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Rising CJ, Huelsnitz CO, Shepherd RF, Klein WMP, Sleight AG, Wilsnack C, Boyd P, Feldman AE, Khincha PP, Werner-Lin A. Diet and physical activity behaviors: how are they related to illness perceptions, coping, and health-related quality of life in young people with hereditary cancer syndromes? J Behav Med 2024:10.1007/s10865-024-00489-z. [PMID: 38642305 DOI: 10.1007/s10865-024-00489-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 04/05/2024] [Indexed: 04/22/2024]
Abstract
Individuals with inherited cancer syndromes, such as Li-Fraumeni syndrome (LFS), may be motivated to adopt health-protective behaviors, such as eating more fruits and vegetables and increasing physical activity. Examining these health behaviors among young people with high lifetime genetic cancer risk may provide important insights to guide future behavioral interventions that aim to improve health-related quality of life (HRQOL). We used a self-regulatory framework to investigate relationships among diet and physical activity behaviors and psychosocial constructs (e.g., illness perceptions, coping, HRQOL) in adolescents and young adults (AYAs; aged 15-39 years) with LFS. This longitudinal mixed-methods study included 57 AYAs aged 16-39 years at enrollment), 32 (56%) of whom had a history of one or more cancers. Participants completed one or two telephone interviews and/or an online survey. We thematically analyzed interview data and conducted regression analyses to evaluate relationships among variables. AYAs described adopting healthy diet and physical activity behaviors to assert some control over health and to protect HRQOL. More frequent use of active coping strategies was associated with greater reported daily fruit and vegetable intake. Greater reported physical activity was associated with better quality of psychological health. Healthy diet and physical activity behaviors may function as LFS coping strategies that confer mental health benefits. Clinicians might emphasize these potential benefits and support AYAs in adopting health behaviors that protect multiple domains of health. Future research could use these findings to develop behavioral interventions tailored to AYAs with high genetic cancer risk.
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Affiliation(s)
- Camella J Rising
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA.
| | - Chloe O Huelsnitz
- Behavioral Research Program, Office of the Associate Director, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Rowan Forbes Shepherd
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | - William M P Klein
- Behavioral Research Program, Office of the Associate Director, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Alix G Sleight
- Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Catherine Wilsnack
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, USA
| | - Patrick Boyd
- Behavioral Research Program, Office of the Associate Director, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Alexandra E Feldman
- Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- USC Chan Division of Occupational Science and Occupational Therapy, Los Angeles, CA, USA
| | - Payal P Khincha
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | - Allison Werner-Lin
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA, USA
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Greene NK, Rising CJ, Seidenberg AB, Eck R, Trivedi N, Oh AY. Exploring correlates of support for restricting breast cancer awareness marketing on alcohol containers among women. Int J Drug Policy 2023; 115:104016. [PMID: 36990013 PMCID: PMC10593197 DOI: 10.1016/j.drugpo.2023.104016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Although alcohol consumption increases breast cancer risk, some alcohol products include breast cancer awareness marketing (i.e., pink ribbons) on alcohol containers, which poses a contradiction. Some researchers and advocacy groups have called for restrictions on use of the pink ribbon and other breast cancer awareness marketing on alcohol products. This exploratory study aimed to describe individual and behavioral correlates (age, knowledge, attitudes, purchase intention) of reported support for potential policy restrictions of pink ribbon labeling on alcohol containers. METHODS The study sample was drawn from the Prolific crowd-sourced research platform in September 2020. Eligible participants included U.S. women aged 21+ years. The primary outcome was policy position for restrictions on pink ribbon labeling on alcohol containers, coded as support, neutral, or oppose. The association between pink ribbon labeling attitudes and support or opposition (vs neutral) was examined using multinomial logistic regression. Covariates were 1) knowledge of the alcohol-cancer link; 2) likelihood of buying an alcohol product with pink ribbon labeling; and 3) age. Models were used to calculate adjusted predicted probabilities for support, oppose, and neutral. RESULTS The analytic sample included 511 women. Overall, 46% of women opposed, 34% were neutral, and 20% supported restricting pink ribbon labeling on alcohol containers. Controlling for all covariates, women who reported that wine increases cancer risk had the highest probability of opposing restrictions on pink ribbon labeling (56.4% [95%CI: 48.1%-64.8%]). Women who reported wine had no effect on cancer risk had the highest probability of being neutral about restrictions on pink ribbon labeling (45.5% [95% CI: 35.7%-55.3%]). Across levels of knowledge about the alcohol-cancer risk association, as favorable attitudes toward pink ribbon labeling increased, the probability of policy opposition increased and the probability of being policy neutral decreased. CONCLUSION Findings from this study suggest women's favorable attitudes toward pink ribbon labeling on alcohol containers are a stronger predictor of support or opposition for restrictions on pink ribbon labeling than knowledge of the alcohol-cancer link. Future research could examine whether pink ribbon labeling may interact with potential or current health warnings on alcohol containers.
