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Biomedical subjects

Richard P Moser

Publications and source records attributed to Richard P Moser.

13 recordsLinked to original sources

Concerns about the consequences of cancer predisposition and relationships with quality of life in young adults with Li-Fraumeni syndrome.

Li-Fraumeni syndrome (LFS) is an inherited condition associated with high multi-organ cancer risks from birth. Young adults (YAs; 18-39 years) with LFS experience psychosocial challenges that may negatively affect health-related quality of life (HRQOL). This study aimed to describe a specific psychosocial challenge, concerns about the consequences of LFS (CC-LFS), and investigate relationships among CC-LFS and HRQOL among YAs. An online survey assessed CC-LFS and HRQOL among YAs with LFS enrolled in a National Cancer Institute study. Regression analyses examined relationships between CC-LFS and HRQOL scores, adjusted for age, cancer, and history of mental health challenges. Of 37 total respondents (78% female; Mage&#x2009;=&#x2009;31 years), 51% had a cancer history. Many reported past mental health challenges, including emotional problems (70%), depression/anxiety disorders (68%), and suicidal ideation (43%). Mean scores for mental (M&#x2009;=&#x2009;65.8), physical (M&#x2009;=&#x2009;67.5), and general (M&#x2009;=&#x2009;63.9) HRQOL were lower than in the general population. Higher CC-LFS scores (M&#x2009;=&#x2009;31/50, SD&#x2009;=&#x2009;7.2) were associated with lower scores for each HRQOL domain. Adjusting for covariates, higher CC-LFS scores were associated with lower physical HRQOL (&#x3b2;&#x2009;=&#x2009;-0.491, 95% CI -0.76, -0.22, p&#x2009;<&#x2009;0.001) and general HRQOL (&#x3b2;&#x2009;=&#x2009;-0.466, 95% CI -0.77, -0.16, p&#x2009;=&#x2009;0.004), but not mental HRQOL (p&#x2009;=&#x2009;0.102). CC-LFS accounted for significant proportions of unique variance in general (R2adj&#x2009;=&#x2009;17.7%, p&#x2009;=&#x2009;0.004) and physical HRQOL (R2adj&#x2009;=&#x2009;20.4%, p&#x2009;<&#x2009;0.001). Findings suggest YAs with LFS may experience substantial concerns, mental health challenges, and diminished HRQOL. Concerns about LFS consequences appear to be a psychosocial risk factor that clinicians and researchers might address through targeted interventions to improve YAs' psychosocial health.

Humans↗

Associations of perceived risk and worry with cancer health-protective actions: data from the Health Information National Trends Survey (HINTS).

This study examined the associations of susceptibility, conceptualized as both a cognition (risk) and as affect (worry) and their possible interaction, with cancer screening behaviors. Data for this study were obtained from the 2003 Health Information National Trends Survey (HINTS). Hierarchical regression models assessed the ability of risk, worry and their interaction (after controlling for other important variables) to predict cancer-screening behaviors. Results found that risk and worry (but not their interaction) were associated with regular mammography screening and having had a sigmoidoscopy or colonoscopy but with neither FOBT nor PSA screening. The findings suggest that risk and worry are both important in predicting some types of screening behavior and that these variables operate independently.

Female↗

Identifying sedentary subgroups: the National Cancer Institute's Health Information National Trends Survey.

BACKGROUND: Developing effective interventions for the 24% to 28% of U.S. adults who are sedentary requires a better understanding of the factors related to sedentary lifestyles as well as the communication channels to reach various subgroups. This study identified key sociodemographic and health communication characteristics of various subgroups with high rates of inactivity using signal detection methodology. METHODS: The sample from the nationally representative Health Information National Trends Survey 2003 (n=6369) was randomly split into two samples. Exploratory analyses (conducted 2004 and 2005) were employed on the first sample to identify various subgroups, and the stability of inactivity rates in those subgroups was examined in the second sample. RESULTS: Eight subgroups with varying levels of inactivity were identified. Three subgroups had inactivity levels of 40% or higher, while the lowest subgroup had a level of less than 15%. The highest inactivity subgroup consisted of individuals with at least some college education who were in fair/poor health and who watched 4 or more hours of television per day. The second-highest inactivity subgroup was composed of those without a college education who tended not to use or attend to many communication channels. The third highest inactive subgroup consisted of those without a college education who read the newspaper and were obese. Levels of inactivity in the second independent sample subgroups were not significantly different from those found in the exploratory sample. CONCLUSIONS: This study identified empirically based, physically inactive subgroups that differed on sociodemographic and health communication characteristics. This information should be useful in creating future evidence-based, targeted, and tailored intervention strategies.

