Behavioral dimensions in cancer prevention and detection.

Abstract

Changing health habits requires changing one's lifestyle, which is often difficult and takes time. Education alone does not motivate people to modify their health behaviors. Studies supporting the health belief model have shown that if individuals perceive they are susceptible to an illness and believe it is a serious illness, they may be motivated to take action if the perceived benefits outweigh the perceived barriers to taking actions. Social learning theory likewise reinforces learned behaviors. The important key to cancer control is to change particular behaviors and sustain the activities that are involved in the new behaviors. Such a goal requires repeated efforts and a combination of interventions. First, educational efforts made by physicians or nurses can be instrumental in teaching patients and families about risk factors and what they can do to minimize them. Second, individual contacts are also effective but their effect on long-term change is questionable. Repeated follow-up is costly and may not be the most efficient cancer screening technique. Third, group efforts are also effective, but again, long-term maintenance remains a problem. Fourth, mass media efforts at health education reach large numbers of individuals, but the audience is selective in what it hears. Finally, a fifth strategy not discussed earlier is one that removes any voluntary or conscious control through governmental regulation or political means. Examples of effective changes to the population's health have been the reduction of the speed limit, the limitation on smoking in certain environments, and legislation requiring the use of seat belts. Although these methods have been effective in improving health, they do remove the autonomy and personal responsibility people have for their own health. Despite the numerous studies that have been conducted, it is still not clear whether provision of information leads to a change in attitude, which in turn changes the behavior in question. Or conversely, does a change in behavior lead to a change in attitude? In conclusion, the major question that remains is how best to motivate people to learn about and practice preventive health techniques. Further long-term studies are needed to ascertain how attitudes can be modified so that individuals incorporate healthful beliefs and actions into their daily routines. Through such careful research, understanding of the behavioral dimensions of cancer prevention will improve and better control of cancer will be achieved.