Perceptions Of Personal Health Research Articles

Socioeconomic and Racial/Ethnic Disparities in Perception of Health Status and Literacy in Spine Oncological Patients: Insights from the All of Us Research Program.

A cross-sectional study was performed using the National Institutes of Health All of Us survey database. The aim of this study was to assess socioeconomic and racial disparities in the perception of personal health, health literacy, and healthcare access among spine oncology patients. Racial, ethnic, and socioeconomic disparities in health literacy and perception of health status have been described for many disease processes. However, few studies have assessed the prevalence of these disparities among spine oncology patients. Adult spine oncology patients, identified using ICD-9/10-CM codes, were categorized by race/ethnicity: White/Caucasian (WC), Black/African-American (BAA), and Non-White Hispanic (NWH). Demographics and socioeconomic status were assessed. Questionnaire responses regarding baseline health status, perception of health status, health literacy, and barriers to healthcare were compared. Of the 1,175 patients identified, 207 (17.6%) were BAA, 267 (22.7%) were NWH, and 701 (59.7%) were WC. Socioeconomic status varied among cohorts, with WC patients reporting higher levels of education ( P<0.001 ), annual income greater than $50K ( P<0.001 ), and home ownership ( P<0.001 ). BAA and NWH patients reported greater rates of 7-day "Severe fatigue" ( P<0.001 ) and "10/10 pain" ( P<0.001 ) and lower rates of "Completely" able to perform everyday activities ( P<0.001 ). WC patients had a higher response rate for "Excellent/Very Good" regarding their own general health ( P<0.001 ) and quality ( P<0.001 ). The WC cohort had a significantly higher proportion of patients responding "Never" when assessing difficulty understanding ( P<0.001 ) and needing assistance with health materials ( P<0.001 ). BAA and NWH were significantly less likely to report feeling "Extremely" confident with medical forms ( P<0.001 ). BAA and NWH had significantly higher response rates to feeling "Somewhat Worried" about healthcare costs ( P<0.001 ) and with delaying medical care given "Can't Afford Co-pay" ( P<0.001 ). We identified disparities in perception of health status, literacy, and access among spine oncology patients. 4.

Evaluating the around and after Menopausal Symptoms and Personal Perception of Quality of Life among Women in Qatif, Saudi Arabia, Attending the Hospital and PHCs

Background: Menopause is a period where natural cessation of menses occurs, some quality of life characteristics changes with some symptoms associated with this time such as hot flushes and anxiety. Objective: To evaluate and specify the level of impact of these symptoms on the quality of life among women in the Qatif area, Saudi Arabia and to study the factors that may involve in their perception. Methods: A cross-sectional study was conducted of 151 women aged 40 - 60 years old interviewed at either hospital or PHCs, a translated and revised questionnaire of other studies with some adoption. Results: 151 women out of 200 participated in questionnaires, majority of them were highly educated having at least a bachelor’s degree around 80%, and around 75% of participants were either working or retired, with a moderate level of income and enjoying a good lifestyle 93% in around and 97% in the after menopause. With the majority, were not used hormones 95% or conceptive pills 91%, personal perception of health were high around 93% for around and 97.2% for after menopause with no significant statistical difference between the two groups. Conclusion: Perception and knowledge of menopause were very high, with no differences in the severity of symptoms of the four QOL domains for the around or after menopause among the participants. High level of education and increased level of income and knowledge of the participants may play an important role in the result, so further investigation is advised.

Health of Aging Families: Comparing Compound and Noncompound Caregivers

Providing care to a family member with disabilities takes a toll on the caregiver and the whole family's health. Among aging caregivers, compound caregiving (i.e., caring for additional family members) has become an increasingly common scenario. However, few research studies have focused on compound caregivers. Extant literature describes individual-level outcomes, with sparse knowledge on family-level outcomes. The present study examines the differences in the individual and family health of aging compound and noncompound caregivers, using the family quality of life framework. Web-based cross-sectional data collected from 112 aging caregivers (i.e., over 50 years) was analyzed using chi-square and independent sample t-tests to examine differences between caregivers. Compound caregivers had worse perceptions of personal health (t = -2.96, p = .004, d = -.61) than noncompound caregivers. In terms of family health, although all caregivers shared similar perceptions on the importance, opportunities, initiative, and stability, compound caregivers had lower attainment (t = -2.64, p = .009, d = -.44) and satisfaction (t = -3.90, p < .001, d = -.73) than noncompound caregivers. Findings have practice implications for identifying caregivers' multiple responsibilities. It is necessary to develop individual and family level programs focused on health promotion and caregiving training.

