocial factors found to be associated with diabetes outcomes were measured using validated questionnaires. Structured equation modeling (SEM) was used to investigate the relationship between diabetes fatalism, depressive symptoms, diabetes distress, self-care and glycemic control.

RESULTS

The final model (chi²(903)=24,088.91, p<0.0001, R²=0.93, RMSEA=0.05 and CFI=0.90) showed that higher diabetes distress was directly significantly related to a decreased self-care (r=-0.69, p<0.001) and increased HbA1c (r=0.69, p<0.001). There was no significant direct association between depressive symptoms or fatalism, and glycemic control or self-care. There was, however, an indirect association between increased depressive symptoms and increased fatalism, explained through the direct association with diabetes distress in that higher depressive symptoms (0.76, p<0.001) and higher fatalism (0.11, p<0.001) were significantly associated with higher diabetes distress.

CONCLUSION

Diabetes distress serves as a pathway through which depressive symptoms and fatalism impact both glycemic control and self-care. In addition, pathways between diabetes distress and both self-care behaviors and glycemic control in patients with type 2 diabetes remained separate, suggesting the need to address both psychological and behavioral factors in standard diabetes care, rather than focusing on psychological care primarily through support for self-management and treatment of depression.

Fatalism and hypertension prevalence, awareness, treatment and control in US Hispanics/Latinos: results from HCHS/SOL Sociocultural Ancillary Study

Compared with non-Hispanic whites, US Hispanics/Latinos display similar hypertension prevalence, but lower awareness, treatment, and control. Sociocultural factors may affect these patterns. Fatalism, the belief that health is predetermined by fate, relates to poorer adoption of risk reducing health behaviors. We examined the association of fatalism with hypertension prevalence, awareness, treatment, and control among 5313 Hispanics/Latinos, ages 18-74, who were enrolled from four US communities in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. After accounting for socioeconomic status and acculturation in logistic regression analyses, higher fatalism was associated with increased odds of hypertension (OR 1.14, 95 % CI 1.02, 1.28). This association was non-significant when diabetes and other health-related covariates were statistically adjusted. Fatalism was not associated with hypertension awareness, treatment, or control. Findings suggest that the association of fatalism with hypertension may be due largely to its association with SES, acculturation, or related health conditions.

Fatalism, Diabetes Management Outcomes, and the Role of Religiosity

This study aimed to determine whether fatalistic beliefs were associated with elevated levels of glycated hemoglobin (HbA1c) and to establish the role of religiosity in this relationship. A cross-sectional survey was conducted on a sample of 183 Jewish adults with diabetes visiting a large medical center in northern Israel. Self-administered questionnaires assessed level of religiosity, fatalistic beliefs, diabetes management behaviors, and demographic/personal characteristics; laboratory tests were used to measure HbA1c. Multivariate regression indicated that fatalism was significantly associated with HbA1c (β = 0.51, p = 0.01). The association was no longer statistically significant after including self-reported religiosity in the model (β = 0.31, p = 0.13). This phenomenon is likely due to a confounding relationship between the religious/spiritual coping component of the fatalism index and self-reported religiosity (r = 0.69). The results indicate that addressing fatalistic attitudes may be a viable strategy for improving diabetes management, but call for a better understanding of the interplay between religiosity and fatalism in this context.

"If I know I am on the pill and I get pregnant, it's an act of God": women's views on fatalism, agency and pregnancy

Objectives

Fatalism is the idea that outside forces have control over events. Pregnancy and pregnancy prevention play a prominent role in many women’s lives, and we sought to understand if and how fatalism informed their thinking about these issues.

Study design

We conducted in-depth interviews with 52 unmarried women between the ages of 18 and 30. We used NVivo to analyze the transcripts. The current analysis focuses on the ways that women discussed fatalism and pregnancy both in response to a direct question and as it came up spontaneously.

Results

The majority of respondents expressed a mix of fatalistic and non-fatalistic views about pregnancy. Many related that “fate,” “destiny” and/or God play a role in pregnancy, but most also asserted that pregnancy risk could be substantially reduced, most commonly by using contraception. Fatalism sometimes served a positive function, for example as a mechanism to deal with an unintended pregnancy. Having a fatalistic outlook did not preclude contraceptive use. Rather, some women using highly effective methods related that if they were to become pregnant, they would interpret it as a sign that the pregnancy was “meant to happen.” Finally some women related that there was no guarantee a woman could get pregnant when she wanted to, suggesting that some degree of fatalism may be inevitable when it comes to pregnancy.

Conclusions

Fatalism and agency should not be viewed as opposing outlooks when it comes to pregnancy and pregnancy prevention; having fatalistic views about pregnancy does not preclude contraceptive use.

Implications

Given that women do not have total control over attainment of a wanted pregnancy or even prevention of pregnancy, some amount of fatalism about fertility is a logical and pragmatic response. Both research and clinical practice need to recognize that fatalism and contraceptive use are often not in conflict.

Simultaneous Development of a Multidimensional Fatalism Measure in English and Spanish

Fatalism has been shown to predict several health behaviors, but researchers often find inconsistent results for the same behaviors across studies. This may be partially attributable to the diversity of fatalism measures that have been used in previous studies. A review of the literature revealed 51 different scales, all purported to measure fatalism, but often with heterogeneous content (Esparza 2005). A study done by Esparza (2005) retrieved 29 scales, including the most frequently used scales, and performed an exploratory factor analysis, obtaining as a result five factors: fatalism, helplessness, internality, luck, and divine control. The purpose of this study was to develop a multidimensional fatalism scale based on the previous findings by Esparza (2005). This scale was developed simultaneously in English and Spanish in order to linguistically “decenter” item content. The factor structure was cross-validated and measurement invariance was assessed across language versions. According to the measurement invariance analysis, this test is invariant across English and Spanish in its factor structure, loadings, variances, and covariances. This study results suggest that this scale may be used interchangeably in both English and Spanish.

"There's a higher power, but He gave us a free will": socioeconomic status and the intersection of agency and fatalism in infertility

Existing literature characterizes fatalism as a passive reaction to health in the face of powerlessness and constructs agency as a more activist perspective based in self-efficacy and control. Frequently studied together, researchers extol agency as the appropriate approach to decision-making around health, while discouraging fatalistic outlooks. Despite associating such beliefs with social classes-agency with high socioeconomic status (SES) groups and fatalism with low SES groups-there is little research that compares health beliefs across class groups. By examining the medicalized condition of infertility among women of both high and low SES, this study examines how social class shapes reactions to health and illness. Through 58 in-depth interviews with infertile women in the U.S., we reveal the complexity of fatalism and agency and the reasons behind that complexity. We first examine the commonalities among SES groups and their mutual use of fatalism. We then demonstrate the nuance and continuity between the health beliefs themselves-fatalism can be agentic and agency can be achieved through fatalism. In other words, we disrupt the binary construction of health beliefs, their conflation with social class, and the static application of health beliefs as psychological attributes, ultimately exposing the classist basis of the concepts. Doing so can result in improved patient care and reduced health inequalities.