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Jensen JD, Shannon J, Iachan R, Deng Y, Kim SJ, Demark-Wahnefried W, Faseru B, Paskett ED, Hu J, Vanderpool RC, Lazovich D, Mendoza JA, Shete S, Robertson LB, Balkrishnan R, Briant KJ, Haaland B, Haggstrom DA, Fuemmeler BF. Examining Rural-Urban Differences in Fatalism and Information Overload: Data from 12 NCI-Designated Cancer Centers. Cancer Epidemiol Biomarkers Prev 2022; 31:393-403. [PMID: 35091459 DOI: 10.1158/1055-9965.epi-21-0355] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 07/01/2021] [Accepted: 12/02/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Rural populations experience a disproportionate cancer burden relative to urban populations. One possibility is that rural populations are more likely to hold counterproductive cancer beliefs such as fatalism and information overload that undermine prevention and screening behaviors. METHODS Between 2016 and 2020, 12 U.S. cancer centers surveyed adults in their service areas using online and in-person survey instruments. Participants (N = 10,362) were designated as rural (n = 3,821) or urban (n = 6,541). All participants were 18 and older (M = 56.97, SD = 16.55), predominately non-Hispanic White (81%), and female (57%). Participants completed three items measuring cancer fatalism ("It seems like everything causes cancer," "There's not much you can do to lower your chances of getting cancer," and "When I think about cancer, I automatically think about death") and one item measuring cancer information overload ("There are so many different recommendations about preventing cancer, it's hard to know which ones to follow"). RESULTS Compared with urban residents, rural residents were more likely to believe that (i) everything causes cancer (OR = 1.29; 95% CI, 1.17-1.43); (ii) prevention is not possible (OR = 1.34; 95% CI, 1.19-1.51); and (iii) there are too many different recommendations about cancer prevention (OR = 1.26; 95% CI, 1.13-1.41), and cancer is always fatal (OR = 1.21; 95% CI, 1.11-1.33). CONCLUSIONS Compared with their urban counterparts, rural populations exhibited higher levels of cancer fatalism and cancer information overload. IMPACT Future interventions targeting rural populations should account for higher levels of fatalism and information overload.
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Affiliation(s)
- Jakob D Jensen
- Department of Communication, University of Utah, Salt Lake City, Utah.
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Jackilen Shannon
- Oregon Health and Science University - Portland State University, School of Public Health, Oregon Health and Science University, Portland, Oregon
| | | | | | - Sunny Jung Kim
- Department of Health Behavior and Policy, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia
| | - Wendy Demark-Wahnefried
- Department of Nutrition Sciences and O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Babalola Faseru
- Department of Population Health, University of Kansas Medical Center, Kansas City, Kansas
- University of Kansas Cancer Center, Kansas City, Kansas
| | - Electra D Paskett
- Department of Internal Medicine, College of Medicine, and OSU Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio
| | - Jinxiang Hu
- University of Kansas Cancer Center, Kansas City, Kansas
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, Kansas
| | - Robin C Vanderpool
- Department of Health, Behavior and Society and Markey Cancer Center, University of Kentucky, Lexington, Kentucky
| | - DeAnn Lazovich
- Division of Epidemiology and Community Health and Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Jason A Mendoza
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center and Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Sanjay Shete
- Department of Biostatistics and Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Linda B Robertson
- School of Medicine and UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Rajesh Balkrishnan
- Department of Public Health Sciences and UVA Cancer Center, University of Virginia, Charlottesville, Virginia
| | - Katherine J Briant
- Office of Community Outreach and Engagement, Fred Hutch/University of Washington Cancer Consortium, Seattle, Washington
| | - Benjamin Haaland
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
- Department of Population Sciences, University of Utah, Salt Lake City, Utah
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Occa A, Kim S, Carcioppolo N, Morgan SE, Anderson D. A Comparison of Metaphor Modality and Appeals in the Context of Skin Cancer Prevention. JOURNAL OF HEALTH COMMUNICATION 2019; 25:12-22. [PMID: 31752624 DOI: 10.1080/10810730.2019.1694607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Health communication experts continually seek out effective strategies to strengthen persuasive campaigns. While there is evidence that verbal metaphors can improve persuasion, little attention has been given to the potential of visual metaphors to enhance health communication effects. To fill this gap, an experiment was conducted to test the effects of metaphor modality (visual vs. verbal) and type of fear appeal used (death-based or appearance-based) on skin protection intentions. Additionally, the moderating role of an individual characteristic (need for cognition), and the mediating role of two processing outcomes (message elaboration and perceived message effectiveness) were examined. Results indicated that there was no significant difference between the main effects of metaphor modality and type of fear appeal, but these message features interacted making the death-based fear appeal the most effective strategy. Need for cognition directly affected perceptions of effectiveness but did not affect skin protection intentions nor message elaboration. Of the two message processing outcomes examined, only perceived message effectiveness mediated the relationship between metaphor modality and skin protection intentions. Theoretical explanations and practical implications are discussed.
