Perceived Ambiguity About Cancer Prevention Recommendations: Relationship to Perceptions of Cancer Preventability, Risk, and Worry
Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland 20892-7363, USA. Journal of Health Communication
(Impact Factor: 1.61).
02/2006; 11 Suppl 1(sup001):51-69. DOI: 10.1080/10810730600637541
In this study, we apply the concept of "ambiguity," as developed in the decision theory literature, to an analysis of potential psychological consequences of uncertainty about cancer prevention recommendations. We used Health Information National Trends Survey (HINTS) 2003 data to examine how perceived ambiguity about cancer prevention recommendations relates to three other cognitive variables known to influence cancer-protective behavior: perceived cancer preventability, perceived cancer risk, and cancer-related worry. Using logistic regression analyses, we tested several predictions derived from a review of literature on the effects of ambiguity perceptions on decision making, cognitions, and emotions. We found perceived ambiguity to have a strong negative relationship with perceived cancer preventability, consistent with "ambiguity aversion"-a pessimistic bias in the interpretation of ambiguity. Cancer worry moderated this relationship; ambiguity aversion increased with higher levels of worry. At the same time, perceived ambiguity was positively related to both perceived cancer risk and cancer worry. Furthermore, perceived risk partially mediated the relationship between perceived ambiguity and worry. These findings suggest that perceived ambiguity about cancer prevention recommendations may have broad and important effects on other health cognitions. We discuss ethical implications of these findings for health communication efforts, and propose a tentative causal model to guide future research.
Available from: William MP Klein
- "Many people believe that there is much ambiguity in recom - mendations for cancer prevention and in what we know about the causes of cancer . These perceptions can be prob - lematic if they provoke maladaptive anxiety and reduced interest in taking protective actions . As observed in previous samples ( e . g . , Han et al . , 2006 ) , participants in the current study believed that health messages about cancer prevention are confusing , and nearly all participants endorsed the state - ment ' ' it seems like everything causes cancer . ' ' Such percep - tions are endorsed by a wide range of people varying in age , minority status , and SES ( Han et al . , 2009 ) . "
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ABSTRACT: The perception that extant health messages about risk factors for a disease are ambiguous can be associated with greater anxiety and reduced interest in taking precautionary action. In this experiment, 247 female alcohol consumers who perceived varying degrees of ambiguity in current cancer prevention messages read an unambiguous article about the documented link between alcohol consumption and breast cancer. Before reading the article, half were given the opportunity to self-affirm by reflecting on an important value-a technique previously shown to enhance receptivity to threatening messages. The authors found that self-affirmation increased message acceptance among those who perceived relatively higher levels of ambiguity in cancer communications. Also, the relation between perceived ambiguity and risk perception became positive among self-affirmed participants, suggesting they had become less defensive. Self-affirmation may be an effective technique to use when delivering health communications to audiences who perceive a lack of consistency in prevention messages.
Journal of Health Communication 03/2015; 20(5):1-7. DOI:10.1080/10810730.2014.999892 · 1.61 Impact Factor
Available from: PubMed Central
- "Arkes and Gaissmaier noted a preferential response to information presented in graphic versus quantitative forms . However, some data suggest the need to consider how factors, such as perceived ambiguity of cancer screening guidelines, might affect health attitudes (worry, fear, and anxiety) after risk information is presented . "
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ABSTRACT: Informed decision making requires that those individuals making health and health-care decisions understand the advantages and disadvantages associated with particular health options. Research and theory suggest factors that contribute to the decision-making process: data on the likelihood of risks and benefits, level of certainty about outcomes, familiarity with the health issue, characteristics of information sources and presentation, and patient values and beliefs. As the health information environment increases in complexity, it becomes important to understand how interactions among information sources, family, and friends may affect the processing of health information and choices and their alignment with available evidence.
This paper discusses the potential interactions among social networks, information sources and evidential preferences for health information as they influence health decisions. The role of family and friends who increasingly search for health information for others and the potential for information filtering influenced by second- or third-party attitudes and preferences is explored. Evidential preferences suggestive of the potential value of social math (creatively presented statistics) strategies for presenting data, the information-processing factors that may make personal experiences, anecdotes and testimonials that are often shared within social networks and may exert powerful influences on health decisions are examined in this article.
The paper concludes with recommendations for revised health-communication practices, health professional training to improve patient understanding in the clinical encounter, and directions for future research. Simple, direct, and socially relevant communications that avoid conflicts with the values and beliefs of the individual, as well as those of the family and social network, are recommended.
BMC Medical Informatics and Decision Making 12/2013; 13 Suppl 3(Suppl 3):S7. DOI:10.1186/1472-6947-13-S3-S7 · 1.83 Impact Factor
Available from: Kerry A Sherman
- "Halbert and colleagues evaluated acceptance of BRCA1/2 test results in 157 African American women at high and moderate risk for having a deleterious mutation who were offered genetic testing through a genetic counseling research program. They found that women who were less certain about their risk of developing breast cancer were approximately three times more likely to receive BRCA1/2 test results compared to women who reported greater certainty, suggesting that ambiguity reduction is a strong motivator of decision making (Han et al. 2006). "
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ABSTRACT: Breast cancer is a significant health concern for African American women. Nonetheless, uptake of genetic risk assessment (including both genetic counseling and testing) for breast cancer gene mutations among these populations remains low. This paper systematically reviews cognitive (i.e., beliefs) and affective (i.e., emotions) factors influencing BRCA1/2 genetic risk assessment among African American women as well as psychosocial interventions to facilitate informed decision making in this population. A systematic search of CINAHL, PubMed, and PsycINFO was undertaken, yielding 112 published studies. Of these, 18 met the eligibility criteria. African American woman are likely to participate in genetic risk assessment if they are knowledgeable about cancer genetics, perceive a high risk of developing breast cancer, have low expectancies of stigmatization from medical professionals, view themselves as independent from family, and have fatalistic beliefs and a future temporal orientation. Anticipated negative affective responses, such as an inability to "handle" the results of testing, are barriers to uptake. Specific perceptions, beliefs, and emotional factors are associated with genetic risk assessment among African American women. Understanding these factors is key in the development of interventions to facilitate informed decision making in this population.
Journal of community genetics 08/2013; 5(2). DOI:10.1007/s12687-013-0164-y
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