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Affiliation(s)
- Naomi K Greene
- Behavioral Research Program, Division of Cancer Control and Population Sciences National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive| Rockville, MD 20850-9761, USA.
| | - Camella J Rising
- Behavioral Research Program, Division of Cancer Control and Population Sciences National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive| Rockville, MD 20850-9761, USA; Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, USA
| | - Andrew B Seidenberg
- Behavioral Research Program, Division of Cancer Control and Population Sciences National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive| Rockville, MD 20850-9761, USA; Truth Initiative Schroeder Institute, Washington, DC, USA
| | - Raimee Eck
- Behavioral Research Program, Division of Cancer Control and Population Sciences National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive| Rockville, MD 20850-9761, USA
| | - Neha Trivedi
- Behavioral Research Program, Division of Cancer Control and Population Sciences National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive| Rockville, MD 20850-9761, USA; NORC at the University of Chicago, Public Health Department, 4350 East-West Hwy, Suite 800, Bethesda, MD 20814, USA
| | - April Y Oh
- Behavioral Research Program, Division of Cancer Control and Population Sciences National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive| Rockville, MD 20850-9761, USA
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Werner-Lin A, Forbes Shepherd R, Rising CJ, Thompson AS, Huelsnitz C, Wilsnack C, Boyd P, Sleight AG, Hutson S, Khincha PP. How do young people with a hereditary cancer predisposition syndrome understand and experience cancer survivorship? "With Li-Fraumeni syndrome, it's just an intermission". Psychooncology 2023; 32:375-382. [PMID: 36514197 DOI: 10.1002/pon.6080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/15/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Adolescents and young adult (AYA) cancer survivors face unique medical and psychosocial sequalae, including chronic health conditions, late effects of treatment and fear of recurrence. The meaning of cancer survivorship may be further complicated for AYAs with hereditary cancer predisposition syndromes. This study used a patient-centered framework to investigate how AYAs with Li-Fraumeni syndrome (LFS) consider cancer survivorship. METHODS An interprofessional team conducted 30 semi-structured interviews with AYAs (aged 18-41, mean 31 years) enrolled in the National Cancer Institute's LFS Study (NCT01443468). Twenty had experienced at least one cancer diagnosis. Interview data were thematically analyzed by an inter-professional team using interpretive description and grounded theory methods. FINDINGS Participants viewed "survivorship" as a period marked by no evidence of formerly diagnosed disease. By contrast, participants felt the label "survivor" was tenuous since LFS is characterized by multiple primary malignancies and uncertainty about intervals between one diagnosis and the next. Many AYAs viewed survivorship as requiring a high degree of suffering. Though many personally rejected "survivor" identities, almost all articulated its various functions including positive, negative, and more complicated connotations. Instead, they chose language to represent a range of beliefs about survival, longevity, prognosis, and activism. CONCLUSIONS AYAs with LFS struggle with the term "survivor" due to their multi-organ cancer risk, short intervals between malignancies, and evolving identities. Loved ones' cancer-related suffering informed perspectives on survivorship. Survivorship care for AYAs with cancer risk syndromes requires interprofessional interventions that address their unique biomedical and psychosocial needs.
