Aaron Smith-McLallen

Cancer Information Scanning and Seeking in the General Population

The amount of cancer-related information available in the media and other sources continues to increase each year. We wondered how people make use of such content in making specific health decisions. We studied both the information they actively seek (“seeking”) and that which they encounter in a less purposive way (“scanning”) through a nationally representative survey of adults aged 40–70 years (n = 2,489) focused on information use around three prevention behaviors (dieting, fruit and vegetable consumption, and exercising) and three screening test behaviors (prostate-specific antigen, colonoscopy, mammogram). Overall, respondents reported a great deal of scanning and somewhat less seeking (on average 62% versus 28% for each behavior), and they used a range of sources including mass media, interpersonal conversations, and the Internet, alongside physicians. Seeking was predicted by female gender, age of 55–64 vs. 40–44, higher education, Black race and Hispanic ethnicity, and being married. Scanning was predicted by older age, female gender, and education. Respondents were fairly consistent in their place on a typology of scanning and seeking across behaviors. Seeking was associated with all six behaviors, and scanning was associated with three of six behaviors.

Predictors of intentions to perform six cancer-related behaviours: Roles for injunctive and descriptive norms

This study reports an application of the integrative model to the prediction of intentions to engage in three cancer screening behaviours (mammogram, colonoscopy and PSA test) and three healthy lifestyle behaviours (exercising, eating fruits and vegetables, and controlling ones diet to lose weight). We examined the roles of attitudes, perceived behavioural control, injunctive norms (what important others think one should do), and descriptive norms (perceptions of what others do) as predictors of participants intentions to engage in each behaviour. Results indicated that injunctive norms were the strongest predictors of prostate and colon cancer screening intentions and contributed significantly to the prediction of intentions to get a mammogram. In contrast, injunctive norms contributed relatively little to the prediction of lifestyle behaviours, but were strongly predictive of intentions to eat fruits and vegetables. Implications for designing behaviour-specific communications and interventions are discussed.

Predicting intentions to engage in cancer prevention and detection behaviors: examining differences between Black and White adults.

Reducing cancer-related mortality rates can be achieved by increasing cancer screening rates and by increasing the number of people who engage in healthy lifestyle behaviors. This study uses the Integrative Model of Behavioral Prediction (IM; Fishbein, 2000) to examine differences between Blacks and Whites in the US in the degree to which attitudes, perceived behavioral control (PBC) and normative pressure contribute to predicting intentions to engage in three cancer screening behaviors (mammogram, colonoscopy and PSA test) and three healthy lifestyle behaviors (controlling ones diet to lose weight, eating fruits and vegetables and exercising regularly). Prior research has demonstrated that these behaviors are effective at reducing incidence and mortality rates for some cancers. Results indicated that for Blacks intentions to engage in all behaviors were driven by PBC. Patterns were more varied for Whites and indicated that normative pressure was a particularly important determinant of screening intentions whereas attitudes were most strongly associated with dieting intentions. Results suggest that interventions targeting these behaviors should be tailored by behavior and by ethnicity.

Adjuvant Chemotherapy Use and Health Care Costs After Introduction of Genomic Testing in Breast Cancer

PURPOSE We assessed the associations between the 21-gene recurrence score assay (RS) receipt, subsequent chemotherapy use, and medical expenditures among patients with early-stage breast cancer. PATIENTS AND METHODS Data from the Pennsylvania Cancer Registry were used to assemble a retrospective cohort of women with early-stage breast cancer from 2007 to 2010 who underwent initial surgical treatment. These data were merged with administrative claims from the 12-month periods before and after diagnosis to identify comorbidities, treatments, and expenditures (n = 7,287). Propensity score-weighted regression models were estimated to identify the effects of RS receipt on chemotherapy use and medical spending in the year after diagnosis. RESULTS The associations between RS receipt and outcomes varied markedly by patient age. RS use was associated with lower chemotherapy use among women younger than 55 (19.2% lower; 95% CI, 10.6 to 27.9). RS use was associated with higher chemotherapy use among women 75 to 84 years old (5.7% higher; 95% CI, 0.4 to 11.0). RS receipt was associated with lower adjusted 1-year medical spending among women younger than 55 (

Validation of Molecular Pathology Codes for the Identification of Mutational Testing in Lung and Colon Cancer.

15,333 lower; 95% CI,

Patient surveys for cancer populations: Initial experiences with Cancer CAHPS.

2,841 to

Communication and attitude change: causes, processes, and effects

27,824) and with higher spending among women who were 75 to 84 years old (

Psychosocial determinants of cancer-related information seeking among cancer patients.

3,489 higher; 95% CI,

BLACK AND WHITE: THE ROLE OF COLOR BIAS IN IMPLICIT RACE BIAS

857 to

Truth or Consequences: Overcoming Resistance to Persuasion with Positive Thinking

6,122). CONCLUSION RS receipt was associated with reduced use of adjuvant chemotherapy and lower health care spending among women with breast cancer who were younger than 55. Conversely, among women 75 and older, RS testing was associated with a modest increase in chemotherapy use and slightly higher spending. From a population perspective, the impact of RS testing on breast cancer treatment and health care costs is much greater in younger women.