COVID-19 vaccine hesitancy: a survey in a population highly compliant to common vaccinations

ABSTRACT Vaccination is a key protective factor against COVID-19. Some vaccines have already received emergency authorization from Health Agencies, but growing skepticism and vaccine hesitancy will probably affect COVID-19 vaccination campaigns. In the attempt to shed light on this issue, we conducted an online survey in a population of parents referring to 4 pediatric practices in Naples, Italy in whom we evaluated potential vaccine acceptability in relation to socio-demographic characteristics, perception of personal health and of the impact of COVID-19, and attitudes toward general vaccination practices. Vaccination rates were analyzed also in the corresponding pediatric population. Almost 27% of participants declared they were in favor of vaccinations, and in fact real life vaccination rates in children exceeded the national mean. Only 26.5% of respondents declared they would receive COVID-19 vaccine. Vaccine refusal was attributed to safety concerns in 76% of parents. Specific vaccine attributes further reduced the acceptance rate. Female gender, younger age and lower education level were associated with non-adherence to vaccination. Among extrinsic factors of COVID-19 vaccination, only information from National Health Authorities was significantly associated to vaccine acceptance. The rate of potential COVID-19 vaccine acceptability was very poor in our population of parents. Vaccine hesitancy was mainly due to safety concerns. Demographic and educational factors were correlated to vaccine acceptability. Health education and communication strategies are needed to achieve large-scale vaccine acceptability and finally herd immunity.

The partisan cues and perceived risks: the effect of partisan social media frames during the COVID-19 crisis in Mexico

ABSTRACT We present the results of a survey experiment designed to evaluate the effects of social media exposure on perceptions of personal health and job risks during the COVID-19 pandemic in Mexico. Our framing experiment treats respondents to positive and negative partisan messages from high-level politicians. Descriptive findings show divergent evaluations of how the government is addressing the crisis by supporters of the government and opposition parties. Results show that respondents are sensitive to negative frames regardless of the political color of the messenger. Further, supporters of the incumbent are more likely to deflect government’s responsibility when treated with a negative frame by a politician from the opposition.

Barriers and facilitators to a healthy lifestyle in postpartum women: A systematic review of qualitative and quantitative studies in postpartum women and healthcare providers.

A healthy postpartum lifestyle is vital for the promotion of optimal maternal health, return to pre-pregnancy weight and prevention of postpartum weight retention, but barriers exist. We performed a systematic review that aimed to describe the barriers and facilitators to a healthy lifestyle in the first 2 years postpartum from the perspectives of women and healthcare providers. Databases were searched for eligible studies published up to 26 August 2019. Following thematic analysis, identified themes were mapped to the Theoretical Domains Framework and the Capability, Opportunity, Motivation and Behaviour model. We included 28 qualitative and quantitative studies after screening 15,643 citations and 246 full texts. We identified barriers and facilitators relating to capability (e.g., lack of knowledge regarding benefits of lifestyle behaviours; limitations in healthcare providers' skills in providing lifestyle support), opportunity (e.g., social support from partners, family, friends and healthcare providers; childcare needs) and motivation (e.g., identifying benefits of exercise and perception of personal health; enjoyment of the activity or food). We suggest intervention components to include in lifestyle interventions for postpartum women based on the identified themes. Our findings provide evidence to inform the development of interventions to support postpartum women in adopting and maintaining a healthy lifestyle.

Personal Perception of Health in Urban Women of Low Socioeconomic Status: A Qualitative Study.

