Deliberative and intuitive risk perceptions as predictors of colorectal cancer screening over time

Abstract

Cancer risk perceptions may involve intuitions – including both affect as well as gut-level thoughts about risk – and deliberative risk magnitudes. Yet, little research has examined the potentially diverse relations between risk perceptions and behavior across time. A highly diverse primary care sample (N=544, aged ≥50) was utilized to compare how deliberative and intuitive perceptions of risk relate to chart-confirmed colorectal cancer screening at cross-sectional and prospective time points. At baseline, deliberative and intuitive risk perceptions were negatively associated with chart-confirmed colorectal cancer screening adherence in bivariable but not multivariable analyses. Among those who were non-adherent with colorectal cancer screening at baseline, deliberative and intuitive risk perceptions were positively associated with prospective uptake of chart-confirmed colorectal cancer screening adherence at 12-months in bivariable analyses; only deliberative risk perceptions remained significant in the multivariable model. This study indicates that diverse risk perceptions are differentially important for screening at different time points.

Measurement invariance of intuitive cancer risk perceptions across diverse populations: The Cognitive Causation and Negative Affect in Risk scales

“…These constructs may be operative when personal cancer risk assessment is prompted during cancer control and prevention interventions. Indeed, CC and NAR have relevant behavioral correlates: CC and NAR with colorectal cancer screening adherence (Hay et al, 2016a) and patient activation (Hay et al, 2016b) and NAR with intention to undergo colonoscopy (Boonyasiriwat et al, 2014). Risk perception in diverse populations is an under-researched topic (Huerta and Macario, 1999).…”

Cancer beliefs and patient activation in a diverse, multilingual primary care sample

“…The first factor, Cognitive Causation, includes 10 items that tap into the belief that thoughts about cancer risk may encourage the development of disease, and that minimizing such thoughts could actually reduce cancer risk. Higher cognitive causation is related to reduced colorectal cancer‐screening adherence . The second factor, Negative Affect in Risk, includes 6 items and taps feelings generated during the risk perception process; this factor is also associated with reduced colorectal cancer‐screening intentions .…”

“…Higher cognitive causation is related to reduced colorectal cancer-screening adherence. 26 The second factor, Negative Affect in Risk, includes 6 items and taps feelings generated during the risk perception process; this factor is also associated with reduced colorectal cancerscreening intentions. 27 The third factor, Unpredictability of Cancer, keys into beliefs about irreducible uncertainties regarding whether any one person might get cancer.…”

“…Second, we examine associations between cancer risk beliefs, survey language, and patient activation in this population. Based on prior work indicating that cancer risk beliefs can present a barrier to cancer screening, we hypothesize that cancer risk beliefs will be lower in those with higher patient activation. Given the importance of patient activation in cancer control, understanding the relation of specific cancer risk beliefs to patient activation levels will enhance opportunities for tailored cancer control intervention development across diverse, multilingual populations.…”

Is the patient activation measure associated with adherence to colonoscopy after a positive fecal occult blood test result?

“…In a cross-sectional study of 378 patients with Inflammatory Bowel Disease [20], high self-efficacy was strongly correlated with colonoscopy adherence (OR 1.2. adjusted for health status and patient knowledge, p < 0.001). Hay et al [21] examined the role of risk perception in promoting colorectal cancer (CRC) screening behavior in a diverse, inner city, primary care population. Perception of the chance of developing CRC was significantly associated with adherence to screening recommendations.…”