Adult↗

Cancer knowledge and disparities in the information age.

Increasing information flow often leads to widening gaps in knowledge between different socioeconomic status (SES) groups as higher SES groups are more likely to acquire this new information at a faster rate than lower SES groups. These gaps in knowledge may offer a partial but robust explanation for differential risk behaviors and health disparities between different social groups. Drawing on the Health Information National Trends Survey (HINTS 2003), a national survey of communication behaviors conducted by the National Cancer Institute (NCI), we examine the relationship between publicity and knowledge gaps on two cancer topics that received different levels of publicity: knowledge about tobacco and sun exposure and their respective links to cancer. Analyses of the HINTS 2003 data suggest that differential knowledge levels of causes of cancer between SES groups are one potential explanation of cancer disparities that have been extensively reported in the literature. It is evident that high income and high education are associated with awareness about causes of major cancers such as lung and skin, and may allow people to protect themselves and minimize their risks. The data also show that heavier media attention could attenuate the knowledge gaps though moderate publicity or lack of news coverage may actually widen them. Last, the findings in this article suggest that it is necessary to take into account the SES variation within different racial and ethnic groups rather than mask them by treating the groups as one.

Adult↗

Awareness of the National Cancer Institute's Cancer Information Service: results from the Health Information National Trends Survey (HINTS).

Established in 1975, the National Cancer Institute's (NCI's) Cancer Information Service (CIS) is a national information and education network that serves the nation by providing the latest scientific cancer information to the American public. The purpose of this study was to determine the public's awareness of the CIS and other national cancer and health organizations by analyzing data from the NCI's Health Information National Trends Survey (HINTS 2003). This study also examined sociodemographic, health, and communication correlates of awareness of CIS and other national health organizations: American Cancer Society (ACS), National Institutes of Health (NIH), and NCI. Results indicated that awareness of the CIS was low (32.8%). Some subgroups were more likely to be aware of the CIS than others. When comparing awareness levels of the four national health organizations, marked differences in patterns of awareness among specific subgroups emerged for many sociodemographic variables. For example, minority groups were significantly more aware of the CIS than Whites; however, for all three other organizations a greater percentage of Whites were aware of each organization. For the NIH, NCI, and ACS, respondents in the highest income group were most aware of each organization and, as income level increased awareness also increased. The CIS, respondents with the lowest income levels, however, were more aware of the CIS compared with middle- and high-income groups. A similar pattern was found for other sociodemographic variables. Results of this study will guide the development of a targeted promotional campaign for the CIS.

Adolescent↗

Perceived ambiguity about cancer prevention recommendations: relationship to perceptions of cancer preventability, risk, and worry.

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.

Adult↗

The health information national trends survey: research from the baseline.

The decades surrounding the turn of the millennium will be remembered as a time of extraordinary opportunity in cancer communication. In 1990, the number of age-adjusted deaths due to cancer in the U.S. population began a slow steady decline after a century of disparaging increase. Reasons for this decline have been attributed to long-awaited successes in primary prevention, especially related to tobacco, and early detection for cervical, breast, prostate, and colorectal cancers, as well as advances in treatment. This was also a time of unparalleled change in the cancer communication environment. Scientific health discoveries escalated with the completion of the Human Genome project in 2003, and penetration of the Internet made health information available directly to consumers. To seize the opportunity afforded by these changes, the National Cancer Institute (NCI) launched the Health Information National Trends Survey (HINTS). Fielded for the first time in 2003, the HINTS is a nationally representative, general population survey of noninstitutionalized adults in the United States 18 years and older. This supplement contains a compilation of original research conducted using the data generated by the first administration of the HINTS telephone interviews. Covering topics in cancer knowledge, cancer cognition, risk perception, and information seeking, the articles represent an interdisciplinary view of cancer communication at the turn of the millennium and offer insight into the road ahead.

Computer Communication Networks↗

Familial testicular cancer: interest in genetic testing among high-risk family members.

PURPOSE: This study is part of an ongoing National Cancer Institute multidisciplinary, etiologically-focused, cross-sectional study of Familial Testicular Cancer (FTC). The current report targets interest in clinical genetic testing for susceptibility to FTC. METHODS: Demographics, knowledge, health beliefs, and psychological and social factors were evaluated as covariates related to interest in genetic testing. RESULTS: The majority (66%) of 229 participants (64 affected men, 66 unaffected men, and 99 women) from 47 multiple-case FTC families expressed interest in having a genetic test within 6 months, should such a test become available. Interest was similar among the three subgroups mentioned above. Worries about insurance discrimination based on genetic test results were associated with a significantly lower interest in testing. Alternatively, participants were more likely to be interested in genetic testing if they were younger and had higher levels of family support, a physician's recommendation supporting testing, cancer distress, and a need for information to inform the health care of their children. CONCLUSIONS: This study reveals social and relationship factors that FTC survivors and their relatives considered important when contemplating the use of new genetic technologies. This is the first study describing hypothetical interest in genetic testing for familial testicular cancer.

