A survey of smoking status and cancer risk perceptions among participants attending a hospital-based head and neck screening program

Abstract

Screening for head and neck cancer is underutilized. Given that lack of knowledge of the risk factors may partially account for screening underutilization. we surveyed subjective risk and knowledge of risk factors for head and neck cancer among 124 individuals who attended a free. hospital-based head and neck cancer screening. Few participants were current smokers. Most attendees perceived their risk as similar to others of their age and sex. Personal health habits comprised almost all of the risk-decreasing factors, yet less than half of the risk-increasing factors. generated. Personal habits were less frequently endorsed than factors such as pollution and heredity. Those who mentioned a risk behavior, or a family cancer history, reported higher subjective risk. Those who mentioned a personal health habit reported lower subjective risk. Results highlight needed efforts to increase screening among high-risk individuals through targeted education messages.     

Objective risk, subjective risk, and colorectal cancer screening among a clinic sample

Among cancers, colorectal (CRC) is the third most incident and the second most lethal. Although screening for the disease has been shown to be effective in reducing morbidity and mortality, screening rates remain low. Risk of disease has been shown to increase screening uptake, but different types of risk may influence intent to screen, screening in a timely manner, or participating in screening at all. A cross-sectional design was used to select a diverse sample of CRC asymptomatic patients 50 or more years of age (N=104) visiting one of three Midwestern medical clinics. Results showed a positive relationship between receipt of CRC screening and planning to screen for CRC in the future. Objective risk factors (personal/family history and having a primary care physician) were associated with CRC screening uptake and screening within the time intervals recommended by professional screening guidelines, but subjective risk did not obtain significance for screening participation. Both objective (primary care physician) and subjective risk (long-term comparative risk, knowledge) were associated with future plans to screen. Findings suggest that CRC screening behaviors may be differentially influenced by type of risk.     

Efficacy of stress management program for depressive patients with advanced head and neck cancer: A single-center pilot study

Background/ObjectivePatients with head and neck cancer (HNC) have some problems such as dysfunction of breathing, eating, and/or speaking. The aim of this study was to examine efficacy of the stress management program for HNC patients (SMAP-HNC) compared with usual care (UC).MethodWe conducted a pilot study of SMAP-HNC for depressive HNC patients between January 2016 and March 2018. The program contains psychoeducation, stress coping training, and operant reinforcement. The outcome measure was the Hospital Anxiety and Depression Scale (HADS), Functional Assessment of Cancer Therapy (FACT), and Brief Coping Inventory (COPE).ResultsTwenty patients were randomly assigned to SMAP-HNC and UC group. Although a small sample sizes, there was no significant difference of depression score change between SMAP-HNC and UC group (Hedges’d g -0.83; 95% CI -1.80 to 0.13).ConclusionsIt was the first study to conduct stress management program for HNC patients. Unfortunately, our trial designed as a randomized controlled trial is underpowered to make conclusion as to the efficacy of SMAP-HNC. However, there are some valuable suggestions to modify the stress management program in future.     

Relapse and risk perception among members of a smoking cessation clinic

Assessed perceptions of the health risks associated with smoking in comparison with not smoking among members of smoking cessation clinics. We measured these perceptions at three different time periods during the clinic, and then again at a 6-month follow-up. Results indicated that members who were abstinent at the follow-up had lowered their perceptions of the likelihood of contracting smoking-related illnesses (e.g., emphysema) if they were not smoking. In contrast, those who had relapsed lowered their perceptions of the health risks associated with smoking, but not their perceptions of nonsmoking disease vulnerability. The implications of these changes in risk perception for therapy involvement are discussed.     

Radon and cigarette smoking: perceptions of this synergistic health risk.

Past approaches to the measurement of the perceived risk of combined hazards have failed to demonstrate awareness of synergy (S. E. Hampson et al., 1998; D. Hermand, E. Mullet, & B. Coutelle, 1995; D. Hermand, E. Mullet, & S. Lavieville, 1997). Respondents (N = 650) were provided with information about the synergistic risk of lung cancer from the combination of smoking and radon, and their risk perceptions were assessed on two occasions. At Time 1, using Likert-type scales, there was no evidence of synergistic risk perception. At Time 2, using a scale based on the appraisal of relative risk with anchors allowing for the expression of synergy, the combined hazard of radon and smoking was rated as significantly more of a health risk than the single hazards. The findings are discussed in terms of methodological issues in assessing synergistic risk.     

