Sociodemographic correlates of cancer fatalism and the moderating role of religiosity: Results from a nationally-representative survey

The influence of culture on the health beliefs and health behaviours of older Vietnam-born Australians living with chronic disease

AIM

To explore the health beliefs and health behaviours of older Vietnam-born people living with chronic disease in Western Australia.

DESIGN

This study was designed as a focused ethnography guided by the interpretative research paradigm and Leininger's Theory of Culture Care.

METHODS

Data were collected through participant observation and interviews undertaken at participants' homes in Western Australia over 7 months in 2019. Data were analysed using Wolcott's approach for transferring qualitative data, comprising three phases: description, thematic analysis and interpretation.

RESULTS

This study included 12 participants. The health perspectives and practices of older Vietnam-born Australians significantly reflected the traditional Vietnamese values. These included the stigma towards chronic disease as an inevitable consequence of ageing; self-blame thoughts about chronic disease causations and maintained traditional dietary practices. However, some aspects of their health behaviours such as beliefs and practices in traditional medicine, Western medicine and physical exercise reflected a blended approach combining both Vietnamese-oriented and Westernized-orientated practices. Individual factors were also identified as contributing to chronic disease self-care among participants.

CONCLUSION

This study emphasizes culture played a significant role in shaping the way that older Vietnam-born Australians believed and behaved while living with chronic conditions. However, it also indicates that culture is not a stationary concept, it evolves gradually and is socially constructed.

IMPLICATIONS

A better understanding of the health beliefs and practices of older Vietnam-born Australians is expected to contribute to the delivery of culturally safe and effective support for this population. The achievement of culturally safe care requires a systemic approach and collaboration of strategies across sectors.

PATIENT AND PUBLIC CONTRIBUTION

This study encompassed the contribution of 12 older Vietnam-born Australians who offered the researcher the privilege to enter their world and the staff of social care organization who opened the gate for the researcher to approach participants.

Exploring the role of cancer fatalism and engagement with skin cancer genetic information in diverse primary care patients

OBJECTIVE

To broaden the currently limited reach of genomic innovations, research is needed to understand how psychosocial and cultural factors influence reactions to genetic testing in diverse subgroups. Cancer fatalism is important in cancer prevention and deserves theoretical and empirical attention in the context of genomics and behavior change.

METHODS

The current study employed data from a randomized controlled trial (N = 593) offering skin cancer genetic testing (using the melanocortin-1 receptor [MC1R] gene) in primary care in Albuquerque, New Mexico, USA. We examined interrelations of cancer fatalism with demographics, general health beliefs, perceived risk, perceived control, sun protection and skin screening behaviors and cancer worry in the skin cancer context stratified across Hispanic versus non-Hispanic ethnicity, and examined cancer fatalism as a moderator of intervention effects on study primary outcomes, including 3-month sun protection, cancer worry and perceived risk.

RESULTS

Cancer fatalism was significantly related to the perception of control over skin cancer risk behaviors (ps ≤ 0.01) and demographics (ethnicity, education, health literacy; ps < 0.05), but not consistently related to general health beliefs or risk perception. Cancer fatalism did not moderate intervention effects on primary outcomes, except those with higher cancer fatalism randomized to intervention had higher levels of 3-month cancer worry (p = 0.019).

CONCLUSIONS

These findings will guide future work considering the role of cancer fatalism in use of genomic technologies in the general population. This work anticipates strategies required to address cancer fatalism as translational genomics becomes more commonly available to diverse general population subgroups.

The association between religiosity, spirituality, and breast cancer screening: A cross-sectional analysis of Alberta’s Tomorrow Project

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Religion and spirituality provide a foundation for regulating health behaviors such as cancer screening.

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However, religion and spirituality were not associated with mammography in a population-level sample of women from Alberta, Canada.

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Religion and spirituality may be associated with mammography in population subgroups.

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Future research should employ longitudinal analyses.

Breast cancer is the leading cause of cancer-related mortality among women. Screening permits the early detection and treatment of malignancies, thereby reducing mortality. A woman’s religiosity and spirituality (R/S) may facilitate screening through encouragement of healthy behaviors. Population-level data from Alberta’s Tomorrow Project (ATP) were used to explore the cross-sectional association between R/S and breast cancer screening among women aged 50 to 69 years who did not have a history of breast cancer. Two variables were used to measure R/S: (1) R/S Salience was defined as the importance of religion and spirituality in one’s life; (2) R/S Attendance was defined as the frequency of attendance at religious or spiritual services. We regressed breast cancer screening (mammogram: yes/no) on each R/S variable in separate multivariable logistic regression models. At baseline (n = 2569), 94% of women reported receiving a mammogram. Greater R/S Salience was not associated with receipt of mammogram: the adjusted odds ratio (aOR) was 1.04 (95% confidence interval [CI]: 0.71–1.51. R/S Attendance also showed no association with mammogram: attending at least once monthly versus never attending (aOR: 1.10; 95% CI: 0.71–1.69); attending one to four times yearly versus never attending (aOR: 0.95, 95% CI: 0.57–1.58). Further research could examine specific subgroups of the population, e.g., whether use of R/S to promote breast cancer screening may be more effective among females with strong pre-existing connections to faith.

Family Socioeconomic Status and Learning Engagement in Chinese Adolescents: The Multiple Mediating Roles of Resilience and Future Orientation

This study explored the mediating effects of resilience and future orientation on the relationship between family socioeconomic status (SES) and learning engagement within the context of Chinese culture based on the cognitive theory of social class. A total of 1,245 junior high school students were recruited to complete anonymous questionnaires regarding the objective and subjective SES of their families, resilience, future orientation, and learning engagement. The mediating effects were tested by stepped multiple linear regression. Results indicated the following: (1) the relationships between objective and subjective SES, resilience, future orientation, and learning engagement was significantly positive; (2) resilience only mediated the relationship between subjective SES and learning engagement, whereas future orientation mediated the relationships between objective/subjective SES and learning engagement; (3) resilience and future orientation sequentially mediated the relationship between subjective SES and learning engagement. The current study contributes to a better understanding of how family SES influences adolescent academic performance from the perspective of adolescent cognitive abilities. In addition, this study provides implications for the prevention and intervention of academic performance of poor adolescents due to low SES.