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Lipkus, Isaac Marcelo

Overview:

Research Interests
Dr. Lipkus is interested in how: 1) dispositional (e.g., hostility) and attitudinal variables (e.g.,
belief in a world) affect coping with negative life events (e.g., cancer, conflict in interpersonal
relationships), and 2) the impact of risk perceptions (e.g., optimistic and pessimistic biases) on
modifying precautionary behaviors (e.g., early prevention and detection of cancer,etc.).

Positions:

Professor in the School of Nursing, with tenure

School of Nursing
School of Nursing

Professor in Community and Family Medicine

Community and Family Medicine
School of Medicine

Professor in Psychiatry and Behavioral Sciences

Psychiatry & Behavioral Sciences
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.A. 1988

M.A. — University of North Carolina at Chapel Hill

Ph.D. 1991

Ph.D. — University of North Carolina at Chapel Hill

Grants:

Intervention to Increase Exercise among Breast Cancer Survivors

Administered By
School of Nursing
AwardedBy
National Institutes of Health
Role
Co-Sponsor
Start Date
July 01, 2015
End Date
September 30, 2017

Effects of Message Framing and Risk Feedback on CRC Screening

Administered By
School of Nursing
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
September 24, 2014
End Date
August 31, 2017

Theory-based Intervention to Increase Exercise for Improved Breast Cancer Survivorship

Administered By
School of Nursing
AwardedBy
Oncology Nursing Society
Role
Principal Investigator
Start Date
January 01, 2015
End Date
January 15, 2017

Does Cytoplasmic PELP1 Predict Resistance To Tamoxifen Chemoprevention?

Administered By
Medicine, Medical Oncology
AwardedBy
National Institutes of Health
Role
Co-Mentor
Start Date
September 01, 2010
End Date
August 31, 2015

Improving Adherence to Recommended Surveillance in Breast Cancer Survivors

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Mentor
Start Date
September 01, 2010
End Date
August 31, 2015

Patient self-management and gene guided therapy for CHC

Administered By
School of Nursing
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
April 13, 2012
End Date
March 31, 2015

Effects of Message Framing on Cessation among Couples where both Partners Smoke

Administered By
School of Nursing
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
March 01, 2012
End Date
February 28, 2015

Science Education in Health Ed Class: Tobacco and Addiction

Administered By
Pharmacology & Cancer Biology
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
July 01, 2008
End Date
June 30, 2014

Young Smokers' Reactions to Genetic Risk for Lung Cancer

Administered By
School of Nursing
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
August 01, 2007
End Date
July 31, 2013

IPA Karen Nicely

Administered By
School of Nursing
AwardedBy
Durham Veterans Affairs Medical Center
Role
Principal Investigator
Start Date
April 01, 2012
End Date
September 30, 2012

Using Message Framing to Promote Physical Activity in Colorectal Cancer Survivors

Administered By
Radiation Oncology
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
August 01, 2008
End Date
July 31, 2012

Assessing Risk Communication Educational Practices in Genetic Counseling Programs

Administered By
School of Nursing
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
August 01, 2008
End Date
May 31, 2012

Increasing Attention to Smoking Risk Messages

Administered By
School of Nursing
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
September 21, 2007
End Date
July 31, 2011

Stress and Behavior in Health and Disease

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Mentor
Start Date
July 01, 1989
End Date
June 30, 2011

Strategies to help inform colorectal cancer risk magnitudes

Administered By
School of Nursing
AwardedBy
National Institutes of Health
Role
Mentor
Start Date
September 30, 2007
End Date
May 31, 2010

Daughters And MothErS (DAMES) Against Breast Cancer

Administered By
School of Nursing
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
June 10, 2007
End Date
May 31, 2010

Effects of Communicating RPFNA Results on Decisions about Tamoxifen Use

Administered By
School of Nursing
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
April 23, 2007
End Date
March 31, 2010

Cancer Information Service

Administered By
Duke Cancer Institute
AwardedBy
National Cancer Institute
Role
Principal Investigator
Start Date
January 15, 2005
End Date
January 14, 2010

Testing Pharmacological Therapies for Pregnant Smokers

Administered By
Duke Cancer Institute
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
May 01, 2002
End Date
April 30, 2008

Promoting Health in Prostate and Breast Cancer Survivors

Administered By
School of Nursing
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
March 01, 2001
End Date
December 31, 2006

Message Framing Effects on Youth's Smoking Behavior

Administered By
Duke Cancer Institute
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
September 13, 2002
End Date
August 31, 2006

Affecting Perceived Risks and Ambivalence About Smoking

Administered By
Duke Cancer Institute
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
March 01, 2003
End Date
February 28, 2006

Increasing Colorectal Cancer Screening Among Carpenters

Administered By
Duke Cancer Institute
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
September 30, 1993
End Date
November 30, 2005

The Obstetrics and Gynecology Risk Group

Administered By
Obstetrics and Gynecology
AwardedBy
Josiah Charles Trent Memorial Foundation
Role
Co Investigator
Start Date
June 01, 2004
End Date
May 31, 2005

Cancer Information Service

Administered By
Duke Cancer Institute
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
October 15, 1999
End Date
January 14, 2005

Recruiting Teen Smokers Into A Self-Help Quit Program

Administered By
Psychiatry & Behavioral Sciences, General Psychiatry
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
January 15, 1999
End Date
December 31, 2002

Models of Personality, Health and Disease

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Research Associate
Start Date
August 01, 1995
End Date
July 31, 2001

Increasing Breast Screening Among Nonaherent Women

Administered By
Psychiatry & Behavioral Sciences, Medical Psychology
AwardedBy
National Institutes of Health
Role
Co-Principal Investigator
Start Date
September 30, 1993
End Date
July 31, 1999

Using Tailored Messages To Improve Colorectal Screening

Administered By
Community and Family Medicine
AwardedBy
National Institutes of Health
Role
Co-Principal Investigator
Start Date
July 01, 1997
End Date
June 30, 1999

Improving Cancer Risk Communication

Administered By
Community and Family Medicine
AwardedBy
National Institutes of Health
Role
Co-Principal Investigator
Start Date
September 30, 1996
End Date
May 31, 1999

Increasing Breast Screening Among Nonadherent Women

Administered By
Community and Family Medicine
AwardedBy
National Institutes of Health
Role
Co-Principal Investigator
Start Date
September 30, 1993
End Date
July 31, 1998

Enhancing Cancer Control In A Community Health Center

Administered By
Community and Family Medicine
AwardedBy
National Institutes of Health
Role
Co-Principal Investigator
Start Date
July 01, 1993
End Date
December 31, 1997
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Publications:

Exploration of Exercise Outcome Expectations Among Breast Cancer Survivors.

Exercise is associated with decreased recurrence risk and improved survival and quality of life for breast cancer survivors. However, only an estimated 17% to 37% of survivors adhere to the American Cancer Society exercise guidelines. A critical first step to increase exercise among survivors is to understand how they believe exercise will affect them.The aim of this study is to explore common exercise outcome expectations among 20 female survivors of stage IA to IIB breast cancer who completed adjuvant treatment and an exercise intervention.A mixed-method descriptive study consisting of semistructured telephone interviews assessed exercise outcome expectations and how the experience of cancer and its treatment influenced the expected outcomes of exercise. The qualitative data were analyzed using a summative content analysis procedure; means were calculated for each item of the exercise outcome questionnaire. The qualitative and quantitative data were compared and contrasted.The sample was 70% white and 30% African American, with a mean (SD) age of 62 (8.5) years, and mean (SD) time since treatment completion of 4.2 (1.3) years. Three themes emerged from the interviews: (1) prevalence of common expectations, (2) pervasive impact of fatigue, and (3) a brighter future. Overall, findings revealed that breast cancer survivors have low levels of agreement that exercise may mitigate late and long-term cancer and treatment effects.In general, breast cancer survivors (even those who are motivated to exercise) do not hold strong beliefs that exercise will decrease late and long-term treatment effects.Clinicians can educate survivors about exercise benefits.