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Affiliation(s)
- Allison Werner-Lin
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rowan Forbes Shepherd
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Camella J Rising
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Ashley S Thompson
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Chloe Huelsnitz
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Catherine Wilsnack
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas, USA
| | - Patrick Boyd
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Alix G Sleight
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
- Department of Physical Medicine and Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Sadie Hutson
- Department of Nursing, University of Tennessee, Knoxville, Tennessee, USA
| | - Payal P Khincha
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
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Oh AY, Rising CJ, Gaysynsky A, Tsakraklides S, Huang GC, Chou WYS, Blake KD, Vanderpool RC. Advancing multi-level health communication research: A Delphi study on barriers and opportunities. Transl Behav Med 2022; 12:1133-1145. [PMID: 36378100 PMCID: PMC9802573 DOI: 10.1093/tbm/ibac068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Adopting a multi-level perspective that considers the many interrelated contexts influencing health could make health communication interventions more effective and equitable. However, despite increasing interest in the use of multi-level approaches, multi-level health communication (MLHC) interventions are infrequently utilized. We therefore sought to conduct a modified Delphi study to better understand how researchers conceptualize MLHC interventions and identify opportunities for advancing MLHC work. Communication and health behavior experts were invited to complete two rounds of surveys about the characteristics, benefits, pitfalls, best practices, barriers, and facilitators of MLHC interventions; the role of technology in facilitating MLHC interventions; and ways to advance MLHC intervention research (46 experts completed the first survey, 44 completed both surveys). Survey data were analyzed using a mixed-methods approach. Panelists reached consensus on two components of the proposed definition of MLHC interventions and also put forward a set of best practices for these interventions. Panelists felt that most health intervention research could benefit from a multi-level approach, and generally agreed that MLHC approaches offered certain advantages over single-level approaches. However, they also expressed concern related to the time, cost, and complexity of MLHC interventions. Although panelists felt that technology could potentially support MLHC interventions, they also recognized the potential for technology to exacerbate disparities. Finally, panelists prioritized a set of methodological advances and practical supports that would be needed to facilitate future MLHC intervention research. The results of this study point to several future directions for the field, including advancing how interactions between levels are assessed, increasing the empirical evidence base demonstrating the advantages of MLHC interventions, and identifying best practices for the use of technology. The findings also suggest that researchers may need additional support to overcome the perceived practical challenges of conducting MLHC interventions.
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Affiliation(s)
- April Y Oh
- Implementation Science Team, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Camella J Rising
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Anna Gaysynsky
- Health Communication and Informatics Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
- ICF Next, ICF, Rockville, MD, USA
| | | | - Grace C Huang
- Public Health and Epidemiology, Westat, Rockville, MD, USA
| | - Wen-Ying Sylvia Chou
- Health Communication and Informatics Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Kelly D Blake
- Health Communication and Informatics Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Robin C Vanderpool
- Health Communication and Informatics Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
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Rising CJ, Wilsnack C, Boyd P, Sleight AG, Hutson SP, Khincha PP, Werner-Lin A. Family communication challenges of adolescents and young adults with Li-Fraumeni syndrome: Implications for psychosocial care. Patient Educ Couns 2022; 105:3259-3266. [PMID: 35918231 PMCID: PMC9529832 DOI: 10.1016/j.pec.2022.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/12/2022] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES This qualitative-descriptive study explored adolescent and young adult (AYA) perspectives, experiences, and challenges with openness and closedness in family communication about Li-Fraumeni syndrome (LFS). METHODS We conducted interviews with AYAs (aged 15-39 years) with LFS enrolled in the National Cancer Institute's LFS study (NCT01443468). An interprofessional clinician-researcher team analyzed transcribed data using the constant comparative method and interpretive description. RESULTS AYAs (N = 38; 26 females, 12 males, mean age=29 years) reported navigating openness and closedness about LFS in their families, which varied by LFS topic, relationship, disease trajectory, and developmental phase. AYAs described communication challenges, including broaching difficult topics (e.g., reproductive decision-making, end-of-life), balancing information-sharing with emotionally protecting family and self, and struggling with interactions that cause relational tensions. CONCLUSIONS AYAs reported experiencing LFS family communication challenges that disrupted their psychosocial well-being. LFS-related stressors and life transitions complicated and were complicated by these challenging family interactions. PRACTICE IMPLICATIONS Clinicians may support AYAs with LFS by inquiring about family communication, responding empathically to communication concerns, providing resources to support difficult conversations, and engaging mental health providers as needed. Researchers could partner with AYAs to develop tailored communication skills training and social support tools.
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Affiliation(s)
- Camella J Rising
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, USA.
| | - Catherine Wilsnack
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, USA.
| | - Patrick Boyd
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, USA.
| | - Alix G Sleight
- Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, USA.
| | - Sadie P Hutson
- College of Nursing, The University of Tennessee, Knoxville, USA.
| | - Payal P Khincha
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, USA.
| | - Allison Werner-Lin
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, USA.
