Rebecca A. Ferrer’s research while affiliated with National Cancer Institute of Thailand and other places

Introduction: Accumulating evidence suggests that preconception epigenetic changes elevate the risk for obesity throughout the lifespan. Little is known about how parents may react to learning about parent-child epigenetic transmission of obesity risk. Further, it is unclear how trust in science may moderate these responses. Methods: We compared risk perceptions, behavioral intentions, perceived control, and information-focused ratings of 322 parents with high weight status who were randomized to read an article about the role of preconception epigenetics in intergenerational obesity risk transmission, versus three comparators that focused on genetics, family environment, or an unrelated topic. Results: Parents had largely similar reactions to the epigenetics, genetics, and family environment articles in terms of perceived credibility, relevance, and threat response, but the epigenetics article failed to produce the elevated cognitive (F(3, 310) = 3.027, p = 0.030) and affective/intuitive (F(3, 310) = 3.05, p = 0.029) risk perceptions observed in response to the genetics and family environment articles compared to control. Science trust moderated individual reactions to the epigenetics concepts, such that those with low science trust exhibited lower attentiveness to the epigenetics article (F(4, 249) = 2.92, p = 0.022), and groups with low, medium, or high science trust exhibited distinct reaction profiles in terms of affective/intuitive risk perception (F(6, 310) = 2.40, p = 0.028). Conclusion: An audience's trust in science should be considered when tailoring messages about the role of epigenetics in conveying obesity risk from parent to child.

Risk perceptions are instrumental in predicting how people will process and react to threats. While social contexts have long been associated with changes in risk perception, whether and which social contexts alter risk perceptions is not well understood. This paper explores one such social context––support-giving––which has previous links to affect, cognition, and behavior, including how threats are processed. Using a tripartite model in which risk perceptions are split between deliberative (logical), affective (emotional), and experiential (lived) assessments, we used two studies, a longitudinal-correlational (Study 1) and experimental (Study 2), to explore whether support-giving relates to and impacts risk perceptions. Findings from Study 1 revealed that support-giving toward a close other at Time 1 was associated with an increase in affective risk perceptions at Time 2. Study 2 clarified the direction of this association, finding that there was an increase in affective and experiential risk perceptions for those randomly assigned to a support-giving condition, as compared to the control. Deliberative risk perceptions did not differ between conditions. Given that affective risk perceptions strongly predict behavior, support-giving may be a promising new avenue by which to inspire preventative behavior.

Background Nearly 20% of US cancer survivors develop cardiovascular disease (CVD) from cardiotoxic cancer treatments. Patients and providers may consider alternative treatments to lower cardiotoxicity risk, but these may be less effective at preventing relapse/recurrence, presenting a difficult tradeoff. Aims This study explored survivors' cancer treatment decision‐making when weighing this tradeoff. Methods Using adjusted multivariable logistic regression, we examined 443 US survivors' risk perceptions (deliberative, affective, and intuitive) about cancer and CVD and associations of these with their selection between two hypothetical cancer treatments: Treatment A: 5% chance of cancer recurrence and 10% chance of CVD; Treatment B: 10% chance of recurrence and 5% chance of CVD. We explored the effects of delay discounting by randomizing to a condition describing cancer recurrence/CVD as either immediate or delayed. Results More survivors (Mage = 48, range = 18–93; M = 10.8 years post‐diagnosis) selected Treatment A than Treatment B ( 72% v. 28%) . Timing of onset was not associated with treatment selection. Greater affective risk perception (worry) about cancer was associated with increased odds of choosing Treatment A, whereas greater CVD worry was associated with decreased odds ( OR‐cancer = 1.33, p = 0.006; OR‐CVD = 0.72, p = 0.007). Neither deliberative nor experiential risk perceptions were associated with treatment choice. Conclusions Survivors were more likely to select the treatment that minimized recurrence rather than CVD—regardless of the timing of onset. Treatment decision was linked to both cancer‐ and CVD‐related worry but not deliberative or experiential risk perceptions. During treatment discussions, clinicians should open conversations about the risks of treatment‐associated cardiotoxicity, the probabilities, and patients' relative worries about cancer and cardiotoxicity.

Cancer-related pain affects a large proportion of all patients with cancer yet remains inadequately managed, particularly among patients from certain racialized backgrounds. Recently, there has been increased research and clinical interest in the use of medical cannabis for cancer pain management, including its potential to ameliorate race-based disparities in cancer pain control. Although medical cannabis is not currently a US Food and Drug Administration–approved treatment option for cancer-related pain, many oncologists discuss and recommend its use with their patients, underscoring the need for researchers and clinicians to proactively identify barriers to cannabis for cancer pain management that may disproportionately affect patients from certain racial groups. In this commentary, we highlight challenges that patients from racialized backgrounds may face when incorporating cannabis into their palliative care regimens and discuss opportunities for researchers and clinicians to address these challenges should medical cannabis become a recommended treatment option for cancer pain management. In particular, we identify challenges at the structural (eg, lack of insurance coverage), clinician (eg, racialized stereotypes regarding addiction and pain), and individual (eg, internalized stigma) levels and emphasize the importance of multilevel approaches in combating these challenges as the evidence base regarding medical cannabis and its potential harms and therapeutic benefits continues to accumulate.