Introduction: Women of low socioeconomic status experience health disparities that contribute to poor outcomes. Objectives: The purpose of this study was to explore self-perception of health and health promoting behaviors in women who were patients in a federally qualified health center. Methods: A qualitative descriptive design was used to interview 19 women. The researchers conducted content analysis and used descriptive statistics to present participant demographics. Results: Women viewed health primarily as physical and themselves as healthy, in-between healthy and unhealthy, or unhealthy. Healthy women made more active attempts to improve their health, while not healthy women reported twice as many barriers to health maintenance and felt defined by their illnesses. Conclusion: Findings support that a women’s self-perception of health is aligned with self-management health behaviors and health outcomes.

The impact of health anxiety on perceptions of personal and children's health in parents with Lynch syndrome.

This study examined the differences in perceptions of one's health and one's child's health between parents with Lynch syndrome (LS) characterized with high versus low health anxiety. Twenty-one parents completed semistructured telephone interviews about their perceptions of their own health and the health of their children. Qualitative content analysis using a template coding approach examined the differences between parents with high and low health anxiety. Findings revealed that the most prevalent difference emerged on perceptions of personal health, showing individuals with high health anxiety reported more extreme worries, were more hypervigilant about physical symptoms, experienced the emotional and psychological consequences of LS as more negative and severe, and engaged in more dysfunctional coping strategies than those with low health anxiety. Unexpectedly, with regards to perceptions of their children, parents in the high and low health anxiety groups exhibited similar worries. However, high health anxiety parents reported using dysfunctional coping about their children's health more frequently than those with low health anxiety. The findings suggest that health anxiety is of clinical significance for individuals with LS. Accurately identifying and treating health anxiety among this population may be one avenue to reduce the distress experienced by LS carriers.

Structured intervention plan including component-resolved diagnostics helps reducing the burden of food allergy among school-aged children.

Food allergies can substantially burden patients and families by negatively affecting finances, social relationships, and personal perceptions of health. This study was performed under the Finnish Allergy Programme aimed at reducing avoidance diets to foods in schoolchildren by 50%. The main goal of this study was to investigate how many children could be freed from diet restrictions in a Finnish school district through a diagnostic algorithm including component-resolved diagnostics and food challenge. The secondary aim was to provide a crude estimate of the burden of the elimination food diets in the region, and the savings associated with the proposed intervention. A total of 205 children on a food avoidance diet according to the school register because of food allergy were invited into the study. One hundred and fifty-seven children were interviewed, tested for IgE to extracts and allergen components and food challenged in respective order. After two years, 12 children still had an avoidance diet and three of them were treated successfully with sOTI; the rest suspended their avoidance diet (n=134) or dropped out of the study (n=11). The cost of the elimination diets was estimated in 172700€ per year at start and 13200€ per year at the end of the study; total savings were 128400€ yearly. The results demonstrate a 65% reduction of avoidance diets to foods in school-aged children, exceeding the 50% aim of the Finnish Allergy Programme. Therefore, it is possible to actively reduce the number of food allergy diagnoses that remain unmonitored in the society through a tailored diagnostic work-up.

STRUCTURED INTERVENTION PLAN WITH COMPONENT-RESOLVED DIAGNOSTICS HELP REDUCE THE BURDEN OF FOOD ALLERGY IN CHILDREN

Introduction Food allergies can substantially burden patients and families by negatively affecting finances, social relationships and personal perceptions of health. This study was performed under the Finnish Allergy Programme aimed at reducing avoidance diets to foods in schoolchildren by 50%. The goal of this study was to investigate how many children could be freed from diet restrictions in a school district through a diagnostic algorithm including Component-Resolved Diagnostics and food challenge. The secondary aim was to provide a crude estimate of the burden of the elimination food diets and the savings associated to the proposed intervention. Methods 205 children with food avoidance diet according to the school register because of food allergy, were invited into the study. 157 children were interviewed, tested for IgE to extracts and allergen components and food challenged in respective order. Results After two years, 12 children still had an avoidance diet and three of them were treated successfully with OIT; the rest suspended their avoidance diet (n=134) or dropped out of the study (n=11). The cost of the elimination diets was estimated in 172700€ per year at start, 13200€ per year at the end of the study; total savings were 128080€ yearly. Equivalent cost savings for the US will be presented. Conclusions The results demonstrate a 65% reduction of avoidance diets to foods in school-aged children, exceeding the 50% aim of the Finnish Allergy Programme. Therefore, it is possible to actively reduce the number of food allergy diagnoses that remain unmonitored in the society through a tailored diagnostic work-up.