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Rising CJ, Gaysynsky A, Blake KD, Jensen RE, Oh A. Willingness to Share Data From Wearable Health and Activity Trackers: Analysis of the 2019 Health Information National Trends Survey Data. JMIR Mhealth Uhealth 2021; 9:e29190. [PMID: 34898448 PMCID: PMC8713093 DOI: 10.2196/29190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/21/2021] [Accepted: 10/08/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Sharing data from wearable health and activity trackers (wearables) with others may improve the health and behavioral outcomes of wearable users by generating social support and improving their ability to manage their health. Investigating individual factors that influence US adults' willingness to share wearable data with different types of individuals may provide insights about the population subgroups that are most or least likely to benefit from wearable interventions. Specifically, it is necessary to identify digital health behaviors potentially associated with willingness to share wearable data given that the use of and engagement with various technologies may broadly influence web-based health information-sharing behaviors. OBJECTIVE This study aims to identify sociodemographic, health, and digital health behavior correlates of US adults' willingness to share wearable data with health care providers and family or friends. METHODS Data for the analytic sample (N=1300) were obtained from the 2019 Health Information National Trends Survey of the National Cancer Institute. Digital health behavior measures included frequency of wearable device use, use of smartphones or tablets to help communicate with providers, use of social networking sites to share health information, and participation in a web-based health community. Multivariable logistic regression analysis of weighted data examined the associations between digital health behaviors and willingness to share wearable device data, controlling for sociodemographics and health-related characteristics. RESULTS Most US adults reported willingness to share wearable data with providers (81.86%) and with family or friends (69.51%). Those who reported higher health self-efficacy (odds ratio [OR] 1.97, 95% CI 1.11-3.51), higher level of trust in providers as a source of health information (OR 1.98, 95% CI 1.12-3.49), and higher level of physical activity (OR 2.00, 95% CI 1.21-3.31) had greater odds of willingness to share data with providers. In addition, those with a higher frequency of wearable use (OR 2.15, 95% CI 1.35-3.43) and those who reported use of smartphones or tablets to help communicate with providers (OR 1.99, 95% CI 1.09-3.63) had greater odds of willingness to share data with providers. Only higher level of physical activity was associated with greater odds of willingness to share wearable data with family or friends (OR 1.70, 95% CI 1.02-2.84). Sociodemographic factors were not significantly associated with willingness to share wearable data. CONCLUSIONS The findings of this study suggest that, among US adult wearable users, behavior-related factors, rather than sociodemographic characteristics, are key drivers of willingness to share health information obtained from wearables with others. Moreover, behavioral correlates of willingness to share wearable data are unique to the type of recipient (ie, providers vs family or friends). Future studies could use these findings to inform the development of interventions that aim to improve the use of patient-generated data from wearable devices in health care settings.
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Affiliation(s)
- Camella J Rising
- Behavioral Research Program, Division of Cancer Control and Population Sciences, US National Cancer Institute, Rockville, MD, United States
| | - Anna Gaysynsky
- Behavioral Research Program, Division of Cancer Control and Population Sciences, US National Cancer Institute, Rockville, MD, United States
| | - Kelly D Blake
- Behavioral Research Program, Division of Cancer Control and Population Sciences, US National Cancer Institute, Rockville, MD, United States
| | - Roxanne E Jensen
- Health Care Delivery Research Program, Division of Cancer Control and Population Sciences, US National Cancer Institute, Rockville, MD, United States
| | - April Oh
- Implementation Science, Office of the Director, Division of Cancer Control and Population Sciences, US National Cancer Institute, Rockville, MD, United States
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Wright KB, Cai X, Fisher C, Rising CJ, Burke-Garcia A, Afanaseva D. A Content Analysis of Social Support Messages about Environmental Breast Cancer Risk within Blogs for Mothers. Health Commun 2021; 36:1796-1804. [PMID: 32744079 PMCID: PMC7855537 DOI: 10.1080/10410236.2020.1800241] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Bloggers can help stimulate online conversations among their readers about a variety of health topics, including breast cancer. However, in previous studies, researchers have not specifically examined supportive messages within an online blogger community that stem from an intervention where bloggers were provided with evidence-based information about breast cancer risk that they could tailor and disseminate to their readers. In the current study, we content analyzed 282 supportive messages within online conversations from participants in blogger communities over a 2-month period immediately following an intervention where the authors provided 74 bloggers who write about motherhood issues with an infographic based on evidence-based information from the Breast Cancer and the Environment Research Program (BCERP) about environmental breast cancer risk/prevention. Bloggers who shared information about their personal breast cancer risk generated a significantly higher number of blog reader comments than bloggers who did not share information about their personal breast cancer risk. Bloggers who cited breast cancer statistics in posts were more likely to draw esteem and emotional support from their readers. Bloggers' repetition of information from blog intervention messages was more likely to elicit esteem, informational, and emotional support from readers. Disclosure of a personal breast cancer diagnosis was associated with mixed types of social support messages. The theoretical and practical implications are discussed along with key limitations of the study and future directions for research in this area.
