Tailored interventions could be improved by (a) identifying the most salient characteristics to be tailored, (b) further delineating essential components of TIs, (c) determining the efficacy of different delivery channels, (d) determining factors that moderate effects of TIs, and (e) clarifying whether the efficacy of TIs changes over time.

Patient-centered care is valued in nursing. However, until recently, nurse-researchers have focused on testing the effects of standardized rather than patient-centered interventions (PCIs). The latter are those interventions that are altered to address selected patient characteristics (e.g., beliefs, habits, or goals). PCIs have been well received, and in some studies they have been associated with improved health outcomes. In this article we describe briefly the concept patient centered, summarize the development of research on PCIs, discuss kinds of PCIs, provide examples of PCIs and how they have been derived and implemented, and raise issues for theory and future research.

Although much research has focused upon why people do and do not engage in recommended health behaviors, there is a need to develop more accurate theories to explain and predict engagement in health behaviors. Because health behaviors differ in important ways, it could be most fruitful to understand one type of health behavior, such as secondary prevention behavior. This paper proposes a theory of care-seeking behavior (CSB), based on a theory of general behavior by Triandis. Other popular theories about health behavior (i.e., Health Belief Model and Theory of Reasoned Action) also are reviewed. Empirical support for the variables identified in the theory of CSB is presented, drawing from the literature on secondary prevention for cancer. The theory of CSB is applied to the situation of seeking care for cancer symptoms. Directions for future research based upon this theory are delineated.

Although cancer survivors often face stressors and experience psychologic symptoms and distress, research on the particular stressors and coping strategies upon finishing cancer treatments is rare. The study purposes were to identify the stressors experienced and the strategies used by women cancer survivors at this phase of survivorship. The specific aims were to describe the stressors at the end of primary cancer treatments and delineate coping strategies that were used and helpful. Using a longitudinal design, interviews were conducted within 4 weeks and 3 to 4 months after treatment. Participants (N = 51) were women aged 34 to 77, and had radiation and/or chemotherapy for primary breast or gynecologic cancers. Participants' primary stressors at the end of treatment included feelings of uncertainty about treatment, follow-up, and symptoms; physical concerns; difficulty concentrating, attitudes about body, and dealing with mortality. Participants used acceptance, religion, and distraction as primary coping strategies. These strategies also were rated highly as helpful coping strategies. Clinicians can provide anticipatory guidance, based upon previous survivors' strategies, as well as assess and address particular stressors at this phase. Nurses can design and test patient-centered interventions that address women's specific stressors and promote effective coping strategies among women at this phase of survivorship.

Consistent with the TCSB, Hmong women's beliefs, affect, cultural norms and external conditions helped to understand their use of breast and cervical screening. Findings could guide nursing and public health interventions to improve culturally sensitive, cancer screening for Hmong women.

The effect of an informational intervention that provided objective descriptions, in concrete terms, of the usual experiences during the various phases of radiation therapy was tested in a random clinical trial. The patients had Stage A, B, or C prostatic cancer. Forty-two control patients received the information routinely provided to all patients in the treatment setting. Forty-two experimental patients received, in addition, four informational messages during the course of radiation therapy. The first message described the experience of treatment planning; the second described the experience of receiving a radiation treatment; the third described side effects that usually occur, their onset, their characteristics, and activities to lessen their impact; and the fourth described the usual experiences during the months following radiation treatments. The experimental group of patients, compared with those in the control group, reported significantly less disruption in usual activities during and following radiation therapy. The amount of emotional disturbance was low and did not differ by study group. The results of this study, with respect to the interventions' effect on radiation therapy patients' quality of life, were consistent with prior research in other health care situations.

The theory of care-seeking behavior was tested in the context of mammography use among midwestern women (N = 178). In multivariate logistic regressions, mammography adherence in the past 5 years was related to habit, the interaction of anxiety and barriers, belief in one's risk of breast cancer, age, and family history of breast cancer. Recent use of mammograms (i.e., in the past 1 or 2 years, depending on age) was related to norm and habit. Intention was related to utility beliefs regarding mammography, norm, habit, and belief in one's risk of breast cancer. As proposed from theory, anxiety and barriers interacted to influence adherence, the variables of habit, utility beliefs, and norm were related to either recent use or intention. Contrary to theory, belief in one's risk of breast cancer, age, and family history of breast cancer were related to adherence or intention after controlling for theoretically derived variables. The explanatory variables for each outcome were not identical, indicating that these mammography-related outcomes are characteristically different.

Based on a theory of care seeking, the influences of psychosocial variables (anxiety, utility beliefs, norm, and habit) and facilitators (e.g., an identified practitioner) on care-seeking behavior with a breast cancer symptom were examined. Also, the influences of variables not identified by the theory (e.g., optimism and race) on care-seeking behavior were examined. Participants were Caucasian (n = 64) and African-American women (n = 71) with breast symptoms. Care seeking was measured by the days between symptom detection and contact with the health system. Habit was associated with promptness, utility beliefs were associated with delay, and anxiety interacted with having an identified practitioner to explain care seeking. Optimism and having a friend with a breast symptom also were associated with promptness. Race had neither direct nor interactive effects on care seeking.