Authors
Hirschey, R; Docherty, SL; Pan, W; Lipkus, I
MLA Citation
Hirschey, R, Docherty, SL, Pan, W, and Lipkus, I. "Exploration of Exercise Outcome Expectations Among Breast Cancer Survivors." Cancer nursing 40.2 (March 2017): E39-E46.
PMID
26925999
Source
epmc
Published In
Cancer Nursing
Volume
40
Issue
2
Publish Date
2017
Start Page
E39
End Page
E46
DOI
10.1097/ncc.0000000000000362

Lessons Learned From an Online Study with Dual-smoker Couples

Authors
Choi, SH; Mitchell, J; Lipkus, I
MLA Citation
Choi, SH, Mitchell, J, and Lipkus, I. "Lessons Learned From an Online Study with Dual-smoker Couples." American Journal of Health Behavior 41.1 (January 1, 2017): 61-66.
Source
crossref
Published In
American Journal of Health Behavior
Volume
41
Issue
1
Publish Date
2017
Start Page
61
End Page
66
DOI
10.5993/AJHB.41.1.6

Patient's lung cancer diagnosis as a cue for relatives' smoking cessation: evaluating the constructs of the teachable moment.

To understand whether patient-reported experiences with lung cancer may create teachable moments (TM) for their relatives as evidenced by shifts in their risk perceptions, affective response, and self-image and in turn, motivation to quit smoking.Patients at a comprehensive cancer center (n = 152) completed a survey within 6 months of lung cancer diagnosis to assess their cancer-related symptoms and openness and enumerated relatives who were smokers. Relative smokers (n = 218) then completed a survey assessing their risk perceptions, affective response, and self-image as a smoker related to the patient's diagnosis (TM mechanisms), and their motivation to quit smoking. Cross-sectional mediation and moderation analyses were conducted to explore the links between patient-reported experiences, and relatives' TM mechanisms, and motivation to quit smoking.Relative-reported affect was a significant mediator of the association between patient-reported symptoms and relative smoker's desire to quit. Relatives' self-image was a significant moderator of the association between patient-reported symptoms and relative smoker's desire to quit, such that patients' reported symptoms were associated with relatives' desire to quit only when the relative smoker reported a generally positive self-image as a smoker. No evidence was found for moderated mediation. However, the link between symptoms and negative affect was moderated by perceptions of risk.Whether smokers experience a family member's lung cancer as a TM is influenced by multiple interrelated cognitive and affective factors that warrant further exploration. Clearer understanding of these factors could inform how to re-invigorate and sustain this motivation to promote concrete actions toward smoking cessation. Copyright © 2015 John Wiley & Sons, Ltd.

Authors
McBride, CM; Blocklin, M; Lipkus, IM; Klein, WMP; Brandon, TH
MLA Citation
McBride, CM, Blocklin, M, Lipkus, IM, Klein, WMP, and Brandon, TH. "Patient's lung cancer diagnosis as a cue for relatives' smoking cessation: evaluating the constructs of the teachable moment." Psycho-oncology 26.1 (January 2017): 88-95.
PMID
26514587
Source
epmc
Published In
Psycho-Oncology
Volume
26
Issue
1
Publish Date
2017
Start Page
88
End Page
95
DOI
10.1002/pon.4011

Does Quitting Smoking Make a Difference Among Newly Diagnosed Head and Neck Cancer Patients?

To determine if smoking after a cancer diagnosis makes a difference in mortality among newly diagnosed head and neck cancer patients.Longitudinal data were collected from newly diagnosed head and neck cancer patients with a median follow-up time of 1627 days (N = 590). Mortality was censored at 8 years or September 1, 2011, whichever came first. Based on smoking status, all patients were categorized into four groups: continuing smokers, quitters, former smokers, or never-smokers. A broad range of covariates were included in the analyses. Kaplan-Meier curves, bivariate and multivariate Cox proportional hazards models were constructed.Eight-year overall mortality and cancer-specific mortality were 40.5% (239/590) and 25.4% (150/590), respectively. Smoking status after a cancer diagnosis predicted overall mortality and cancer-specific mortality. Compared to never-smokers, continuing smokers had the highest hazard ratio (HR) of dying from all causes (HR = 2.71, 95% confidence interval [CI] = 1.48-4.98). Those who smoked at diagnosis, but quit and did not relapse-quitters-had an improved hazard ratio of dying (HR = 2.38, 95% CI = 1.29-4.36) and former smokers at diagnosis with no relapse after diagnosis-former smokers-had the lowest hazard ratio of dying from all causes (HR = 1.68, 95% CI = 1.12-2.56). Similarly, quitters had a slightly higher hazard ratio of dying from cancer-specific reasons (HR = 2.38, 95% CI = 1.13-5.01) than never-smokers, which was similar to current smokers (HR = 2.07, 95% CI = 0.96-4.47), followed by former smokers (HR = 1.70, 95% CI = 1.00-2.89).Compared to never-smokers, continuing smokers have the highest HR of overall mortality followed by quitters and former smokers, which indicates that smoking cessation, even after a cancer diagnosis, may improve overall mortality among newly diagnosed head and neck cancer patients. Health care providers should consider incorporating smoking cessation interventions into standard cancer treatment to improve survival among this population.Using prospective observational longitudinal data from 590 head and neck cancer patients, this study showed that continuing smokers have the highest overall mortality relative to never-smokers, which indicates that smoking cessation, even after a cancer diagnosis, may have beneficial effects on long-term overall mortality. Health care providers should consider incorporating smoking cessation interventions into standard cancer treatment to improve survival among this population.

Authors
Choi, SH; Terrell, JE; Bradford, CR; Ghanem, T; Spector, ME; Wolf, GT; Lipkus, IM; Duffy, SA
MLA Citation
Choi, SH, Terrell, JE, Bradford, CR, Ghanem, T, Spector, ME, Wolf, GT, Lipkus, IM, and Duffy, SA. "Does Quitting Smoking Make a Difference Among Newly Diagnosed Head and Neck Cancer Patients?." Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 18.12 (December 2016): 2216-2224.
PMID
27613928
Source
epmc
Published In
Nicotine and Tobacco Research (OUP)
Volume
18
Issue
12
Publish Date
2016
Start Page
2216
End Page
2224

Message Framing and Physical Activity Promotion in Colorectal Cancer Survivors.

To test effects of gain-framed versus loss-framed mailed brochures on increasing physical activity (PA) among colorectal cancer (CRC) survivors.
.Randomized trial with repeated measures at baseline, 1 month, and 12 months postintervention.
.Mail recruitment from tumor registries.
.148 inactive CRC survivors who had completed primary therapy. 
.PA and constructs from the Theory of Planned Behavior (TPB) were assessed at baseline, 1 month, and 12 months. Participants were randomized to receive pamphlets describing PA benefits (gain framed) or disadvantages of not being physically active (loss framed). Baseline characteristics were compared using descriptive statistics. Repeated measures linear models were used to test PA changes.
.Minutes of PA and TPB constructs.
.Significant PA increases were observed in both study arms. Results did not differ by message frame. At one month, about 25% of previously inactive participants increased activity to national recommendations. Those who increased PA compared to those who did not had higher baseline scores on subjective norms, perceived behavioral control, and PA intentions. 
.Independent of message framing, mailed brochures are highly effective in producing within-subject short- and long-term increases in PA.
.CRC survivors may increase short- and long-term levels of PA by receiving inexpensive print brochures.

Authors
Hirschey, R; Lipkus, I; Jones, L; Mantyh, C; Sloane, R; Demark-Wahnefried, W
MLA Citation
Hirschey, R, Lipkus, I, Jones, L, Mantyh, C, Sloane, R, and Demark-Wahnefried, W. "Message Framing and Physical Activity Promotion in Colorectal Cancer Survivors." Oncology nursing forum 43.6 (November 2016): 697-705.
PMID
27768135
Source
epmc
Published In
Oncology Nursing Forum
Volume
43
Issue
6
Publish Date
2016
Start Page
697
End Page
705

Willingness to provide support for a quit attempt: A study of partners of smokers.

Support from close others predicts smoking abstinence, yet little research has investigated what factors promote support. This study investigates predictors of support for a quit attempt. Partners of smokers (N = 131) reported their relationship quality, concern for partner's health, own smoking status, and intended support for a quit attempt. Smokers were less supportive than were nonsmokers. Relationship quality, concern for partners' health, and motivation to quit were positively associated, and nicotine dependence was negatively associated, with intended support. The findings suggest that support for smoking cessation depends on one's own smoking behaviors as well as characteristics of the relationship.