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Affiliation(s)
- Kevin B Wright
- Department of Communication, George Mason University, Fairfax, VA, USA
| | - Xiaomei Cai
- Department of Communication, George Mason University, Fairfax, VA, USA
| | - Carla Fisher
- UF Health Cancer Center, College of Journalism and Communications, University of Florida, Gainesville, FL, USA
| | - Camella J Rising
- Department of Communication, George Mason University, Fairfax, VA, USA
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Fisher CL, Wright KB, Rising CJ, Mullis MD, Afanaseva D, Burke-Garcia A, Cai X. Culturally Appropriate Breast Cancer and Environmental Risk Messages: Targeting Racially and Ethnically Diverse Mothers. J Cancer Educ 2021; 36:284-293. [PMID: 31820415 DOI: 10.1007/s13187-019-01626-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The National Institute of Environmental Health Sciences (NIEHS)-funded Breast Cancer and Environment Research Program (BCERP) provides evidence-informed educational materials targeting mothers with daughters to help them engage in lifestyle changes to reduce their environmental risk of breast cancer. Building on a partnership we developed to disseminate these materials via social media, we teamed with mommy bloggers and readers to evaluate the cultural appropriateness of the information using evidence-based practices for message design. We sought to (1) identify cross-culture factors that speak to a broad group of mothers and culture-specific factors to integrate when targeting specific cultures and (2) capture cultural challenges mothers encounter when they share the information with family to understand the social context in which they receive, interpret, and act on risk-reducing messages. We conducted 50 interviews with racially and ethnically diverse bloggers/readers and thematically analyzed transcripts, comparing findings across cultures. Across cultures, mothers identified five key factors for ensuring cultural appropriateness, but with notable cultural differences: (1) incorporate diverse images, (2) provide more information specific to environmental and cultural risk, (3) heighten the message of "it's a family affair", (4) make behavioral changes feasible, and (5) use less text, more visuals. Across cultures, women experienced intergenerational communication challenges with family, which were tied to (1) lack of openness, (2) relational norms, and (3) generational resistance. Findings provide message design considerations for targeting mothers broadly or based on race/ethnicity and support the notion that the larger family system should be considered when disseminating cancer risk education.
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Affiliation(s)
- Carla L Fisher
- College of Journalism and Communications, University of Florida, UF Health Cancer Center, PO Box 118400, Gainesville, FL, 32611-8400, USA.
| | - Kevin B Wright
- Department of Communication, George Mason University, 4400 University Dr, MSN3D6, Fairfax, VA, 22030, USA
| | - Camella J Rising
- Department of Communication, George Mason University, 4400 University Dr, MSN3D6, Fairfax, VA, 22030, USA
| | - Michaela Devyn Mullis
- College of Journalism and Communications, University of Florida, PO Box 118400, Gainesville, FL, 32611-8400, USA
| | | | - Amelia Burke-Garcia
- NORC at the University of Chicago, 4350 East-West Highway, 8th floor, Bethesda, MD, 20814, USA
| | - Xiaomei Cai
- Department of Communication, George Mason University, 4400 University Dr, MSN3D6, Fairfax, VA, 22030, USA
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Krakow M, Rising CJ, Trivedi N, Yoon DC, Vanderpool RC. Prevalence and Correlates of Family Cancer History Knowledge and Communication Among US Adults. Prev Chronic Dis 2020; 17:E146. [PMID: 33211995 PMCID: PMC7735478 DOI: 10.5888/pcd17.200257] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction Knowing one’s family cancer history (FCH) plays an important role in cancer prevention. Communicating health histories with relatives can increase awareness about familial cancer risk and aid health care providers in personalizing cancer prevention recommendations. Methods This study used data from the National Cancer Institute’s 2018 Health Information National Trends Survey. We calculated frequencies and weighted population estimates for key FCH communication variables. Multivariable logistic regression models estimated associations between sociodemographic characteristics and FCH communication. Results Findings provide the first nationally representative estimates of FCH communication. Less than one-third (31.1%) of the population reported knowing FCH very well, 70.0% had discussed FCH with at least 1 biological relative, 39.0% had discussed FCH with a health care provider, and 22.2% reported being completely confident in completing FCH on medical forms. Findings also identified key demographic factors, including sex, household income, education level, and race and ethnicity, associated with these FCH measures among the US adult population. Conclusion Results can be used to target and tailor FCH communication interventions for patients, families, and providers.