Background: Cancer is one of the leading causes of death in the United States. It is critical to understand the associations among multilevel determinants of cancer prevention and control behaviors. This study examined associations of neighborhood factors with perceived risk of cancer and self-efficacy for reducing cancer risk. Methods: Cross-sectional analyses included 2324 U.S. adults from the Midlife in the U.S. Wave 3. Participants completed surveys of neighborhood environment (perceived neighborhood trust and safety, built environment conditions, social integration), perceived cancer risk and cancer prevention efficacy. Multivariate linear regressions examined associations of neighborhood context with risk perceptions and self-efficacy. Results: In the model that adjusted for sociodemographic characteristics, better perceived neighborhood trust and safety were associated with lower perceived cancer risk. In fully adjusted models for sociodemographic characteristics and contextual factors, higher perceptions of neighborhood trust and safety were associated with higher cancer prevention self-efficacy. Perceptions of better built neighborhood conditions and higher social integration were significantly associated with lower perceived cancer risk and higher perceived cancer prevention efficacy. Conclusions: Perceptions of neighborhood context may play a role in shaping psychosocial factors such as perceived cancer risk and self-efficacy, even after controlling for robust predictors of these perceptions.

Affective science is a broad and burgeoning field, and the National Institutes of Health (NIH) support research on a similarly broad range of topics. Across NIH, funding is available for basic, translational, and intervention research, including research in non-human animals, healthy populations, and those with or at risk for disease. Multiple NIH Institutes and Centers have specific programs devoted to topics within the affective science umbrella. Here, we introduce the funding priorities of these six: the National Cancer Institute (NCI), National Center for Complementary and Integrative Health (NCCIH), National Institute of Mental Health (NIMH), National Institute on Aging (NIA), National Institute on Drug Abuse (NIDA), and National Institute on Minority Health and Health Disparities (NIMHD). We then discuss overlapping themes and offer a perspective on promising research directions.

Behavior change can be challenging to facilitate and achieve. Behavior change frameworks largely focus on social cognitive determinants, omitting affective determinants or including them in a superficial way. However, evidence points to the role of affect in decision-making and behavior, particularly when the behavior at focus for change is affectively pleasant or when the behavior to be facilitated is affectively unpleasant. This paper identifies challenges and opportunities to further affective science by using behavior change as a context and, relatedly, to further the science of behavior change by leveraging theoretical and methodological innovations in affective science.

Racial and ethnic disparities in pain management pose significant challenges to equitable cancer care delivery. These disparities are driven by complex interactions between patient-, provider-, and system-related factors that resist reductionistic solutions and require innovative, holistic approaches. On September 19, 2022, the Society for Integrative Oncology (SIO) and the American Society of Clinical Oncology (ASCO) published a joint guideline to provide evidence-based recommendations on integrative medicine for cancer pain management. Integrative medicine, which combines conventional treatments with complementary modalities from cultures and traditions around the world, are uniquely equipped to resonate with diverse cancer populations and fill existing gaps in pain management. While some complementary modalities, such as music therapy and yoga, lack sufficient evidence to make a specific recommendation, other modalities, such as acupuncture, massage, and hypnosis, demonstrated an intermediate level of evidence, resulting in moderate strength recommendations for their use in cancer pain management. However, several factors may hinder real-world implementation of the SIO-ASCO guideline and must be addressed to ensure equitable pain management for all communities. These barriers include, but are not limited to, the lack of insurance coverage for many complementary therapies, the limited diversity and availability of complementary therapy providers, the negative social norms surrounding complementary therapies, the under-representation of racial and ethnic subgroups in the clinical research of complementary therapies, and the paucity of culturally attuned interventions tailored to diverse individuals. This commentary examines both the challenges and the opportunities for addressing racial and ethnic disparities in cancer pain management through integrative medicine.