Hiperfrecuentación médica en mayores y salud.

El envejecimiento demográfico de la población, su intensificación a medio plazo y el incremento de los gastos farmacológicos, sanitarios y en servicios sociales de las personas mayores pone en riesgo la sostenibilidad económica del presupuesto sociosanitario público, por lo que es necesario mejorar la eficacia de este gasto. El objetivo de este estudio es realizar una revisión del estado de la cuestión sobre el uso excesivo, por parte de algunas personas mayores, de los servicios sanitarios. De forma que se defina cuál es el perfil de ese mayor y los hábitos que lo caracterizan. Se ha realizado una revisión sistemática en las bases de datos Scopus, Pubmed y Web of Science utilizando como descriptores: hiperfrecuentación médica (number of visits to the doctor), gasto en salud (heath expenditure), personas mayores (elderly) y calidad de vida (quality of life). Según los estudios consultados un mayor de 65 años gasta 3,2 veces más en salud que personas de menor edad, consumiendo el 40,3 del gasto total en sanidad. Desde el enfoque subjetivo, se centra en la percepción personal de la salud, un aspecto que es esencial a la hora de predecir o buscar ayuda médica. De hecho, la percepción del propio estado de salud está más asociada al uso de los servicios de salud que la propia condición clínica o patológica del sujeto. Otro de los problemas más relevantes en la indagación del estado de salud es la importancia que tiene el autoconcepto y la autoestima, junto con el estado de ánimo del sujeto, en la evaluación que hace el mismo de su estado de salud. Tanto una autoestima baja como los estados y procesos depresivos tienden a ir asociados con una evaluación negativa de la misma y todo ello, a requerir un mayor uso de los servicios sanitarios, sin existir, en muchas ocasiones una necesidad real de atención médica.

Health behaviours of young mothers: Implications for health promotion and cancer prevention.

Objective:Evidence suggests that younger mothers engage in poorer health behaviours, resulting in increased cancer risk. We aimed to better understand the health behaviours of younger mothers and the factors that influence their lifestyle choices, in order to improve cancer prevention within this population.Methods:A multiple focus group, photo-elicitation-aided approach was used, in which young mothers (n = 27; aged 16–24 years) were provided with cameras and asked to capture ‘a week in your life’. Photographs were developed and participants invited to an initial focus group where photographs were used to elicit discussion, exploring participants’ health behaviours. Data were thematically analysed particularly identifying themes relating to barriers and facilitators of positive health behaviours. Participants were later invited to participate in a second focus group, to explore and validate identified themes further.Results:Themes emerged from the data relating to (1) the mothers’ personal perceptions of health, (2) health-related behaviours and (3) beliefs about cancer and its causes. Barriers to positive health behaviours included a lack of money, childcare and cookery skills; facilitators included the social media, commercial weight loss programmes and local community organisations.Conclusion:Study findings provide insight into the health behaviours and life choices of young mothers. They help illustrate health perceptions in relation to cancer risk, providing an understanding of how their daily routine and circumstance influence young women’s decisions and lifestyle behaviour choices and highlighting barriers to, and facilitators of, positive health behaviours. Data hold potential to inform future health-related research among young mothers, particularly relating to cancer prevention intervention.