Authors
vanDellen, MR; Boyd, SM; Ranby, KW; MacKillop, J; Lipkus, IM
MLA Citation
vanDellen, MR, Boyd, SM, Ranby, KW, MacKillop, J, and Lipkus, IM. "Willingness to provide support for a quit attempt: A study of partners of smokers." Journal of health psychology 21.9 (September 2016): 1840-1849.
PMID
25603929
Source
epmc
Published In
Journal of Health Psychology
Volume
21
Issue
9
Publish Date
2016
Start Page
1840
End Page
1849
DOI
10.1177/1359105314567209

Effects of physical and mental health on relationship satisfaction: a dyadic, longitudinal examination of couples facing prostate cancer.

Prostate cancer may affect quality of life in men diagnosed as well as their spouses. Changes in health may disrupt the couple's relationship functioning which disrupts recovery. This study examined how mental and physical health relates to relationship satisfaction for couples at diagnosis through the year following treatment.Patients with stage I-II prostate cancer and their spouses (N = 159 couples) were recruited from a urology clinic and completed questionnaires at diagnosis, 1 month, 6 months, and 12 months post prostatectomy on demographics, mental and physical health quality of life, and relationship satisfaction. The Actor-Partner Interdependence Model was employed to examine effects of each partners' mental and physical health on their own and their partner's relationship satisfaction.Patients and spouses had declined mental and physical health at 1 month post-surgery. Health improved at 6 and 12 months but did not fully return to pre-surgery levels. Actor effects showed that patient's physical health consistently predicted own relationship satisfaction. Both patient's and spouse's mental health consistently related to their own relationship satisfaction. Partner effects showed that patient's and spouse's physical health had an effect on each other's relationship satisfaction at 1 month. Spouse's mental health predicted patient's relationship satisfaction throughout the year following treatment.The effects of patient and spouse mental and physical health quality of life on their own as well as their partner's relationship satisfaction differed across time which will inform psychosocial interventions for couples with prostate cancer. Copyright © 2015 John Wiley & Sons, Ltd.

Authors
Ross, KM; Ranby, KW; Wooldridge, JS; Robertson, C; Lipkus, IM
MLA Citation
Ross, KM, Ranby, KW, Wooldridge, JS, Robertson, C, and Lipkus, IM. "Effects of physical and mental health on relationship satisfaction: a dyadic, longitudinal examination of couples facing prostate cancer." Psycho-oncology 25.8 (August 2016): 898-904.
PMID
26257321
Source
epmc
Published In
Psycho-Oncology
Volume
25
Issue
8
Publish Date
2016
Start Page
898
End Page
904
DOI
10.1002/pon.3931

Randomized trial finds that prostate cancer genetic risk score feedback targets prostate-specific antigen screening among at-risk men.

Prostate-specific antigen (PSA) screening may reduce death due to prostate cancer but leads to the overdiagnosis of many cases of indolent cancer. Targeted use of PSA screening may reduce overdiagnosis. Multimarker genomic testing shows promise for risk assessment and could be used to target PSA screening.To test whether counseling based on the family history (FH) and counseling based on a genetic risk score (GRS) plus FH would differentially affect subsequent PSA screening at 3 months (primary outcome), a randomized trial of FH versus GRS plus FH was conducted with 700 whites aged 40 to 49 years without prior PSA screening. Secondary outcomes included anxiety, recall, physician discussion at 3 months, and PSA screening at 3 years. Pictographs versus numeric presentations of genetic risk were also evaluated.At 3 months, no significant differences were observed in the rates of PSA screening between the FH arm (2.1%) and the GRS-FH arm (4.5% with GRS-FH vs. 2.1% with FH: χ2 = 3.13, P = .077); however, PSA screening rates at 3 months significantly increased with given risk in the GRS-FH arm (P = .013). Similar results were observed for discussions with physicians at 3 months and PSA screening at 3 years. Average anxiety levels decreased after the individual cancer risk was provided (P = .0007), with no differences between groups. Visual presentation by pictographs did not significantly alter comprehension or anxiety.This is likely the first randomized trial of multimarker genomic testing to report genomic targeting of cancer screening. This study found little evidence of concern about excess anxiety or overuse/underuse of PSA screening when multimarker genetic risks were provided to patients. Cancer 2016. © 2016 American Cancer Society.

Authors
Turner, AR; Lane, BR; Rogers, D; Lipkus, I; Weaver, K; Danhauer, SC; Zhang, Z; Hsu, F-C; Noyes, SL; Adams, T; Toriello, H; Monroe, T; McKanna, T; Young, T; Rodarmer, R; Kahnoski, RJ; Tourojman, M; Kader, AK; Zheng, SL; Baer, W; Xu, J
MLA Citation
Turner, AR, Lane, BR, Rogers, D, Lipkus, I, Weaver, K, Danhauer, SC, Zhang, Z, Hsu, F-C, Noyes, SL, Adams, T, Toriello, H, Monroe, T, McKanna, T, Young, T, Rodarmer, R, Kahnoski, RJ, Tourojman, M, Kader, AK, Zheng, SL, Baer, W, and Xu, J. "Randomized trial finds that prostate cancer genetic risk score feedback targets prostate-specific antigen screening among at-risk men." Cancer (July 19, 2016).
PMID
27433786
Source
epmc
Published In
Cancer
Publish Date
2016
DOI
10.1002/cncr.30162

The Effects of Brief Waterpipe Tobacco Use Harm and Addiction Education Messages Among Young Adult Waterpipe Tobacco Users.

This study investigated the immediate effects of brief education messages delivered online about harms and addictiveness of waterpipe tobacco use among young adult waterpipe users aged 18 to 30 years.Participants (n = 327, mean age 24.8 years, 62.1% male, 77.6% white, 67.8% used waterpipe monthly, 26.4% weekly, 5.8% daily) were recruited online and randomized to one of three experimental conditions: (1) Control condition viewing no messages; (2) Harms condition viewing messages about harms of waterpipe tobacco; (3) Harms and addiction condition viewing messages about harms and addictiveness of waterpipe tobacco. Outcomes included perceived harm and addictiveness of waterpipe, worry about harm and addiction, and desire to quit.Compared to the control condition, participants in the harms condition reported significantly greater perceived harm and addictiveness of waterpipe relative to cigarettes, perceived risk of harm and addiction, worry about harm and addiction, and desire to quit. There were few significant differences in these outcomes between participants in the harms condition and the harms and addiction condition. Mediation analyses suggest waterpipe tobacco use harm messages may increase desire to quit by producing greater worry about harm and addiction.Brief education messages about waterpipe tobacco use harm increased young adult's perceptions of harm and addictiveness of waterpipe tobacco use and generated stronger desire to quit. The waterpipe tobacco use addiction messages tested had little added impact. Studies should prospectively examine the real-world impact of waterpipe tobacco use harm messages and investigate more effective strategies for designing addiction messages.This study demonstrates that brief education messages about waterpipe tobacco use harm can increase young adult waterpipe tobacco user's perceptions of harm and addictiveness of waterpipe tobacco use and generate stronger desire to quit. The findings indicate messages on addictiveness of waterpipe tobacco use have no added impact on these outcomes.

Authors
Mays, D; Tercyak, KP; Lipkus, IM
MLA Citation
Mays, D, Tercyak, KP, and Lipkus, IM. "The Effects of Brief Waterpipe Tobacco Use Harm and Addiction Education Messages Among Young Adult Waterpipe Tobacco Users." Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 18.5 (May 2016): 777-784.
PMID
26438650
Source
epmc
Published In
Nicotine and Tobacco Research (OUP)
Volume
18
Issue
5
Publish Date
2016
Start Page
777
End Page
784
DOI
10.1093/ntr/ntv223

Feasibility and Smokers' Evaluation of Self-Generated Text Messages to Promote Quitting.