A family member's job loss as a risk factor for smoking among adolescents.

Life events are associated with an increased likelihood of adolescent smoking. This study examined a family member's job loss as a predictor of smoking initiation over a 1-year period. Southern California students completed surveys in 6th and 7th grade. Of the 2,168 students, 252 (12%) reported that an adult in the household had lost a job within the past 6 months. Controlling for demographic, socioeconomic. educational, and parenting characteristics. 6th-grade never-smokers who reported a job loss were significantly more likely to have tried smoking by 7th grade and to have smoked in the past 30 days. Job loss for a household member is a risk factor for adolescents' involvement in problem behaviors such as smoking.     

A three-year follow-up of older adult participants in a memory-skills training program

This study examined the long-term effects of participation in a self-taught memory training program. In all, 27 memory training and 13 nontraining participants were assessed at approximately 3-year follow-ups. Assessment of these groups prior to the introduction of training had revealed nonsignificant differences in memory performance but marked differences in level of memory complaints, with training participants evidencing higher levels of complaints. The current assessment again demonstrated overall nonsignificant differences in memory performance but significant differences in memory complaints between the two groups. More specifically, the training group evidenced significant decreases in memory performance over the 3-year interval, but no significant changes in memory complaints were observed for either group. Thus, memory training appeared to have little long-term effect on memory functioning. Future research should explore long-term maintenance strategies in memory training with older adults.     

A follow-up of a media-based,worksite smoking cessation program

Described an examination of data collected 2 years following the onset of a media-based, worksite smoking cessation intervention. Thirty-eight companies in Chicago were randomly assigned to one of two experimental conditions. In the inital 3-week phase, all participants in both conditions received self-help manuals and were instructed to watch a 20-day televised series designed to accompany the manual. In addition, participants in the group (G) condition received six sessions emphasizing quitting techniques and social support. In the second phase, which continued for 12 months, employees in G participated in monthly peer-led support groups and received incentives, while participants in the nongroup (NG) condition received no further treatment. Twenty-four months after pretest, 30% of employees in G were abstinent compared to only 19.5% in NG. This study is one of the few experimentally controlled worksite smoking cessation interventions to demonstrate significant program differences 2 years following the initial intervention. Our thanks to Lori Klett and Libby Yeager-Turner for their help in data collection. Work on the project was supported in part by National Institute on Drug Abuse grant DA-04406-01 and a grant from the Chicago Lung Association to the second author.     

The relation between risk perceptions and physical activity among older adults: A prospective study

Past studies have found that risk perceptions of suffering from diseases play an important role in the development of intentions to perform physical activity (PA). According to the behaviour motivation hypothesis, perceived risk could be positively and directly related to PA, but this possibility has been ignored and/or underestimated. Accounting for recent methodological developments on the importance of study design and risk perception assessment, the purpose of the present study was to examine the risk-perceptions–PA relationship among older adults. Participants (N?=?143) aged from 61 to 70 years initially underwent measurement of risk perceptions, baseline PA, socio-demographic and health factors. Six months later, they were asked about their PA participation. Multiple regression analyses revealed that perceived risk of suffering from diseases and conditions without regular PA participation was an independent positive predictor of later PA, over and beyond baseline behaviour, socio-demographic and health variables. This study fills a gap in the existing literature on the PAs of older adults and reveals that risk perceptions are directly linked to their participation. In addition, it extends existing knowledge in health psychology on the behaviour motivation hypothesis, and emphasises the necessity of methodological adjustments when assessing the risk-perception–behaviour relationship.     