계획행동이론(TPB)에 기초한 여가교육이 중년여성의 건강인식 및 생성감에 미치는 영향

계획행동이론(TPB)에 기초한 여가교육이 중년여성의 건강인식 및 생성감에 미치는 영향

Self-Assessed Health into Late Adulthood

Abstract. Self-assessed health (SAH) is the personal assessment of one’s own health ( Idler &amp; Benyamini, 1997 ; Jylhä, 2009 ). It is often measured using a single item asking whether adults rate their health as excellent, very good, good, fair, or poor. When measured at a single point in time, SAH relates to a variety of short-term and long-term health outcomes and behaviors, including morbidity, healthcare utilization, and mortality ( Benyamini, 2008 ; Mossey &amp; Shapiro, 1982 ; Westerhof &amp; Wurm, 2015 ). Recently, attention has shifted away from examining SAH at a single point in time toward understanding whether SAH trajectories can better predict health outcomes ( Ayyagari et al., 2012 ; Schmitz et al., 2013 ). Therefore, it is critical to understand the factors contributing to the SAH process. This article provides a multidisciplinary overview of SAH and SAH change while illustrating the benefits of adopting a lifespan approach in future research. The current SAH literature, including cross-sectional and longitudinal studies, is used to examine what is known about the SAH process into late adulthood. From the literature, it is clear SAH is a multidimensional construct, susceptible to age-related change and sociohistorical contexts. Understanding the developmental mechanisms and multiple influences underlying change, however, may help further the use of SAH as a life-long health-promotion tool. Lifespan concepts are applied to expand discussion and recommendations are made concerning the application of alternative variables and methodologies. Future studies of SAH should consider these personal perceptions of health not only as predictors of health outcomes in later life, but also as tools for effective health promotion in everyday life.

Factors associated with quality of life in a cohort of patients with palliative advanced cancer from a developing country: Relevance of perception of cancer curability.

93 Background: Improving quality of life (QOL) is a key goal in palliative care for patients with advanced cancer. Most studies about QOL in palliative care patients have been performed in the developed world. However, little is known about the factors that influence patients QOL in developing countries. The aim of this study is to describe factors associated with QOL in a cohort of patients with advanced cancer who were enrolled in the outpatient clinic public hospital in Santiago, Chile. Methods: Patients with advanced cancer admitted to the National Program of Palliative Care at a public Hospital in Santiago, Chile were prospectively enrolled in a study to assess QOL longitudinally. QOL was assessed with the EORTC-QLQ-PAL 15 questionnaire. Demographics, symptom intensity, depression and anxiety were assessed. Descriptive statistics and regression analysis were performed. Information about cancer curability and perception of personal health were also included. Results: In this preliminary report, the first 37 patients were included. Baseline characteristics were: mean patient age was 64, 21 (57%) females, 14 (38%) had GI cancer, 7 (19%) lung cancer, 4 (11%) breast cancer and 12 (22%) other. Mean (SD) QOL was 63 (34) in a 0 to 100 scale. QOL was not associated with age, gender, functionality, depression, anxiety, spiritual pain or financial distress. QOL was negatively associated with total symptom burden (coef -.53, p = .48), and positively associated with believing that cancer was curable (coef 33.3, p = .003). In a multivariate analysis, QOL was independently associated with both lower overall symptom burden (coef -.55, p = .38) and believing that cancer was curable (coef 28.6, p = .009). Conclusions: In palliative care patients with advanced cancer from a developing country, QOL was associated with lower overall symptom burden and with believing that cancer was curable. Further studies are needed to explore whether clarifying prognostic information about cancer curability in developing countries may impact patients’ QOL.

Perceptions of nursery staff and parent views of healthy eating promotion in preschool settings: an exploratory qualitative study.