Cigarette smoking is a leading cause of preventable mortality. Mobile technologies, including text messaging, provide opportunities to promote quitting. Many text messaging-based cessation interventions contain content created by experts. However, smokers may be best persuaded by receipt of text messages they created based on their reasons for quitting, assisted or not by a motivational facilitator. This study assessed the feasibility and participants' evaluation of two ways to self-generate smoking cessation messages delivered via cell-phone.We enrolled smokers (N = 24) and randomized them to: (1) behavioral counseling assistance plus self-generated messages, or (2) self-generated messages only. Both groups wrote: (1) their reasons for wanting to quit and then (2) text messages related to their reason(s) for quitting, Messages were delivered as text messages as well as with a link to verbatim self-recorded audio message for 10 days. At follow-up, participants evaluated the intervention.Participants composed and recorded messages and evaluated them and the intervention favorably. The counseling+message group wrote an average of 7.66 (SD = 4.86) text messages while the message-only wrote an average of 6.66 (SD = 2.93) messages. Most participants felt that the messages were of appropriate length, including the frequency and timing of message delivery.It is feasible for smokers to self-generate motivational text and audio messages concerning reasons for quitting, even among smokers without an immediate desire to quit. Participants evaluated the messages and intervention favorably. Future research should test self-generated messages in larger trials of self- versus expert-generated message.This study assessed the feasibility and participants' evaluation of two ways to self-generate smoking cessation messages delivered via cell-phone. It is feasible for smokers to self-generate motivational text and audio messages concerning reasons for quitting, even among smokers without an immediate desire to quit. Participants evaluated the messages and intervention favorable. Future research should test self-generated messages in larger trials of self- versus expert-generated messages.

Authors
Shaw, RJ; Pollak, K; Zullig, LL; Bennett, G; Hawkins, K; Lipkus, I
MLA Citation
Shaw, RJ, Pollak, K, Zullig, LL, Bennett, G, Hawkins, K, and Lipkus, I. "Feasibility and Smokers' Evaluation of Self-Generated Text Messages to Promote Quitting." Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 18.5 (May 2016): 1206-1209.
PMID
26647104
Source
epmc
Published In
Nicotine and Tobacco Research (OUP)
Volume
18
Issue
5
Publish Date
2016
Start Page
1206
End Page
1209
DOI
10.1093/ntr/ntv268

Association between felt ambivalence and the desire to quit waterpipe use among college students.

College waterpipe tobacco smokers who feel more ambivalence, that is, conflicted about its use, may have a stronger desire to quit. Using baseline survey data of 315 college waterpipe smokers, we examined this relationship. While frequency of feeling ambivalence was low, greater ambivalence was related with desire to quit (r = .46,p < .001). This relationship remained significant after accounting for several correlates of desire to quit (e.g. perceived risk and worries about harm and addiction). Findings suggest that ambivalence may be an important independent variable linked with desire to quit and should be explored further as a factor influencing waterpipe tobacco use.

Authors
Lipkus, IM; Noonan, D
MLA Citation
Lipkus, IM, and Noonan, D. "Association between felt ambivalence and the desire to quit waterpipe use among college students." Journal of health psychology (March 27, 2016).
PMID
27020085
Source
epmc
Published In
Journal of Health Psychology
Publish Date
2016

Assessing and Predicting Susceptibility to Waterpipe Tobacco Use Among College Students.

College youth susceptible to waterpipe tobacco smoking (WTS) represent an important target to intervene upon in order to prevent their uptake of this product. This study examined the performance of a 4-item susceptibility measure to WTS to predict future waterpipe use and correlates of susceptibility.A cohort of college students from 11 university campuses in North Carolina and Virginia completed an online survey in 2012 and again in 2013 that assessed WTS susceptibility and subsequent waterpipe use. Tobacco use, marijuana use, binge drinking, and sensation seeking were also assessed.Overall, 964 students who reported having never used waterpipe tobacco in 2012 completed the online surveys both years. Overall, about 27% of college youth were susceptible to WTS each year. Participants susceptible in 2012 were 2.5 times more likely to report having used waterpipe tobacco the subsequent year than non-susceptible participants after controlling for significant correlates of waterpipe use. Correlates of susceptibility were: being male, past 30 day cigarette smoking, use of other tobacco products, binge drinking and marijuana use, as well as higher sensation seeking.A 4-item WTS susceptibility measure predicts future WTS. This measure can be used to identify and intervene upon susceptible college youth to curb further exploration of WTS. Indeed, a nontrivial proportion of college students found susceptible go on to use waterpipe tobacco within a year.

Authors
Lipkus, IM; Reboussin, BA; Wolfson, M; Sutfin, EL
MLA Citation
Lipkus, IM, Reboussin, BA, Wolfson, M, and Sutfin, EL. "Assessing and Predicting Susceptibility to Waterpipe Tobacco Use Among College Students." Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 17.9 (September 2015): 1120-1125.
PMID
25542922
Source
epmc
Published In
Nicotine and Tobacco Research (OUP)
Volume
17
Issue
9
Publish Date
2015
Start Page
1120
End Page
1125
DOI
10.1093/ntr/ntu336

A preliminary exploration of college smokers' reactions to nicotine dependence genetic susceptibility feedback.

INTRODUCTION: Many young smokers underestimate their risk for becoming addicted to cigarettes. We explored whether informing light college smokers (i.e., fewer than 5 cigarettes/day) of their genetic predisposition to nicotine dependence influenced their perceived risks and worry about becoming addicted, their ability to quit (i.e., self-efficacy), their desire to quit, and smoking cessation. METHODS: College smokers (n = 142) received educational materials on mechanisms and consequences of nicotine addiction and were offered genetic susceptibility testing for nicotine dependence. Participants who accepted testing were randomized to receive feedback or no feedback (i.e., control). Tested participants learned they were above or not above average genetic risk for nicotine dependence. All participants responded to questions about perceived risks and worry about becoming addicted, efficacy to quit, and desire to quit. Cessation was assessed during a 1-month follow-up. RESULTS: Efficacy beliefs, worry about becoming addicted, and desire to quit did not differ by study condition or feedback. Perceived risk for becoming addicted was highest among tested participants informed they were above average risk for nicotine dependence. Overall, self-reported 30- but not 7-day quit rate was higher among participants who underwent genetic testing compared with control participants. CONCLUSIONS: This pilot study is the first to show that among light college smokers, receipt of genetic susceptibility feedback to nicotine dependence potentially curbs smoking without producing detrimental effects.

Authors
Lipkus, IM; Schwartz-Bloom, R; Kelley, MJ; Pan, W
MLA Citation
Lipkus, IM, Schwartz-Bloom, R, Kelley, MJ, and Pan, W. "A preliminary exploration of college smokers' reactions to nicotine dependence genetic susceptibility feedback." Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 17.3 (March 2015): 337-343.
PMID
25173776
Source
epmc
Published In
Nicotine and Tobacco Research (OUP)
Volume
17
Issue
3
Publish Date
2015
Start Page
337
End Page
343
DOI
10.1093/ntr/ntu155

Effects of Numerical Versus Foreground-Only Icon Displays on Understanding of Risk Magnitudes.

The aim of this work is to advance knowledge of how to measure gist and verbatim understanding of risk magnitude information and to apply this knowledge to address whether graphics that focus on the number of people affected (the numerator of the risk ratio, i.e., the foreground) are effective displays for increasing (a) understanding of absolute and relative risk magnitudes and (b) risk avoidance. In 2 experiments, the authors examined the effects of a graphical display that used icons to represent the foreground information on measures of understanding (Experiments 1 and 2) and on perceived risk, affect, and risk aversion (Experiment 2). Consistent with prior findings, this foreground-only graphical display increased perceived risk and risk aversion; however, it also led to decreased understanding of absolute (although not relative) risk magnitudes. Methodologically, this work shows the importance of distinguishing understanding of absolute risk from understanding of relative risk magnitudes, and the need to assess gist knowledge of both types of risk. Substantively, this work shows that although using foreground-only graphical displays is an appealing risk communication strategy to increase risk aversion, doing so comes at the cost of decreased understanding of absolute risk magnitudes.

Authors
Stone, ER; Gabard, AR; Groves, AE; Lipkus, IM
MLA Citation
Stone, ER, Gabard, AR, Groves, AE, and Lipkus, IM. "Effects of Numerical Versus Foreground-Only Icon Displays on Understanding of Risk Magnitudes." Journal of health communication 20.10 (January 2015): 1230-1241.
PMID
26065633
Source
epmc
Published In
Journal of Health Communication
Volume
20
Issue
10
Publish Date
2015
Start Page
1230
End Page
1241
DOI
10.1080/10810730.2015.1018594

Relationships among factual and perceived knowledge of harms of waterpipe tobacco, perceived risk, and desire to quit among college users.