The relation between risk perceptions and physical activity among older adults: a prospective study

Past studies have found that risk perceptions of suffering from diseases play an important role in the development of intentions to perform physical activity (PA). According to the behaviour motivation hypothesis, perceived risk could be positively and directly related to PA, but this possibility has been ignored and/or underestimated. Accounting for recent methodological developments on the importance of study design and risk perception assessment, the purpose of the present study was to examine the risk-perceptions-PA relationship among older adults. Participants (N=143) aged from 61 to 70 years initially underwent measurement of risk perceptions, baseline PA, socio-demographic and health factors. Six months later, they were asked about their PA participation. Multiple regression analyses revealed that perceived risk of suffering from diseases and conditions without regular PA participation was an independent positive predictor of later PA, over and beyond baseline behaviour, socio-demographic and health variables. This study fills a gap in the existing literature on the PAs of older adults and reveals that risk perceptions are directly linked to their participation. In addition, it extends existing knowledge in health psychology on the behaviour motivation hypothesis, and emphasises the necessity of methodological adjustments when assessing the risk-perception-behaviour relationship.     

Psychological support needs of patients with head and neck cancer and their caregivers: A qualitative study

Objective: The aim of this study was to explore the psychological support needs of patients with head and neck cancer (HNC) and their caregivers. The appropriate timing, length, format and content of sessions were also investigated.

Design: Eighty-three patients with HNC and 73 of their caregivers completed questionnaires at diagnosis. Follow-up questionnaires were mailed to patients six months later.

Main outcome measures: Free text-comments to open-ended questions in the questionnaires were analysed using an inductive thematic approach with coding and theme development directed by the content of responses. This was used to determine psychological support needs both at diagnosis and at six month follow-up.

Results: Patients described ‘just being there’, empathy, maintaining normality and practical support as helpful from family/friends. They desired information, honesty, positivity and empathy from clinical staff. Formal psychological support was desired by approximately 40% of patients and caregivers, particularly early after diagnosis and during treatment. Most participants desired face to face sessions, providing individualised information and coping strategies.

Conclusion: The results of this study suggest that psychological interventions for patients with HNC and their caregivers should be delivered early after diagnosis in face to face sessions, presenting honest and factual information about the disease and coping strategies.     

Interest in and barriers to participation in multiple family groups among head and neck cancer survivors and their primary family caregivers

This study examined interest in and barriers to participation in a multiple family group intervention (MFG) for adult cancer survivors and their family caregivers. The intervention was developed to assist families in coping with the persistent challenges of cancer diagnosis, treatment, and rehabilitation. Eighty eligible families having a member diagnosed and treated for cancers of the head and neck region completed a baseline quality of life survey consisting of standardized psychosocial measures, and then all patients and their families were invited to participate in a day-long multiple family group program. However, despite extensive recruitment efforts and accommodations to address anticipated barriers for nonparticipation, only 15 of the 80 (19%) eligible families agreed to attend the MFG workshop. Post-MFG, participating families reported high levels of program satisfaction and usefulness. These findings are discussed in the context of increasing the use of family-focused interventions in cancer care settings.     

Illness perceptions and distress in women at increased risk of breast cancer

Variation in the levels of distress in women at increased risk of breast cancer has been reported, yet there is limited understanding of the factors that are associated with heightened distress in this population. This study took a theoretical approach using Leventhal's Self Regulatory Model (SRM) to understand variation in distress levels. The study examined the associations between perceptions of breast cancer and distress in women at increased risk of breast cancer, and a comparison sample with no experience of the disease in their social environment. Questionnaire data from 117 women at increased risk of breast cancer and 100 comparison women were analysed. Women at increased risk of breast cancer showed comparable levels of general distress but significantly higher levels of cancer specific distress than the comparison group. There were few differences in illness perceptions between the samples, although a number of cognitive perceptions of breast cancer were related to both general and cancer specific distress in the increased risk sample, but not in the comparison sample. The results suggest that the SRM provides a useful framework to explore the psychological response to genetic risk. Further research is required in this population to examine illness perceptions in more detail, validate quantitative measures of illness perceptions, and examine interactions between risk perception and the SRM constructs.     

Health status, perceptions of risk, and prevention interest for health and nonhealth problems

Healthy and acutely ill college students indicated their risk compared to their peers for 10 health and nonhealth problems. Participants as a whole showed clear evidence of optimistic bias. However, whereas healthy participants showed an equal tendency to be biased optimistically for health and nonhealth problems, ill participants felt significantly more vulnerable to future health relative to nonhealth problems. This was the case even though the future health problems were objectively unrelated to their current illnesses. Perceptions of the preventability of the health and nonhealth problems paralleled the comparative risk judgments. Finally, those who were ill expressed relatively little interest in receiving prevention information. Possible mechanisms and implications are discussed.     