BackgroundIn the UK just over a fifth of all children start school overweight or obese and overweight 2–5 year olds are at least 4 times more likely to become overweight adults. This can lead to serious future health problems. The WHO have recently highlighted the preschool years as a critical time for obesity prevention, and have recommended preschools as an ideal setting for intervention. However, existing evidence suggests that the preschool environment, including the knowledge, beliefs and practices of preschool staff and parents of young children attending nurseries can be a barrier to the successful implementation of healthy eating interventions in this setting.MethodsThis study examined the perceptions of preschool centre staff and parents’ of preschool children of healthy eating promotion within preschool settings. The participants were preschool staff working in private and local authority preschool centres in the North East of England, and parents of preschool children aged 3–4 years. Preschool staff participated in semi-structured interviews (n = 16 female, 1 male). Parents completed a mapping activity interview (n = 14 mothers, 1 father). Thematic analysis was applied to interpret the findings.ResultsComplex communication issues surrounding preschool centre dietary ‘rules’ were apparent. The staff were keen to promote healthy eating to families and felt that parents needed ‘education’ and ‘help’. The staff emphasised that school policies prohibited providing children with sugary or fatty snacks such as crisps, cakes, sweets and ‘fizzy’ drinks, however, some preschool centres appeared to have difficulty enforcing such guidelines. Parents were open to the idea of healthy eating promotion in preschool settings but were wary of being ‘told what to do’ and being thought of as ‘bad parents’.ConclusionsThere is a need to further explore nursery staff members’ personal perceptions of health and how food policies which promote healthier food in preschool settings can be embedded and implemented. Family friendly healthy eating strategies and activities which utilise nudge theory should be developed and delivered in a manner that is sensitive to parents’ concerns. Preschool settings may offer an opportunity for delivery of such activities.

The Feasibility, Safety, and Efficacy of Using a Wireless Pedometer to Improve the Activity Level in a Cohort of Nurses.

This study had two aims: (1) to test the feasibility, safety, and efficacy of using a wireless pedometer in a cohort of nurses; and (2) to understand if wireless pedometer use increased number of steps walked, number of flights of stairs climbed, daily activity level, and improved personal perception of health. This study used a nonexperimental exploratory design to test the feasibility and efficacy of using a wireless pedometer in a cohort of nurses. Pre- and posttest measures captured the number of steps walked, flights of stairs climbed, activity level, and perception of health. Sample characteristics: 27 females, 3 males; 90% non-Hispanic Caucasian, 3% Hispanic; 47% between the ages of 55 and 65 years. Eighty percent of the participants reported that they were caregivers of other people. There was a significant increase from baseline to the end of the study in the following measures: self-perception of steps walked ( p < .001), flights of stairs climbed ( p < .005), self-perception of daily activity ( p < .001), and although there was an improvement in self-perception of health, the change was not significant. The wireless pedometer was a feasible, safe, and efficacious device to use. This study may have implications for interventions aimed at improving caregiver health.

A qualitative study on Canadian youth's perspectives of peers who smoke: an opportunity for health promotion.

BackgroundPeer influence, peer selection, and health risk awareness are factors in smoking among youth. Despite the numerous studies on the social context, social network, and how youth define themselves and their smoking status in relation to tobacco use, qualitative knowledge about the role of smoking within peer relationships from youth themselves is only emerging. In this paper, qualitative findings describing Canadian youth’s perspectives and experiences of smoking within the context of peer relationships are presented.MethodsTo examine youth’s perceptions, a qualitative research study design was used. Seventy-five Canadian youth aged 11–19 years participated in open-ended interviews, focus groups, and photovoice methods. Data analysis involved several levels of analysis consistent with qualitative research.ResultsYouth who smoked were perceived by non-smoking peers as less popular and less socially accepted as represented by the theme: The coolness (not so cool) factor. Non-smoking youth felt that peers who smoked strained relationships and forced them to set boundaries and negotiate friendships as denoted by the theme: Negotiating friendships: Being influenced, but also influencing. Finally, in the theme of Making sense of peers who smoke, youth struggled to understand peers who continued to smoke and why they would start in the first place.ConclusionsAs reinforced in this study, Canadian youth increasingly view smoking as unhealthy and uncool. Moreover, youth report resisting peer influence to smoke and in fact, are now influencing their friends who smoke to quit. The self-empowerment stories of non-smoker youth reinforces the idea that the social meaning of smoking with peers is continuing to change from one where youth accepted and participated in the smoking behaviors of their peers, to an environment where youth’s perceptions of personal health is paramount. Findings from this study could be used to guide health promotion and smoking prevention programs and campaigns for youth.