BACKGROUND Research has established the effects of romantic relationships on individuals’ morbidity and mortality; however, the interplay between relationship functioning, affective processes, and health behaviors has been relatively understudied. During the COVID-19 pandemic, relational processes may affect novel health behaviors such as social distancing and masking. OBJECTIVE The objective of this manuscript is to contribute to health behavior survey research among couples by describing the design, recruitment, and methods of the Relationships, Risk Perceptions, and Cancer-Related Behaviors during the COVID-19 Pandemic (R2C2) Study. This study was developed to understand how relational and affective processes influence romantic partners’ engagement in cancer prevention behaviors as well as health behaviors introduced or exacerbated by the COVID-19 pandemic. METHODS The R2C2 study used online survey methods to recruit and enroll two cohorts of individuals involved in cohabiting romantic relationships, including one cohort of dyads (n=223 dyads) and one cohort of cancer survivors (n=443). Survey assessments were completed over two timepoints that were 5.57 weeks apart on average (SD=3.14). Health behaviors included COVID-19 vaccination and social distancing, physical activity, diet, sleep, alcohol use, and smoking behavior. We also examined relationship factors, psychological distress, and household chaos. RESULTS From October 2021 to July 2022, we enrolled a total of 926 participants, of which about two-thirds were from the UK (67.76%) and one-third were from the US (32.24%); about two-thirds were married (66.23%) and one-third were members of unmarried couples (32.02%). In Cohort 1 and 2, mean age was about 34 and 50, respectively. In Cohort 1, 3.97% identified as Hispanic/Latino/a, 16.53% Non-Hispanic Asian, 8.53% Non-Hispanic Black or African American, 0.42% Non-Hispanic Middle Eastern or North African, 4.81% Non-Hispanic Multiracial, 1.67% Non-Hispanic Other, and 64.02% Non-Hispanic White; 12.97% identified their sexual orientation as Bisexual or pansexual, 75.10% as heterosexual or straight, 11.09% as homosexual or gay or lesbian, and <1% as something else. In Cohort 2, 2.95% identified as Hispanic/Latino/a, 0.23% Non-Hispanic American Indian and Alaska Native, 1.82% Non-Hispanic Asian, 1.14% Non-Hispanic Black or African American, 0.45% Non-Hispanic Middle Eastern or North African, 2.95% Non-Hispanic Multiracial, and 90.45% Non-Hispanic White; 9.32% identified their sexual orientation as Bisexual or pansexual, 87.27% as heterosexual or straight, 2.95% as homosexual or gay or lesbian, and <1% as something else. The overall enrollment rate for individuals was 66.14% and the overall completion rate was 80.08%. CONCLUSIONS We discuss best practices for collecting online survey data for studies examining relationships and health, challenges related to the COVID-19 pandemic, recruitment of underrepresented groups, and enrollment of dyads; recommendations include conducting pilot studies, allowing for extra time in the data collection timeline for marginalized or underserved populations, surplus screening to account for expected attrition within dyads, as well as planning dyad-specific data quality checks.

Background Research has established the effects of romantic relationships on individuals’ morbidity and mortality. However, the interplay between relationship functioning, affective processes, and health behaviors has been relatively understudied. During the COVID-19 pandemic, relational processes may influence novel health behaviors such as social distancing and masking. Objective We describe the design, recruitment, and methods of the relationships, risk perceptions, and cancer-related behaviors during the COVID-19 pandemic study. This study was developed to understand how relational and affective processes influence romantic partners’ engagement in cancer prevention behaviors as well as health behaviors introduced or exacerbated by the COVID-19 pandemic. Methods The relationships, risk perceptions, and cancer-related behaviors during the COVID-19 pandemic study used online survey methods to recruit and enroll 2 cohorts of individuals involved in cohabiting romantic relationships, including 1 cohort of dyads (n=223) and 1 cohort of cancer survivors (n=443). Survey assessments were completed over 2 time points that were 5.57 (SD 3.14) weeks apart on average. Health behaviors assessed included COVID-19 vaccination and social distancing, physical activity, diet, sleep, alcohol use, and smoking behavior. We also examined relationship factors, psychological distress, and household chaos. Results Data collection occurred between October 2021 and August 2022. During that time, a total of 926 participants were enrolled, of which about two-thirds were from the United Kingdom (n=622, 67.8%) and one-third were from the United States (n=296, 32.2%); about two-thirds were married (n=608, 66.2%) and one-third were members of unmarried couples (n=294, 32%). In cohorts 1 and 2, the mean age was about 34 and 50, respectively. Out of 478 participants in cohort 1, 19 (4%) identified as Hispanic or Latino/a, 79 (17%) as non-Hispanic Asian, 40 (9%) as non-Hispanic Black or African American, and 306 (64%) as non-Hispanic White; 62 (13%) participants identified their sexual orientation as bisexual or pansexual, 359 (75.1%) as heterosexual or straight, and 53 (11%) as gay or lesbian. In cohort 2, out of 440 participants, 13 (3%) identified as Hispanic or Latino/a, 8 (2%) as non-Hispanic Asian, 5 (1%) as non-Hispanic Black or African American, and 398 (90.5%) as non-Hispanic White; 41 (9%) participants identified their sexual orientation as bisexual or pansexual, 384 (87.3%) as heterosexual or straight, and 13 (3%) as gay or lesbian. The overall enrollment rate for individuals was 66.14% and the overall completion rate was 80.08%. Conclusions We discuss best practices for collecting online survey data for studies examining relationships and health, challenges related to the COVID-19 pandemic, recruitment of underrepresented populations, and enrollment of dyads. Recommendations include conducting pilot studies, allowing for extra time in the data collection timeline for marginalized or underserved populations, surplus screening to account for expected attrition within dyads, as well as planning dyad-specific data quality checks. International Registered Report Identifier (IRRID) DERR1-10.2196/48516