Addressing women's breast cancer risk and perceptions of control in medical settings

Many women with family histories of breast cancer deal with two distinct but related issues: their objective physical risk and the emotions this risk engenders. Studies indicate that approximately 70% of African American and white women are concerned about their chances of developing breast cancer someday and perceive themselves to be at risk. Health care providers, including psychologists, need to be aware of the special needs and psychosocial concerns of high-risk women with family histories of breast cancer, since perceptions of breast cancer risk influence screening practices. Providers need training in understanding the significance of specific family patterns of breast cancer, screening guidelines appropriate for women at risk, and the benefits and risks of available prevention options, including genetic screening. Delivering accurate information about both established risk factors known to elevate personal risk, such as age and family history, and factors which women associate with breast cancer, such as bumping and bruising a breast, smoking, and oral contraceptive use, is essential for promoting accurate risk perceptions and appropriate screening schedules.     

Food sharing and perceptions of the status of a relationship

This study examined how individuals may form an impression of the closeness of the relationship between two individuals based on an observation of them sharing food. An opportunity sample of 72 participants watched a video clip of young adults in same-sex or mixed-sex dyads eating a meal together. In the experimental conditions, each member of the dyad also offered or fed a morsel of food to the other person. Analysis showed that food sharing was seen as indicative of familiarity between the members of a dyad. Actually feeding the other person a morsel of food was seen as an indicator of intimacy in male dyads but not in mixed-sex or female dyads. Results are discussed in terms of expectations of intimacy in male and female relationships.     

Psychological re-evaluations: A survey of practices and perceptions of school psychologists

The practice of psychologically re-evaluating students receiving special education services has been mandated by P.L. 94–142 and further operationalized by state departments of education. Intuitively, such a requirement appears sound, for psychologists occasionally make mistakes, children change over time, and efficacy of special education services is variable. Yet given the other mandated practices, such as yearly IEP updates, and the fact that many school psychologists spend a majority of their time testing, we wondered how important three-year psychological re-evaluations are considered by school psychologists. In the present study 40 psychologists across four states were surveyed concerning their perceptions and practices regarding re-evaluations. The psychologists' responses to a 16-item questionnaire indicated that re-evaluations comprised a substantial portion of their evaluations, involved a considerable amount of time, and were perceived as an important check on a child's diagnosis and placement. Re-evaluations and initial evaluations were described as involving nearly identical tests and related activities.     

Exploring coaches' experiences and perceptions of a virtual parasport coach mentorship program

Partnering with a provincial coaching association in Canada, we explored the experiences and perceptions of 15 mentor and 29 mentee coaches who participated in a formal virtual parasport coach mentorship program. Data were gathered via focus groups and individual interviews and analyzed using a reflexive thematic analysis. Mentor coaches built a virtual relationship through mutual trust and respect and were perceived by their mentees as supportive, motivating, and knowledgeable. Mentee coaches valued conversations with their mentors surrounding disability-specific knowledge that enhanced their coaching efficacy. Coaches highlighted the need for a greater sense of community within parasport and recommended keeping a virtual component of the program to foster accessibility and learning. Findings provide insight into effective mentorship in parasport for researchers, practitioners, and organizations overseeing this important initiative. Our results will contribute to higher quality experiences for Canadian parasport coaches and athletes and work to progress the growth of parasport worldwide.     

Impact of combination therapies on HIV risk perceptions and sexual risk among HIV-positive and HIV-negative gay and bisexual men.

The availability of improved HIV treatments may prompt reduced concern about HIV and sexual risk. Gay and bisexual men (N = 554, 17% HIV-positive) completed measures of treatment attitudes, sexual risk, and assumptions regarding the infectiousness of sexual partners. A substantial minority reported reduced HIV concern related to treatment advances. Reduced HIV concern was an independent predictor of sexual risk, particularly among HIV-positive men. In response to hypothetical scenarios describing sex with an HIV-positive partner, participants rated the risk of unprotected sex to be lower if the partner was taking combination treatments and had an undetectable viral load, relative to scenarios with a seropositive partner not taking combination treatments. Prevention efforts must address attitudinal shifts prompted by recent treatment successes, stressing the continued importance of safer sex, and that an undetectable viral load does not eliminate infection risks.