Waterpipe tobacco smoking is increasing in the United States among college students. Through a web-based survey, we explored associations among factual and perceived knowledge, perceived risks and worry about harm and addiction, and desire to quit among 316 college waterpipe tobacco smoking users. Overall, factual knowledge of the harm of waterpipe tobacco smoking was poor, factual and perceived knowledge was weakly correlated, both forms of knowledge were related inconsistently to perceived risks and worry, and neither form of knowledge was associated with the desire to quit. Findings provide preliminary insights as to why knowledge gaps may not predict cessation among waterpipe users.

Authors
Lipkus, IM; Eissenberg, T; Schwartz-Bloom, RD; Prokhorov, AV; Levy, J
MLA Citation
Lipkus, IM, Eissenberg, T, Schwartz-Bloom, RD, Prokhorov, AV, and Levy, J. "Relationships among factual and perceived knowledge of harms of waterpipe tobacco, perceived risk, and desire to quit among college users." J Health Psychol 19.12 (December 2014): 1525-1535.
PMID
23928987
Source
pubmed
Published In
Journal of Health Psychology
Volume
19
Issue
12
Publish Date
2014
Start Page
1525
End Page
1535
DOI
10.1177/1359105313494926

Daughters and Mothers Against Breast Cancer (DAMES): main outcomes of a randomized controlled trial of weight loss in overweight mothers with breast cancer and their overweight daughters.

Few studies to date have used the cancer diagnosis as a teachable moment to promote healthy behavior changes in survivors of cancer and their family members. Given the role of obesity in the primary and tertiary prevention of breast cancer, the authors explored the feasibility of a mother-daughter weight loss intervention.A randomized controlled trial of a mailed weight loss intervention was undertaken among 68 mother-daughter dyads (n = 136), each comprised of a survivor of breast cancer (AJCC stage 0-III) and her adult biological daughter. All women had body mass indices ≥ 25 kg/m(2) and underwent in-person assessments at baseline, 6 months, and 12 months, with accelerometry and exercise capacity performed on a subset of individuals. All women received a personalized workbook and 6 newsletters over a 1-year period that promoted weight loss; exercise; and a nutrient-rich, low-energy density diet. A total of 25 dyads received individually tailored instruction (individual), 25 dyads received team-tailored instruction (TEAM), and 18 dyads received standardized brochures (control).The trial met its accrual target, experienced 90% retention, and caused no serious adverse events. Significant differences in baseline to 12-month changes were observed between individual versus control mothers for body mass index, weight, and waist circumference (WC); significant differences also were observed in the WC of corresponding daughters (P < .05). Significant differences were found between individual versus control and team versus control dyads for WC (P = .0002 and .018, respectively), minutes per week of physical activity (P = .031 and .036, respectively), and exercise capacity (P = .047 for both).Significant improvements in lifestyle behaviors and health outcomes are possible with tailored print interventions directed toward survivors of cancer and their family members. For greater impact, more research is needed to expand this work beyond the mother-daughter dyad.

Authors
Demark-Wahnefried, W; Jones, LW; Snyder, DC; Sloane, RJ; Kimmick, GG; Hughes, DC; Badr, HJ; Miller, PE; Burke, LE; Lipkus, IM
MLA Citation
Demark-Wahnefried, W, Jones, LW, Snyder, DC, Sloane, RJ, Kimmick, GG, Hughes, DC, Badr, HJ, Miller, PE, Burke, LE, and Lipkus, IM. "Daughters and Mothers Against Breast Cancer (DAMES): main outcomes of a randomized controlled trial of weight loss in overweight mothers with breast cancer and their overweight daughters." Cancer 120.16 (August 2014): 2522-2534.
PMID
24804802
Source
epmc
Published In
Cancer
Volume
120
Issue
16
Publish Date
2014
Start Page
2522
End Page
2534
DOI
10.1002/cncr.28761

Contemplating genetic feedback regarding lung cancer susceptibility.

BACKGROUND AND PURPOSE: We examined three theoretical models (self-enhancement theory, consistency theory, and a combined model) for understanding how expectations and test result favorability influence smokers' desire for a retest following hypothetical genetic test results. METHOD: College smokers (N = 128) read a brochure describing a biomarker for lung cancer (the GSTM1 gene) then reported whether they thought they had the gene (indicating lower lung cancer risk) or were missing the gene (indicating higher lung cancer risk). Participants then reported whether they would get retested if they received favorable GSTM1 results versus unfavorable GSTM1 results. RESULTS: Participants were most likely to want a retest, suggesting rejection of the results, if they expected favorable news yet received unfavorable news. CONCLUSION: The findings supported the combined model such that smokers expressed greatest interest in a retest when they imagined genetic risk feedback that challenges both enhancement and consistency motives.

Authors
Shepperd, JA; Novell, CA; O'Neill, SC; Docherty, SL; Sanderson, SC; McBride, CM; Lipkus, IM
MLA Citation
Shepperd, JA, Novell, CA, O'Neill, SC, Docherty, SL, Sanderson, SC, McBride, CM, and Lipkus, IM. "Contemplating genetic feedback regarding lung cancer susceptibility." Ann Behav Med 47.3 (June 2014): 395-403.
PMID
24222509
Source
pubmed
Published In
Annals of Behavioral Medicine
Volume
47
Issue
3
Publish Date
2014
Start Page
395
End Page
403
DOI
10.1007/s12160-013-9561-z

LONGITUDINAL EFFECTS OF ILLNESS UNCERTAINTY ON PROSTATE CANCER PATIENTS' ROMANTIC RELATIONSHIPS IN THE YEAR FOLLOWING TREATMENT

Authors
Ross, K; Randby, KW; vanDellen, M; Robertson, C; Lipkus, IM
MLA Citation
Ross, K, Randby, KW, vanDellen, M, Robertson, C, and Lipkus, IM. "LONGITUDINAL EFFECTS OF ILLNESS UNCERTAINTY ON PROSTATE CANCER PATIENTS' ROMANTIC RELATIONSHIPS IN THE YEAR FOLLOWING TREATMENT." ANNALS OF BEHAVIORAL MEDICINE 47 (April 2014): S14-S14.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
47
Publish Date
2014
Start Page
S14
End Page
S14

Young smokers' interpretations of the estimated lung cancer risk associated with a common genetic variant of low penetrance

Authors
Sanderson, SC; McBride, CM; O'Neill, SC; Docherty, S; Shepperd, J; Lipkus, IM
MLA Citation
Sanderson, SC, McBride, CM, O'Neill, SC, Docherty, S, Shepperd, J, and Lipkus, IM. "Young smokers' interpretations of the estimated lung cancer risk associated with a common genetic variant of low penetrance." Public Health Genomics 17.2 (January 1, 2014): 68-75.
Source
scopus
Published In
Public health genomics
Volume
17
Issue
2
Publish Date
2014
Start Page
68
End Page
75
DOI
10.1159/000356708

Contemplating genetic feedback regarding lung cancer susceptibility

Background and Purpose We examined three theoretical models (self-enhancement theory, consistency theory, and a combined model) for understanding how expectations and test result favorability influence smokers' desire for a retest following hypothetical genetic test results. Method College smokers (N =128) read a brochure describing a biomarker for lung cancer (the GSTM1 gene) then reported whether they thought they had the gene (indicating lower lung cancer risk) or were missing the gene (indicating higher lung cancer risk). Participants then reported whether they would get retested if they received favorable GSTM1 results versus unfavorable GSTM1 results. Results Participants were most likely to want a retest, suggesting rejection of the results, if they expected favorable news yet received unfavorable news. Conclusion The findings supported the combined model such that smokers expressed greatest interest in a retest when they imagined genetic risk feedback that challenges both enhancement and consistency motives. © The Society of Behavioral Medicine 2013.

Authors
Shepperd, JA; Novell, CA; O'Neill, SC; Docherty, SL; Sanderson, SC; McBride, CM; Lipkus, IM
MLA Citation
Shepperd, JA, Novell, CA, O'Neill, SC, Docherty, SL, Sanderson, SC, McBride, CM, and Lipkus, IM. "Contemplating genetic feedback regarding lung cancer susceptibility." Annals of Behavioral Medicine 47.3 (January 1, 2014): 395-403.
Source
scopus
Published In
Annals of Behavioral Medicine
Volume
47
Issue
3
Publish Date
2014
Start Page
395
End Page
403
DOI
10.1007/s12160-013-9561-z

Young smokers' interpretations of the estimated lung cancer risk associated with a common genetic variant of low penetrance.