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Affiliation(s)
- Aurora Occa
- Department of Communication, College of Communication and Information, University of Kentucky, Lexington, Kentucky, USA
| | - Soyoon Kim
- Department of Communication Studies, School of Communication, University of Miami, Coral Gables, Florida, USA
| | - Nicholas Carcioppolo
- Department of Communication Studies, School of Communication, University of Miami, Coral Gables, Florida, USA
| | - Susan E Morgan
- Department of Communication Studies, School of Communication, University of Miami, Coral Gables, Florida, USA
| | - David Anderson
- Department of Communication Studies, School of Communication, University of Miami, Coral Gables, Florida, USA
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Taylor J, Lamont A, Murray M. Talking about sunbed tanning in online discussion forums: Assertions and arguments. Psychol Health 2017; 33:518-536. [PMID: 28911238 DOI: 10.1080/08870446.2017.1375496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE There is increasing evidence of both health and appearance risks associated with sunbed use. At the same time, the sunbed industry promotes the benefits of using sunbeds, and the image of a tanned skin as attractive and healthy arguably remains embedded within contemporary western culture. These tensions are played out in everyday conversations, and this paper reports a study which explored how sunbed users manage them within online discussion forums. DESIGN A total of 556 posts from 13 sunbed-related threads, taken from six different UK-based online forums, were analysed thematically followed by techniques from discourse analysis. MAIN OUTCOME MEASURES Informed by social representations theory and discursive-rhetorical psychology, the way social representations of sunbed use are constructed, debated and disputed in online discussion forums were explored. RESULTS Sunbed users drew upon numerous representations to distance and protect themselves from negativity they were confronted with in the forums, utilising a range of rhetorical, discursive strategies to help them. CONCLUSION Theoretical contributions and potential practical implications of the findings are discussed. Findings indicate, for example, that those working on campaigns and interventions in this area need to consider the wider negativity and argumentative orientation of sunbed users' responses.
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Affiliation(s)
- Jennifer Taylor
- a School of Psychology , Dorothy Hodgkin Building, Keele University , Staffordshire , UK
| | - Alexandra Lamont
- a School of Psychology , Dorothy Hodgkin Building, Keele University , Staffordshire , UK
| | - Michael Murray
- a School of Psychology , Dorothy Hodgkin Building, Keele University , Staffordshire , UK
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Holman DM, Berkowitz Z, Guy GP, Lunsford NB, Coups EJ. The association between beliefs about vitamin D and skin cancer risk-related behaviors. Prev Med 2017; 99:326-331. [PMID: 28322879 PMCID: PMC5896002 DOI: 10.1016/j.ypmed.2017.03.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 03/08/2017] [Accepted: 03/12/2017] [Indexed: 10/19/2022]
Abstract
Major health organizations recommend obtaining most of one's vitamin D through dietary sources rather than from sun exposure, given the link between sun exposure and increased skin cancer risk. The purpose of this study is to examine the association between beliefs about vitamin D and skin cancer risk-related behaviors, a topic on which research is limited. We analyzed cross-sectional online survey data collected in the summer of 2015 from 4127U.S. adults aged 18years and older. Overall, 19.7% of adults believed that sun protection would put them at risk of not getting enough vitamin D. However, less than half (43.1%) thought they could get enough vitamin D from dietary sources. Individuals with this belief were more likely to protect their skin when spending time outdoors (71.3%) compared with those who were neutral or disagreed (56.5%; P<0.001). Only 5.1% of adults believed that indoor tanning is an effective way to get vitamin D. Compared to those who disagreed or were neutral, those who thought it was effective were more likely to be outdoor tanners (45.1% vs. 28.5%; P<0.001) and indoor tanners (13.8% vs 1.9%; P<0.001). Beliefs about vitamin D were associated with skin cancer risk-related behaviors. Including information about vitamin D in skin cancer prevention messages may be beneficial.