Abstract P4-08-03: Evaluating the opportunity and need for communicating breast cancer risk reduction messages to US women

Abstract Background: Before women can modify lifestyle factors to reduce breast cancer risk, they need to know which factors affect risk. This study aimed to identify the extent to which US women are aware of factors that can influence breast cancer risk, as well as develop a profile of women most interested in taking steps to reduce their risk. Methodology: A nationally representative sample of 1,692 women was obtained, with enhancements for specific groups, including mothers aged 25-39, African American, and Hispanic women. The women were sent a link to a short online survey Nov. 6-16, 2012. The survey had an 87% completion rate. The survey was available in English and Spanish and asked about the women's perceptions of personal health and lifestyle choices related to breast cancer risk, their knowledge of risk factors and action steps to reduce breast cancer risk, and their interest in learning more about risk factors and action steps to reduce risk. Results: The respondents’ ages ranged from 18 to 65, with 74% being 30-65. 68% of the women identified as white, 14% as Latina, 12% as African American, and 1% as Asian. Most of the women had had a child (74%). 2.6% of the women had been diagnosed with breast cancer. 65% of the women said they were a little or very overweight. Overall, the women believed that family history or a genetic mutation caused breast cancer 45.5% of the time. Lifestyle choices were thought to cause breast cancer 29.3% of the time and environmental exposures were thought to cause breast cancer 25.2% of the time. Regarding perceived impact of certain behaviors on breast cancer risk, more than half the women believed that not smoking/avoiding second-hand smoke, managing weight, avoiding unnecessary radiation, avoiding/limiting extra hormones, exercising, eating “real” food, getting the right amount of vitamin D, eating a plant-based diet, limiting alcohol consumption, breastfeeding, buying organic produce, using non-harmful personal care products, and cooking/storing food in non-reactive containers have a moderate to strong impact on reducing breast cancer risk. Yet the percentage of women who actually did each behavior was lower than the percentage of women who believed the factor had a moderate to strong impact on reducing risk for most of the factors. Most of the women (78%) were interested or very interested in learning how to reduce risk. Women who were committed to reducing risk and planned to seek out more information were most likely to be white, aged 30-51, have at least one child, and a little overweight. The top three factors these women wanted to learn more about were exercise (41%), monitoring weight (35%), and eating “real” food (30%). In contrast, these women were relatively uninterested in learning how to reduce their alcohol consumption (12%). Conclusion: The knowledge gap between the perceived causes of breast cancer and the putative causes of breast cancer is large, and the gap between the perceived impact of certain lifestyle factors on risk and actually doing these behaviors is even larger. There is opportunity to increase awareness of many important steps to reduce breast cancer risk. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-08-03.

To have or not to have another child: Life cycle, health and cost considerations of Ghanaian women

Given that fertility rates are high in most sub-Saharan countries, it is critically important to understand the drivers of the demand for children to inform population reduction policies. Yet little is known about the individual-level factors that drive the desire for fertility limitation. The desire to limit births may be driven by the achievement of family size targets. However, since children are born at different stages of the life course, fertility desires may also be influenced by past reproductive, socio-economic experiences, and perceptions about future welfare. In this study, the determinants of the desire to stop childbearing were analyzed at the individual-level using prospective longitudinal data (1998–2003) on the reproductive lives of women in six communities in southern Ghana. Using variation within-woman, we modeled the impact of changes in reproductive life cycle events, health status, perceptions of future household economic conditions, perceptions of the cost of additional children, and spousal interactions on a woman’s fertility preferences. We found that the desire to stop childbearing is influenced by reproductive life stage (such as age, parity); events (marital transitions, child death); perceptions of personal health (particularly anticipated demands of the next pregnancy on the woman’s health); the household’s economic welfare; and the overall subjective cost of children. The economic utility models which emphasize cost/benefit considerations, as well as the anthropological and sociological theories which emphasize norms, appear to be validated in this empirical analysis in that both subjective elements and normative considerations are incorporated into fertility decisions.