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Affiliation(s)
- Melinda Krakow
- John D. Bower School of Population Health, University of Mississippi Medical Center, 2500 State Street, Jackson MS 39216.
| | - Camella J Rising
- Health Communication and Informatics Research Branch, National Cancer Institute, Bethesda, Maryland
| | - Neha Trivedi
- Health Communication and Informatics Research Branch, National Cancer Institute, Bethesda, Maryland
| | | | - Robin C Vanderpool
- Health Communication and Informatics Research Branch, National Cancer Institute, Bethesda, Maryland
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Fisher CL, Wright KB, Rising CJ, Cai X, Mullis MD, Burke-Garcia A, Afanaseva D. Helping Mothers and Daughters Talk about Environmental Breast Cancer Risk and Risk-Reducing Lifestyle Behaviors. Int J Environ Res Public Health 2020; 17:ijerph17134757. [PMID: 32630657 PMCID: PMC7370108 DOI: 10.3390/ijerph17134757] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/22/2020] [Accepted: 06/28/2020] [Indexed: 01/30/2023]
Abstract
Background: Mothers and daughters struggle to talk about breast cancer risk. Even less attention is paid to environmental determinants of cancer. Third-party online approaches can be helpful navigating these conversations. The aim of this study was to obtain feedback from mothers exposed to a social media intervention (“mommy bloggers”) and identify their preferences for message-design approaches that could help them talk to their daughter(s) about environmental breast cancer risk. Methods: We conducted semi-structured interviews with 50 mothers. A thematic analysis was conducted using the constant comparative method. Results: Mothers identified four approaches to message design that could help facilitate mother–daughter communication about environmental breast cancer risk. These included two action-oriented approaches that centered on getting the conversation started and keeping the conversation going and two approaches based on lifespan factors to promote daughters’ engagement by using age-appropriate language and visuals and focusing on developmentally specific lifestyle behaviors. Mothers also provided recommended strategies within each approach. Conclusions: Mothers identified various approaches interventionists can utilize to overcome barriers to talking to daughters about environmental breast cancer risk. To promote mother–daughter communication, the messages should be action-oriented to facilitate interaction, but also developed with lifespan and developmental considerations in mind to engage daughters.
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Affiliation(s)
- Carla L. Fisher
- UF Health Cancer Center, College of Journalism and Communications, University of Florida, P.O. Box 118400, Gainesville, FL 32611-8400, USA;
- Correspondence: ; Tel.: +1-352-294-1019
| | - Kevin B. Wright
- Department of Communication, George Mason University, 4400 University, Dr, MSN3D6, Fairfax, VA 22030, USA; (K.B.W.); (C.J.R.); (X.C.)
| | - Camella J. Rising
- Department of Communication, George Mason University, 4400 University, Dr, MSN3D6, Fairfax, VA 22030, USA; (K.B.W.); (C.J.R.); (X.C.)
| | - Xiaomei Cai
- Department of Communication, George Mason University, 4400 University, Dr, MSN3D6, Fairfax, VA 22030, USA; (K.B.W.); (C.J.R.); (X.C.)
| | - Michaela D. Mullis
- UF Health Cancer Center, College of Journalism and Communications, University of Florida, P.O. Box 118400, Gainesville, FL 32611-8400, USA;
| | - Amelia Burke-Garcia
- NORC at the University of Chicago, 4350 East West Highway, Bethesda, MD 20814, USA;
| | - Dasha Afanaseva
- Fors Marsh Group, 901 N. Glebe Road, Arlington, VA 22201, USA;
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Rising CJ, Jensen RE, Moser RP, Oh A. Characterizing the US Population by Patterns of Mobile Health Use for Health and Behavioral Tracking: Analysis of the National Cancer Institute's Health Information National Trends Survey Data. J Med Internet Res 2020; 22:e16299. [PMID: 32406865 PMCID: PMC7256752 DOI: 10.2196/16299] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/23/2019] [Accepted: 02/03/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Multiple types of mobile health (mHealth) technologies are available, such as smartphone health apps, fitness trackers, and digital medical devices. However, despite their availability, some individuals do not own, do not realize they own, or own but do not use these technologies. Others may use mHealth devices, but their use varies in tracking health, behaviors, and goals. Examining patterns of mHealth use at the population level can advance our understanding of technology use for health and behavioral tracking. Moreover, investigating sociodemographic and health-related correlates of these patterns can provide direction to researchers about how to target mHealth interventions for diverse audiences. OBJECTIVE The aim of this study was to identify patterns of mHealth use for health and behavioral tracking in the US adult population and to characterize the population according to those patterns. METHODS We combined data from the 2017 and 2018 National Cancer Institute Health Information National Trends Survey (N=6789) to characterize respondents according to 5 mutually exclusive reported patterns of mHealth use for health and behavioral tracking: (1) mHealth nonowners