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Affiliation(s)
- Dawn M Holman
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F76, Atlanta, GA 30341, USA..
| | - Zahava Berkowitz
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F76, Atlanta, GA 30341, USA
| | - Gery P Guy
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F76, Atlanta, GA 30341, USA
| | - Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F76, Atlanta, GA 30341, USA
| | - Elliot J Coups
- Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.; Department of Medicine, Rutgers Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA; Department of Health Education and Behavioral Science, Rutgers School of Public Health, Rutgers, The State University of New Jersey, 195 Little Albany Street, New Brunswick, NJ 08903, USA
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Carcioppolo N, Orrego Dunleavy V, Yang Q. How Do Perceived Descriptive Norms Influence Indoor Tanning Intentions? An Application of the Theory of Normative Social Behavior. HEALTH COMMUNICATION 2017; 32:230-239. [PMID: 27230254 PMCID: PMC5278634 DOI: 10.1080/10410236.2015.1120697] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Indoor tanning bed use is highly influenced by perceived norms about a tanned appearance. The theory of normative social behavior (TNSB) details the many ways in which norms can impact intentions and behavior, but has never been assessed in the context of indoor tanning. Considering this, we conducted a survey among female university students (N = 274) to determine the extent to which the TNSB predicted intentions to use indoor tanning beds. Overall, the path model predicted about 46% of the variance in intentions, and the majority of significant indirect effects were witnessed through the outcome expectation variables included in the TNSB, suggesting that these may be the most salient mechanisms-as predicted by the TNSB-through which norms can impact tanning intentions. In light of these results, theoretical and practical implications are discussed, and specific recommendations are given to extend the predictive utility of the TNSB in the context of indoor tanning.
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Affiliation(s)
| | | | - Qinghua Yang
- b Annenberg School for Communication , University of Pennsylvania
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Carcioppolo N. When Does Perceived Susceptibility to Skin Cancer Influence Indoor Tanning? The Moderating Role of Two Risk Perception Beliefs. JOURNAL OF HEALTH COMMUNICATION 2016; 21:1170-1178. [PMID: 27786607 DOI: 10.1080/10810730.2016.1237593] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Previous research has demonstrated an inconsistent relationship between perceived susceptibility to skin cancer and indoor tanning. The current study explored potential moderators of this relationship to better understand how risk perceptions can impact indoor tanning intentions and behavior. A national online survey (N = 267) was administered in the United States to establish the relationship between perceived susceptibility to skin cancer, cancer fatalism, and external risk attribution beliefs on indoor tanning intentions and behavior. Results revealed significant 3-way interactions among these risk perceptions on both intentions and behavior that run contrary to much of the published research on perceived susceptibility and health behavior. These findings suggest that the relationship between perceived susceptibility to skin cancer and indoor tanning is conditional on other risk perceptions. These results are discussed in terms of their theoretical and practical implications.
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Affiliation(s)
- Nick Carcioppolo
- a Department of Communication Studies , University of Miami , Coral Gables , Florida , USA
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