Adolescent↗

Respiratory effects of marijuana and tobacco use in a U.S. sample.

OBJECTIVE: Although a number of studies have examined the respiratory impact of marijuana smoking, such studies have generally used convenience samples of marijuana and tobacco users. The current study examined respiratory effects of marijuana and tobacco use in a nationally representative sample while controlling for age, gender, and current asthma. DESIGN: Analysis of the nationally representative third National Health and Nutrition Examination Survey (NHANES III). SETTING: U.S. households. PARTICIPANTS: A total of 6,728 adults age 20 to 59 who completed the drug, tobacco, and health sections of the NHANES III questionnaire in 1988 and 1994. Current marijuana use was defined as self-reported 100+ lifetime use and at least 1 day of use in the past month. MEASUREMENTS AND MAIN RESULTS: Self-reported respiratory symptoms included chronic bronchitis, frequent phlegm, shortness of breath, frequent wheezing, chest sounds without a cold, and pneumonia. A medical exam also provided an overall chest finding and a measure of reduced pulmonary functioning. Marijuana use was associated with respiratory symptoms of chronic bronchitis (P=.02), coughing on most days (P=.001), phlegm production (P=.0005), wheezing (P<.0001), and chest sounds without a cold (P=.02). CONCLUSION: The impact of marijuana smoking on respiratory health has some significant similarities to that of tobacco smoking. Efforts to prevent and reduce marijuana use, such as advising patients to quit and providing referrals for support and assistance, may have substantial public health benefits associated with decreased respiratory health problems.

Adult↗

Psychological research on death attitudes: an overview and evaluation.

One of the most substantial legacies of Herman Feifel was his pioneering research on attitudes toward death and dying in a variety of populations. The authors review the large and multifaceted literature on death anxiety, fear, threat and acceptance, focusing on the attitudes toward death and dying of relevant professional and patient groups, and the relationship of death concern to aging, physical and mental health, religiosity, and terror management strategies. We conclude with several recommendations for improving the conceptual and practical yield of future work in this area.

Adult↗

Parental and sibling effects in adolescent outcomes.

This study examined the differential effects of parenting and sibling influences (and the interaction between the two) in predicting adolescents' problem behaviors. The reliability and validity of the Sibling Relationship Questionnaire was also assessed. Subjects were 99 intact families from the San Francisco Bay area, all of whom contained both parents and at least one target child between 10 and 18 years of age still living in the home. Analysis indicated that sibling behavior was a significant predictor of deviant behavior, as measured by the Child Behavior Checklist, even when parenting effects were statistically controlled. Parenting effects had a separate effect on adolescents' positive behaviors. The analysis of the Sibling Relationship Questionnaire indicated adequate test-retest and internal consistency reliability, and construct validity. Findings are discussed in terms of the larger literature on socialization on the different ways that siblings and parents influence adolescent outcomes.

Adolescent↗

Psychosocial correlates of fruit and vegetable consumption among African American men.

OBJECTIVE: To determine the best predictors of fruit and vegetable consumption among African American men age 35 years and older. DESIGN: Data (n = 291) from a 2001 nationally representative mail survey commissioned by the American Cancer Society. PARTICIPANTS: 291 African American men age 35 years and older. MAIN OUTCOME MEASURES DEPENDENT VARIABLES: (1) total fruits and vegetables without fried potatoes, (2) total fruit with juice, and (3) total vegetables without fried potatoes. Independent variables included 3 blocks of predictors: (1) demographics, (2) a set of psychosocial scales, and (3) intent to change variables based on a theoretical algorithm. ANALYSIS: Linear regression models; analysis of variance for the intent to change group. Alpha = .05. RESULTS: Regression model for total fruits and vegetables, significant psychosocial predictors: social norms, benefits, tangible rewards, and barriers-other. Total fruit with juice: social norms, benefits, tangible rewards. Total vegetables, no fried potatoes: tangible rewards, barriers-other interests. CONCLUSIONS AND IMPLICATIONS: For African American men, fruit consumption appears to be motivated by perceived benefits and standards set by important people in their lives; vegetable consumption is a function of extrinsic rewards and preferences for high-calorie, fatty foods. The results suggest that communications to increase fruit and vegetable consumption should be crafted to reflect differences in sources of motivation for eating fruits versus eating vegetables.

Adult↗