and nonusers report not owning or using devices to track health, behaviors, or goals; (2) supertrackers track health or behaviors and goals using a smartphone or tablet plus other devices (eg, Fitbit); (3) app trackers use only a smartphone or tablet; (4) device trackers use only nonsmartphone or nontablet devices and do not track goals; and (5) nontrackers report having smartphone or tablet health apps but do not track health, behaviors, or goals. RESULTS Being in the mHealth nonowners and nonusers category (vs all mHealth owners and users) is associated with males, older age, lower income, and not being a health information seeker. Among mHealth owners and users, characteristics of device trackers and supertrackers were most distinctive. Compared with supertrackers, device trackers have higher odds of being male (odds ratio [OR] 2.22, 95% CI 1.55-3.19), older age (vs 18-34 years; 50-64 years: OR 2.83, 95% CI 1.52-5.30; 65+ years: OR 6.28, 95% CI 3.35-11.79), have an annual household income of US $20,000 to US $49,999 (vs US $75,000+: OR 2.31, 95% CI 1.36-3.91), and have a chronic condition (OR 1.69, 95% CI 1.14-2.49). Device trackers also have higher odds of not being health information seekers than supertrackers (OR 2.98, 95% CI 1.66-5.33). CONCLUSIONS Findings revealed distinctive sociodemographic and health-related characteristics of the population by pattern of mHealth use, with notable contrasts between those who do and do not use devices to track goals. Several characteristics of individuals who track health or behaviors but not goals (device trackers) are similar to those of mHealth nonowners and nonusers. Our results suggest patterns of mHealth use may inform how to target mHealth interventions to enhance reach and facilitate healthy behaviors.
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Affiliation(s)
- Camella J Rising
- Health Communication and Informatics Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, United States
| | - Roxanne E Jensen
- Outcomes Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, United States
| | - Richard P Moser
- Office of the Associate Director, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, United States
| | - April Oh
- Health Communication and Informatics Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, United States
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Rising CJ, Bol N. Nudging Our Way to a Healthier Population: The Effect of Calorie Labeling and Self-Control on Menu Choices of Emerging Adults. Health Commun 2017; 32:1032-1038. [PMID: 27676393 DOI: 10.1080/10410236.2016.1217452] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Emerging adults are among those in the United States with concerning rates of overweight and obesity, putting them at risk for chronic diseases. One proposed intervention to address these issues across populations is to require that chain restaurants and similar establishments provide nutrition information, such as calorie labels, on menu items. This study therefore aims to examine the effect of menu calorie labeling and self-control on food and beverage choices of emerging adults. Results of a between-subjects experiment (n = 179) revealed that calorie labeling increased the likelihood of choosing lower calorie food and beverage options. Moreover, calorie labeling only led to selecting a lower calorie food option among those with high self-control, but not among those with low self-control. This moderating effect was not revealed for beverage choice. Public health practitioners and policymakers should consider intervention approaches that address other drivers of choice, such as self-control, in addition to nutrition information.
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Affiliation(s)
| | - Nadine Bol
- b Amsterdam School of Communication Research , University of Amsterdam
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Rising CJ, Bol N, Burke-Garcia A, Rains S, Wright KB. Perceived Stress in Online Prostate Cancer Community Participants: Examining Relationships with Stigmatization, Social Support Network Preference, and Social Support Seeking. J Health Commun 2017; 22:469-476. [PMID: 28414570 DOI: 10.1080/10810730.2017.1304471] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Men with prostate cancer often need social support to help them cope with illness-related physiological and psychosocial challenges. Whether those needs are met depends on receiving support optimally matched to their needs. This study examined relationships between perceived stress, prostate cancer-related stigma, weak-tie support preference, and online community use for social support in a survey of online prostate cancer community participants (n = 149). Findings revealed a positive relationship between stigma and perceived stress. This relationship, however, was moderated by weak-tie support preference and online community use for social support. Specifically, stigma was positively related to perceived stress when weak-tie support was preferred. Analyses also showed a positive relationship between stigma and perceived stress in those who used their online community for advice or emotional support. Health communication scholars should work collaboratively with diagnosed men, clinicians, and online community administrators to develop online interventions that optimally match social support needs.