Authors
Sanderson, SC; McBride, CM; O'Neill, SC; Docherty, S; Shepperd, J; Lipkus, IM
MLA Citation
Sanderson, SC, McBride, CM, O'Neill, SC, Docherty, S, Shepperd, J, and Lipkus, IM. "Young smokers' interpretations of the estimated lung cancer risk associated with a common genetic variant of low penetrance." Public health genomics 17.2 (January 2014): 68-75.
PMID
24556984
Source
epmc
Published In
Public health genomics
Volume
17
Issue
2
Publish Date
2014
Start Page
68
End Page
75
DOI
10.1159/000356708

Developing patient-friendly genetic and genomic test reports: formats to promote patient engagement and understanding.

With the emergence of electronic medical records and patient portals, patients are increasingly able to access their health records, including laboratory reports. However, laboratory reports are usually written for clinicians rather than patients, who may not understand much of the information in the report. While several professional guidelines define the content of test reports, there are no guidelines to inform the development of a patient-friendly laboratory report. In this Opinion, we consider patient barriers to comprehension of lab results and suggest several options to reformat the lab report to promote understanding of test results and their significance to patient care, and to reduce patient anxiety and confusion. In particular, patients' health literacy, genetic literacy, e-health literacy and risk perception may influence their overall understanding of lab results and affect patient care. We propose four options to reformat lab reports: 1) inclusion of an interpretive summary section, 2) a summary letter to accompany the lab report, 3) development of a patient user guide to be provided with the report, and 4) a completely revised patient-friendly report. The complexity of genetic and genomic test reports poses a major challenge to patient understanding that warrants the development of a report more appropriate for patients.

Authors
Haga, SB; Mills, R; Pollak, KI; Rehder, C; Buchanan, AH; Lipkus, IM; Crow, JH; Datto, M
MLA Citation
Haga, SB, Mills, R, Pollak, KI, Rehder, C, Buchanan, AH, Lipkus, IM, Crow, JH, and Datto, M. "Developing patient-friendly genetic and genomic test reports: formats to promote patient engagement and understanding." Genome medicine 6.7 (January 2014): 58-.
PMID
25473429
Source
epmc
Published In
Genome Medicine: medicine in the post-genomic era
Volume
6
Issue
7
Publish Date
2014
Start Page
58
DOI
10.1186/s13073-014-0058-6

Feasibility of using an epigenetic marker of risk for lung cancer, methylation of p16, to promote smoking cessation among US veterans.

Providing smokers feedback using epigenetic markers of lung cancer risk has yet to be tested as a strategy to motivate smoking cessation. Epigenetic modification of Rb-p16 (p16) due to tobacco exposure is associated with increased risk of developing lung cancer. This study examined the acceptance of testing for methylated p16 and the understanding of test results in smokers at risk for development of lung cancer.Thirty-five current smokers with airways obstruction viewed an educational presentation regarding p16 function followed by testing for the presence of methylated p16 in sputum. Participants were offered smoking cessation assistance and asked to complete surveys at the time of enrolment regarding their understanding of the educational material, perception of risk associated with smoking and desire to quit. Participants were notified of their test result and follow-up surveys were administered 2 and 10 weeks after notification of their test result.Twenty per cent of participants had methylated p16. Participants showed high degree of understanding of educational materials regarding the function and risk associated with p16 methylation. Sixty-seven per cent and 57% of participants with low-risk and high-risk test results, respectively, reported that the information was more likely to motivate them to quit smoking. Smoking cessation rates were similar between methylated and non-methylated participants.Testing for an epigenetic marker of lung cancer risk is accepted and understood by active smokers. A low-risk test result does not decrease motivation to stop smoking.NCT01038492.

Authors
Shofer, S; Beyea, M; Li, S; Bastian, LA; Wahidi, MM; Kelley, M; Lipkus, IM
MLA Citation
Shofer, S, Beyea, M, Li, S, Bastian, LA, Wahidi, MM, Kelley, M, and Lipkus, IM. "Feasibility of using an epigenetic marker of risk for lung cancer, methylation of p16, to promote smoking cessation among US veterans." BMJ open respiratory research 1.1 (January 2014): e000032-.
PMID
25478181
Source
epmc
Published In
BMJ Open Respiratory Research
Volume
1
Issue
1
Publish Date
2014
Start Page
e000032
DOI
10.1136/bmjresp-2014-000032

Reactions to framing of cessation messages: insights from dual-smoker couples.

INTRODUCTION: Couples in which both members smoke (dual-smoker couples) have not been the explicit target of cessation interventions. Quit rates are lower and relapse rates are higher among individuals in dual-smoker couples. A potentially effective strategy to motivate dual-smoker couples to quit is to convey messages that highlight how the positive outcomes of quitting (gain frame) or the negative outcomes of continued smoking (loss frame) affect the couple rather than the individual smoker. We explored whether dual-smoker couples' smoking behaviors (e.g., amount smoked) and desire to quit would differ as a function of message frame (gain vs. loss) or outcome focus (individual vs. couple). METHODS: Dual-smoker couples (N = 40) completed a baseline survey and were then randomized to review gain- or loss-framed messages that varied whether the outcomes influenced the individual or the couple. Main outcomes were desire to quit after reading messages and smoking behaviors at a 1-month follow-up. RESULTS: Couple-focused messages produced the strongest desire to quit and decreased amount of cigarettes smoked at follow-up. The latter effect was mediated by desire to quit. Loss-framed messages produced inconsistent effects on desire to quit. There were no significant interactions between outcome focus and message framing. CONCLUSIONS: Findings suggest that messages emphasizing how smoking affects both partners can motivate cessation among dual-smoker couples. Contrary to findings showing that gain-framed messages motivate cessation targeting individual smokers, results suggest that loss-framed messages may be more persuasive than gain-framed messages when the target of the outcome involves significant others.

Authors
Lipkus, IM; Ranby, KW; Lewis, MA; Toll, B
MLA Citation
Lipkus, IM, Ranby, KW, Lewis, MA, and Toll, B. "Reactions to framing of cessation messages: insights from dual-smoker couples." Nicotine Tob Res 15.12 (December 2013): 2022-2028.
PMID
23943846
Source
pubmed
Published In
Nicotine and Tobacco Research (OUP)
Volume
15
Issue
12
Publish Date
2013
Start Page
2022
End Page
2028
DOI
10.1093/ntr/ntt091

Mobile health messages help sustain recent weight loss

Background Using regulatory focus theory, an intervention of daily weight loss-sustaining messages was developed and tested for acceptability, feasibility, and efficacy on helping people sustain weight loss. Methods Participants (n = 120) were randomized to a promotion, prevention, or an attention-control text message group after completion of a weight loss program. Participants completed baseline assessments, and reported their weight at 1 and 3 months postbaseline. Results Participants found the message content and intervention acceptable and valuable. A minimum of one message per day delivered at approximately 8:00 am was deemed the optimal delivery time and frequency. The sustained weight loss rate at month 3 for the control, promotion, and prevention groups was 90%, 95%, and 100%, respectively. Medium-to-large effects were observed for the promotion and prevention groups at month 1 and for prevention at month 3 relative to controls. The mean weight loss for promotion and prevention was 15 pounds, compared with 10 in the controls at month 3. Conclusion A clinically significant decrease in mean weight, higher rate of sustained weight loss, and medium-to-large effects on sustained weight loss occurred in the promotion and prevention interventions. Tools such as this text message-based intervention that are constructed and guided by evidence-based content and theoretical constructs show promise in helping people sustain healthy behaviors that can lead to improved health outcomes. © 2013 Elsevier Inc. All rights reserved.

Authors
Shaw, RJ; Bosworth, HB; Silva, SS; Lipkus, IM; Davis, LL; Sha, RS; Johnson, CM
MLA Citation
Shaw, RJ, Bosworth, HB, Silva, SS, Lipkus, IM, Davis, LL, Sha, RS, and Johnson, CM. "Mobile health messages help sustain recent weight loss." American Journal of Medicine 126.11 (November 1, 2013): 1002-1009.
Source
scopus
Published In
The American Journal of Medicine
Volume
126
Issue
11
Publish Date
2013
Start Page
1002
End Page
1009
DOI
10.1016/j.amjmed.2013.07.001

Motivations for genetic testing for lung cancer risk among young smokers.

