Abstract
Objective: Communication of cancer information is an important element of cancer control, but cancer fear may lead to information avoidance, especially when coping is low. We examined the association between cancer fear and cancer information avoidance, and tested whether this was exacerbated by psychosocial stress.Design: Cross-sectional survey of 1258 population-based adults (58–70 years) in England.Main outcome measures: Cancer fear (intensity and frequency), perceived psychosocial stress and cancer information avoidance. Control variables were age, gender, ethnicity, marital status and education.Results: A quarter (24%) of respondents avoided cancer information. Ordinal logistic regression analyses showed main effects of psychosocial stress (OR = 1.17, 95% CI 1.07–1.29) and cancer fear: cancer information avoidance was lowest in those with no cancer fear (13%), followed by those with moderate (24%; OR = 2.15, 95% CI: 1.49–3.12), and high cancer fear (35%; OR = 3.90, 95% CI: 2.65–5.73). In the adjusted model, the interaction between cancer fear and stress was significant (OR = 1.14, 95% CI 1.004–1.29, p < .05): 40% of those with high fear/high stress avoided cancer information compared with 29% with high fear/low stress.Conclusion: Cancer fear and psychosocial stress interact to produce disengagement with cancer-related information, highlighting the importance of affective processes to cancer control efforts.
Highlights
Cancer control strategies include public communication on prevention and screening, but in order to be effective these communications need to reach their intended audience (Viswanath, 2005)
We examined the association between cancer fear and cancer information avoidance, and tested whether this was exacerbated by psychosocial stress
We examined the effects of cancer fear, perceived stress and their interaction on cancer information avoidance, using ordinal logistic regression analyses and controlling for demographic variables
Summary
Cancer control strategies include public communication on prevention and screening, but in order to be effective these communications need to reach their intended audience (Viswanath, 2005). When danger control strategies are not available, fear motivates actions to control the fear itself (fear control); for example, by denial, avoidance or downgrading the importance of the threat (Witte, 1992, 1998) If this response does not adequately control the threat, it will continue to elicit fear. Coping strategies play a central role in the EPPM in determining the behavioural response to the fear elicited by a threat This conceptualisation of resources determining the response to threatening information has been put forward by other authors using different theoretical underpinnings such as crisis decision theory (for example, Howell, Crosier, & Shepperd, 2014; Sweeny, 2008)
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