The perception of being at risk for cancer is an important prerequisite for cancer screening adherence, as indicated by empirical evidence and its central role in health behavior theories. Yet existent cancer risk perception measures entail one-item assessments of perceived illness probability, a strategy with known limits to reliability and validity. There are compelling arguments that affective (emotional, feeling-based) and intuitive cognitive (automatic, non-rational) processing is important as individuals'think about their personal cancer risk. We developed a questionnaire to measure affective and intuitive cognitive processing of personal cancer risk (Cancer Risk Beliefs Scale) encompassing five factors (Cognitive Causation, Negative Affect in Risk, Defensive Pessimism about Risk, Unpredictability of Cancer Risk, and Cancer Preventability). This current R21 application tests the construct and predictive validity of Cognitive Causation and Negative Affect in Risk in the context of colorectal cancer screening in 800 diverse, primary care patients ages 50 and over. We propose a prospective, observational study to examine the relationship of affective and intuitive cognitive processing of risk with colorectal cancer screening adherence. The primary hypothesis is that those high in affective and intuitive cognitive processing of risk will have an attenuated relationship between cancer risk perceptions and screening. This would provide a novel way to identify those for whom interventions to increase cancer risk appreciation may be less useful in motivating screening. We will characterize these individuals'beliefs with specificity that will be useful in developing alternative interventions for them. We propose;
Aim I : to examine the prevalence and construct validity of cancer risk beliefs in a large, diverse primary care population, Aim II, to examine the relationship of affective and intuitive cognitive processing about cancer risk to colorectal cancer screening adherence, and Aim III, to examine the relationship of affective and intuitive cognitive processing about cancer risk to prospective uptake of colorectal cancer screening. The work proposed here draws on recent research on affect and cognitive processing of uncertainty to offer novel solutions to cancer screening non-adherence.

Public Health Relevance

This work draws from recent decision-making research to offer novel solutions to cancer screening nonadherence. The study tests whether affective and intuitive cognitive processing of personal cancer risk, assessed through the newly-developed Cancer Risk Beliefs Scale, is related to colorectal cancer screening adherence in a diverse primary care population. These findings will provide a novel way to identify and intervene with those who are unresponsive to established perceived risk-enhancing screening interventions.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21CA133376-01A2
Application #
7589131
Study Section
Psychosocial Risk and Disease Prevention Study Section (PRDP)
Program Officer
Nelson, Wendy
Project Start
2009-01-01
Project End
2010-12-31
Budget Start
2009-01-01
Budget End
2009-12-31
Support Year
1
Fiscal Year
2009
Total Cost
$301,735
Indirect Cost
Name
Sloan-Kettering Institute for Cancer Research
Department
Type
DUNS #
064931884
City
New York
State
NY
Country
United States
Zip Code
10065
Hay, Jennifer L; Ramos, Marcel; Li, Yuelin et al. (2016) Deliberative and intuitive risk perceptions as predictors of colorectal cancer screening over time. J Behav Med 39:65-74
Atkinson, Thomas M; Salz, Talya; Touza, Kaitlin K et al. (2015) Does colorectal cancer risk perception predict screening behavior? A systematic review and meta-analysis. J Behav Med 38:837-50
Hay, Jennifer L; Orom, Heather; Kiviniemi, Marc T et al. (2015) ""I don't know"" my cancer risk: exploring deficits in cancer knowledge and information-seeking skills to explain an often-overlooked participant response. Med Decis Making 35:436-45
Hay, Jennifer L; Baser, Raymond; Weinstein, Neil D et al. (2014) Examining intuitive risk perceptions for cancer in diverse populations. Health Risk Soc 16:227-242
Waters, Erika A; Hay, Jennifer L; Orom, Heather et al. (2013) ""Don't know"" responses to risk perception measures: implications for underserved populations. Med Decis Making 33:271-81
Hay, J; Kaphingst, K A; Baser, R et al. (2012) Skin cancer concerns and genetic risk information-seeking in primary care. Public Health Genomics 15:57-72
Kiviniemi, Marc T; Hay, Jennifer L (2012) Awareness of the 2009 US Preventive Services Task Force recommended changes in mammography screening guidelines, accuracy of awareness, sources of knowledge about recommendations, and attitudes about updated screening guidelines in women ages 40-49 and 50 BMC Public Health 12:899