OBJECTIVE: To examine why young people might want to undergo genetic susceptibility testing for lung cancer despite knowing that tested gene variants are associated with small increases in disease risk. METHODS: The authors used a mixed-method approach to evaluate motives for and against genetic testing and the association between these motivations and testing intentions in 128 college students who smoke. RESULTS: Exploratory factor analysis yielded four reliable factors: Test Scepticism, Test Optimism, Knowledge Enhancement and Smoking Optimism. Test Optimism and Knowledge Enhancement correlated positively with intentions to test in bivariate and multivariate analyses (ps<0.001). Test Scepticism correlated negatively with testing intentions in multivariate analyses (p<0.05). Open-ended questions assessing testing motivations generally replicated themes of the quantitative survey. CONCLUSION: In addition to learning about health risks, young people may be motivated to seek genetic testing for reasons, such as gaining knowledge about new genetic technologies more broadly.

Authors
O'Neill, SC; Lipkus, IM; Sanderson, SC; Shepperd, J; Docherty, S; McBride, CM
MLA Citation
O'Neill, SC, Lipkus, IM, Sanderson, SC, Shepperd, J, Docherty, S, and McBride, CM. "Motivations for genetic testing for lung cancer risk among young smokers." Tob Control 22.6 (November 2013): 406-411.
PMID
22744911
Source
pubmed
Published In
Tobacco control
Volume
22
Issue
6
Publish Date
2013
Start Page
406
End Page
411
DOI
10.1136/tobaccocontrol-2011-050306

Long-term outcomes of the FRESH START trial: exploring the role of self-efficacy in cancer survivors' maintenance of dietary practices and physical activity.

BACKGROUND: This study examined whether changes in self-efficacy explain the effects of a mailed print intervention on long-term dietary practices of breast and prostate cancer survivors. The relationship between change in self-efficacy and long-term physical activity (PA) also was examined. METHODS: Breast and prostate cancer survivors (N = 543) from 39 US states and two Canadian provinces participated in the FRESH START intervention trial. Participants were randomly assigned to receive a 10-month program of mailed print materials on diet and PA available in the public domain or a 10-month program of tailored materials designed to increase fruit and vegetable (F&V) intake, decrease fat intake, and/or increase PA. Changes in self-efficacy for F&V intake and fat restriction were analyzed as potential mediators of the intervention's effects on diet at 2-year follow-up. Because we previously found that change in self-efficacy for PA did not vary by group assignment, the relationship between change in self-efficacy and PA at 2-year follow-up was examined across study conditions. RESULTS: Results suggest that change in self-efficacy for fat restriction partially explained the intervention's effect on fat intake (mean indirect effect = -0.28), and change in self-efficacy for F&V consumption partially explained the intervention's effect on daily F&V intake (mean indirect effect = .11). Change in self-efficacy for fat restriction partially accounted for the intervention's impact on overall diet quality among men only (mean indirect effect = 0.60). Finally, change in self-efficacy for PA predicted PA at 2-year follow-up. CONCLUSIONS: Findings suggest that self-efficacy may influence long-term maintenance of healthy lifestyle practices among cancer survivors.

Authors
Mosher, CE; Lipkus, I; Sloane, R; Snyder, DC; Lobach, DF; Demark-Wahnefried, W
MLA Citation
Mosher, CE, Lipkus, I, Sloane, R, Snyder, DC, Lobach, DF, and Demark-Wahnefried, W. "Long-term outcomes of the FRESH START trial: exploring the role of self-efficacy in cancer survivors' maintenance of dietary practices and physical activity." Psychooncology 22.4 (April 2013): 876-885.
PMID
22544562
Source
pubmed
Published In
Psycho-Oncology
Volume
22
Issue
4
Publish Date
2013
Start Page
876
End Page
885
DOI
10.1002/pon.3089

Perceptions of smoking-related risk and worry among dual-smoker couples.

INTRODUCTION: Quit rates are lower and relapse rates are higher for people in close relationships with a partner who smokes. Although desire to quit is often related to health concerns for one's self, much less is known about psychosocial factors associated with quitting in dual-smoker couples. This study investigated relations among beliefs about smoking and desire to quit from both partners' perspectives. METHODS: We recruited 63 couples in which both partners smoke daily. Participants were aged 21-67 (M = 43.0, SD = 11.3) and had been smoking for 4-51 years (M = 22.9, SD = 11.3). RESULTS: Individuals' desire to quit related to worry about partner's health (r = .29, p < .01), perceived risk of partner getting a disease if the partner continues to smoke (r = .39, p < .001), and belief that own smoking has caused partner physical harm (r = .38, p < .001). Within couples, partners were modestly concordant with regard to worry about harm of smoking for oneself (r = .30, p < .05) and partner (r = .30, p < .05), perceived risk of disease for oneself (r = .26, p < .05) and partner (r = .24, p < .05), and desire that partner quit (r = .34, p < .01). Participants had an extremely strong desire (78% = 7 on 1-7 scale) for their partner's help if they attempt to quit. CONCLUSIONS: Dual-smoker couples are at heightened health risks due to exposure to passive smoke and their own smoking. Partners' perceived risk and worry about the harms of smoking could be important leverage points for smoking cessation efforts. Interventions can be informed by considering both partners' beliefs and by helping partners develop plans for quitting and supporting each other.

Authors
Ranby, KW; Lewis, MA; Toll, BA; Rohrbaugh, MJ; Lipkus, IM
MLA Citation
Ranby, KW, Lewis, MA, Toll, BA, Rohrbaugh, MJ, and Lipkus, IM. "Perceptions of smoking-related risk and worry among dual-smoker couples." Nicotine Tob Res 15.3 (March 2013): 734-738.
PMID
22990222
Source
pubmed
Published In
Nicotine and Tobacco Research (OUP)
Volume
15
Issue
3
Publish Date
2013
Start Page
734
End Page
738
DOI
10.1093/ntr/nts210

Presenting quantitative information about decision outcomes: a risk communication primer for patient decision aid developers.

BACKGROUND: Making evidence-based decisions often requires comparison of two or more options. Research-based evidence may exist which quantifies how likely the outcomes are for each option. Understanding these numeric estimates improves patients' risk perception and leads to better informed decision making. This paper summarises current "best practices" in communication of evidence-based numeric outcomes for developers of patient decision aids (PtDAs) and other health communication tools. METHOD: An expert consensus group of fourteen researchers from North America, Europe, and Australasia identified eleven main issues in risk communication. Two experts for each issue wrote a "state of the art" summary of best evidence, drawing on the PtDA, health, psychological, and broader scientific literature. In addition, commonly used terms were defined and a set of guiding principles and key messages derived from the results. RESULTS: The eleven key components of risk communication were: 1) Presenting the chance an event will occur; 2) Presenting changes in numeric outcomes; 3) Outcome estimates for test and screening decisions; 4) Numeric estimates in context and with evaluative labels; 5) Conveying uncertainty; 6) Visual formats; 7) Tailoring estimates; 8) Formats for understanding outcomes over time; 9) Narrative methods for conveying the chance of an event; 10) Important skills for understanding numerical estimates; and 11) Interactive web-based formats. Guiding principles from the evidence summaries advise that risk communication formats should reflect the task required of the user, should always define a relevant reference class (i.e., denominator) over time, should aim to use a consistent format throughout documents, should avoid "1 in x" formats and variable denominators, consider the magnitude of numbers used and the possibility of format bias, and should take into account the numeracy and graph literacy of the audience. CONCLUSION: A substantial and rapidly expanding evidence base exists for risk communication. Developers of tools to facilitate evidence-based decision making should apply these principles to improve the quality of risk communication in practice.