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Affiliation(s)
- Camella J Rising
- a Department of Communication , College of Humanities and Social Sciences, George Mason University , Fairfax , Virginia , USA
| | - Nadine Bol
- b Amsterdam School of Communication Research (ASCoR) , University of Amsterdam , Amsterdam , The Netherlands
| | - Amelia Burke-Garcia
- a Department of Communication , College of Humanities and Social Sciences, George Mason University , Fairfax , Virginia , USA
| | - Stephen Rains
- c Department of Communication , College of Social and Behavioral Sciences, University of Arizona , Tucson , Arizona , USA
| | - Kevin B Wright
- a Department of Communication , College of Humanities and Social Sciences, George Mason University , Fairfax , Virginia , USA
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Fisher CL, Roccotagliata T, Rising CJ, Kissane DW, Glogowski EA, Bylund CL. “I Don’t Want to Be an Ostrich”: Managing Mothers’ Uncertainty during BRCA1/2 Genetic Counseling. J Genet Couns 2016; 26:455-468. [DOI: 10.1007/s10897-016-9998-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 07/12/2016] [Indexed: 10/21/2022]
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Rising CJ, Bol N, Kreps GL. Age-Related Use and Perceptions of eHealth in Men With Prostate Cancer: A Web-Based Survey. JMIR Cancer 2015; 1:e6. [PMID: 28410165 PMCID: PMC5367670 DOI: 10.2196/cancer.4178] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 04/29/2015] [Accepted: 05/24/2015] [Indexed: 12/27/2022] Open
Abstract
Background Men with prostate cancer require ample information and support along the continuum of care, and eHealth is one way to meet such critical information and support needs. Currently, evidence about how age influences use and perceptions about prostate cancer eHealth information and support is lacking. Objective The aim of this paper is to explore use and perceptions about eHealth among men living with prostate cancer. Specifically, we aimed to analyze men with prostate cancer by age-specific cohorts to identify potential age-related differences in use and perceptions about prostate cancer eHealth information. Methods We used survey methodology to examine how men under 65 years old with prostate cancer differ from those aged 65 years old or older in use and perceptions about prostate cancer eHealth information and support (n=289). Results We found that men in the younger cohort used the Internet more often to be informed about treatment options (P=.04) and to learn more about staging/grading (P=.01) than men in the older cohort. Results also showed comparatively greater use of online prostate cancer information for emotional support and encouragement by the younger as compared to the older cohort (P=.001). Furthermore, the older cohort reported more negative psychosocial effects of eHealth (eg, more anxious, depressed) than younger men (P=.002). We also found that as a result of more frequent Internet use, younger men experienced more positive psychosocial effects (eg, more informed, in control) from accessing information about prostate cancer through eHealth channels (b=-0.10, 95% CI -0.28 to 0). Conclusions Men with prostate cancer have different information and support needs; our findings suggest that these needs might vary by age. Future research is needed to unravel age-related factors underlying these differences to be better able to tailor prostate cancer eHealth information to men’s information and support needs.
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Affiliation(s)
- Camella J Rising
- Center for Health and Risk Communication, Department of Communication, George Mason University, Fairfax, VA, United States
| | - Nadine Bol
- Amsterdam School of Communication Research (ASCoR), Department of Communication Science, University of Amsterdam, Amsterdam, Netherlands
| | - Gary L Kreps
- Center for Health and Risk Communication, Department of Communication, George Mason University, Fairfax, VA, United States
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Abstract
Study of a number of routine nursing care activities has suggested a relationship between activities and intracranial pressure (ICP). The purpose of this study was to focus on the relationship between nursing care activities and variations in ICP. A case study method was used to study ICP in five brain-injured patients with a Glasgow Coma Scale (GCS) score of 4 or more. Each patient's condition warranted continuous ICP monitoring with a fiberoptic catheter in a neurological intensive care unit (ICU) of two hospitals in the Upper Midwest. Selected nursing measures--turning, suctioning and bathing--were recorded on the data collection tool as they occurred. Suctioning and turning were noted to be associated with an increase in ICP; however, a sustained increase in ICP was not observed. During the bathing procedures only two baths elicited an ICP greater than 20 mm Hg. All other bathing procedures elicited minimal increases in ICP. These findings further support the need for nurses to be aware of the patient's ICP prior to turning and suctioning.
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Affiliation(s)
- C J Rising
- Dakota Hospital, Fargo, North Dakota 58103-6014
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