Cancer Risks Beliefs & Screening

描述（由研究者提供）：正如经验证据及其在健康行为理论中的核心作用所表明的那样，癌症风险感知是癌症筛查依从性的重要先决条件。然而，现有的癌症风险感知措施需要对感知到的疾病概率进行单项评估，这是一种已知的可靠性和有效性有限的策略。有令人信服的论据表明，情感（情感的，基于感觉的）和直觉认知（自动的，非理性的）处理在个人考虑他们的个人癌症风险时很重要。我们编制了一份调查问卷来衡量个人癌症风险的情感和直觉认知加工（癌症风险信念量表），包括五个因素（认知因果关系、风险的负面影响、风险的防御性悲观主义、癌症风险的不可预测性和癌症的可预防性）。本R21应用程序测试了800名50岁及以上的不同初级保健患者在结直肠癌筛查背景下认知因果关系和风险负面影响的结构和预测有效性。我们提出了一项前瞻性的观察性研究，以检验风险的情感和直觉认知加工与结直肠癌筛查依从性的关系。主要假设是，那些对风险的情感和直觉认知处理较高的人，癌症风险感知与筛查之间的关系较弱。这将提供一种新的方法来识别那些增加癌症风险的干预措施在激励筛查方面可能不太有用的人。我们将具体描述这些个体的信仰特征，这将有助于为他们制定替代干预措施。我们建议;目的一：检查在一个大的、多样化的初级保健人群中癌症风险信念的流行程度和构建有效性；目的二，检查关于癌症风险的情感和直觉认知加工与结直肠癌筛查依从性的关系；目的三，检查关于癌症风险的情感和直觉认知加工与预期接受结直肠癌筛查的关系。这里提出的工作借鉴了最近对不确定性的影响和认知加工的研究，为癌症筛查不依从性提供了新的解决方案。公共卫生相关性：这项工作借鉴了最近的决策研究，为癌症筛查不依从提供新的解决方案。该研究通过新开发的癌症风险信念量表评估个人癌症风险的情感和直觉认知加工是否与不同初级保健人群的结直肠癌筛查依从性有关。这些发现将提供一种新的方法来识别和干预那些对现有的感知风险增强筛查干预措施没有反应的人。

DESCRIPTION (provided by investigator): 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.