Authors
Trevena, LJ; Zikmund-Fisher, BJ; Edwards, A; Gaissmaier, W; Galesic, M; Han, PKJ; King, J; Lawson, ML; Linder, SK; Lipkus, I; Ozanne, E; Peters, E; Timmermans, D; Woloshin, S
MLA Citation
Trevena, LJ, Zikmund-Fisher, BJ, Edwards, A, Gaissmaier, W, Galesic, M, Han, PKJ, King, J, Lawson, ML, Linder, SK, Lipkus, I, Ozanne, E, Peters, E, Timmermans, D, and Woloshin, S. "Presenting quantitative information about decision outcomes: a risk communication primer for patient decision aid developers." BMC medical informatics and decision making 13 Suppl 2 (January 2013): S7-. (Review)
PMID
24625237
Source
epmc
Published In
BMC Medical Informatics and Decision Making
Volume
13 Suppl 2
Publish Date
2013
Start Page
S7
DOI
10.1186/1472-6947-13-s2-s7

Motivations for genetic testing for lung cancer risk among young smokers

Objective To examine why young people might want to undergo genetic susceptibility testing for lung cancer despite knowing that tested gene variants are associated with small increases in disease risk. Methods The authors used a mixed-method approach to evaluate motives for and against genetic testing and the association between these motivations and testing intentions in 128 college students who smoke. Results Exploratory factor analysis yielded four reliable factors: Test Scepticism, Test Optimism, Knowledge Enhancement and Smoking Optimism. Test Optimism and Knowledge Enhancement correlated positively with intentions to test in bivariate and multivariate analyses (ps<0.001). Test Scepticism correlated negatively with testing intentions in multivariate analyses (p<0.05). Open-ended questions assessing testing motivations generally replicated themes of the quantitative survey. Conclusion In addition to learning about health risks, young people may be motivated to seek genetic testing for reasons, such as gaining knowledge about new genetic technologies more broadly.

Authors
O'Neill, SC; Lipkus, IM; Sanderson, SC; Shepperd, J; Docherty, S; Mcbride, CM
MLA Citation
O'Neill, SC, Lipkus, IM, Sanderson, SC, Shepperd, J, Docherty, S, and Mcbride, CM. "Motivations for genetic testing for lung cancer risk among young smokers." Tobacco Control 22.6 (2013): 406-411.
Source
scival
Published In
Tobacco control
Volume
22
Issue
6
Publish Date
2013
Start Page
406
End Page
411
DOI
10.1136/tobaccocontrol-2011-050306

Testing different communication formats on responses to imagined risk of having versus missing the GSTM1 gene.

Genetic markers of lung cancer susceptibility, such as the common variant of the glutathione S-transferase Mu 1 gene (GSTM1-null), confer small probabilities of disease risk. The authors explored the influence of different approaches to communicating the small variations in risk associated with this biomarker. College smokers (N = 128) imagined that they had the GSTM1 wild-type variant versus the GSTM1 null-type variant. The authors presented lung cancer risk in 6 ways that varied the risk format (absolute risk vs. incremental risk) and the presentation style of the information (no graphics vs. graphic display of foreground only vs. graphic display of foreground + background). Presentation style had minor effects. However, absolute risk information increased negative emotions more than did incremental risk information. Perceptions of risk and negative emotions were most profoundly affected by the difference between having the GSTM1 wild-type variant versus the GSTM1 null-type variant. The authors discuss implications for conveying small probabilities related to genetic risk.

Authors
Shepperd, JA; Lipkus, IM; Sanderson, SC; McBride, CM; O'Neill, SC; Docherty, S
MLA Citation
Shepperd, JA, Lipkus, IM, Sanderson, SC, McBride, CM, O'Neill, SC, and Docherty, S. "Testing different communication formats on responses to imagined risk of having versus missing the GSTM1 gene." J Health Commun 18.1 (2013): 124-137.
PMID
22888806
Source
pubmed
Published In
Journal of Health Communication
Volume
18
Issue
1
Publish Date
2013
Start Page
124
End Page
137
DOI
10.1080/10810730.2012.688245

Long-term outcomes of the FRESH START trial: Exploring the role of self-efficacy in cancer survivors' maintenance of dietary practices and physical activity

Background This study examined whether changes in self-efficacy explain the effects of a mailed print intervention on long-term dietary practices of breast and prostate cancer survivors. The relationship between change in self-efficacy and long-term physical activity (PA) also was examined. Methods Breast and prostate cancer survivors (N = 543) from 39 US states and two Canadian provinces participated in the FRESH START intervention trial. Participants were randomly assigned to receive a 10-month program of mailed print materials on diet and PA available in the public domain or a 10-month program of tailored materials designed to increase fruit and vegetable (F&V) intake, decrease fat intake, and/or increase PA. Changes in self-efficacy for F&V intake and fat restriction were analyzed as potential mediators of the intervention's effects on diet at 2-year follow-up. Because we previously found that change in self-efficacy for PA did not vary by group assignment, the relationship between change in self-efficacy and PA at 2-year follow-up was examined across study conditions. Results Results suggest that change in self-efficacy for fat restriction partially explained the intervention's effect on fat intake (mean indirect effect = -0.28), and change in self-efficacy for F&V consumption partially explained the intervention's effect on daily F&V intake (mean indirect effect =.11). Change in self-efficacy for fat restriction partially accounted for the intervention's impact on overall diet quality among men only (mean indirect effect = 0.60). Finally, change in self-efficacy for PA predicted PA at 2-year follow-up. Conclusions Findings suggest that self-efficacy may influence long-term maintenance of healthy lifestyle practices among cancer survivors. Copyright © 2012 John Wiley & Sons, Ltd. Copyright © 2012 John Wiley & Sons, Ltd.

Authors
Mosher, CE; Lipkus, I; Sloane, R; Snyder, DC; Lobach, DF; Demark-Wahnefried, W
MLA Citation
Mosher, CE, Lipkus, I, Sloane, R, Snyder, DC, Lobach, DF, and Demark-Wahnefried, W. "Long-term outcomes of the FRESH START trial: Exploring the role of self-efficacy in cancer survivors' maintenance of dietary practices and physical activity." Psycho-Oncology 22.4 (2013): 876-885.
Source
scival
Published In
Psycho-Oncology
Volume
22
Issue
4
Publish Date
2013
Start Page
876
End Page
885
DOI
10.1002/pon.3089

Development of a theoretically driven mHealth text messaging application for sustaining recent weight loss

Background: Mobile phone short message service (SMS) text messaging, has the potential to serve as an intervention medium to promote sustainability of weight loss that can be easily and affordably used by clinicians and consumers. Objective: To develop theoretically driven weight loss sustaining text messages and pilot an mHealth SMS text messaging intervention to promote sustaining recent weight loss in order to understand optimal frequency and timing of message delivery, and for feasibility and usability testing. Results from the pilot study were used to design and construct a patient privacy compliant automated SMS application to deliver weight loss sustaining messages. Methods: We first conducted a pilot study in which participants (N=16) received a daily SMS text message for one month following a structured weight loss program. Messages were developed from diet and exercise guidelines. Following the intervention, interviews were conducted and self-reported weight was collected via SMS text messaging. Results: All participants (N=16) were capable of sending and receiving SMS text messages. During the phone interview at 1 month post-baseline and at 3 months post-baseline, 13/14 (93%) of participants who completed the study reported their weight via SMS. At 3 months post-baseline, 79% (11/14) participants sustained or continued to lose weight. Participants (13/14, 93%) were favorable toward the messages and the majority (10/14, 71%) felt they were useful in helping them sustain weight loss. All 14 participants who completed the interview thought SMS was a favorable communication medium and was useful to receive short relevant messages promptly and directly. All participants read the messages when they knew they arrived and most (11/14, 79%) read the messages at the time of delivery. All participants felt that at least one daily message is needed to sustain weight loss behaviors and that they should be delivered in the morning. Results were then used to develop the SMS text messaging application. Conclusions: Study results demonstrated the feasibility of developing weight loss SMS text messages, and the development of an mHealth SMS text messaging application. SMS text messaging was perceived as an appropriate and accepted tool to deliver health promotion content.

Authors
Shaw, RJ; Bosworth, HB; Hess, JC; Silva, SG; Lipkus, IM; Davis, LL; Johnson, CM
MLA Citation
Shaw, RJ, Bosworth, HB, Hess, JC, Silva, SG, Lipkus, IM, Davis, LL, and Johnson, CM. "Development of a theoretically driven mHealth text messaging application for sustaining recent weight loss." Journal of Medical Internet Research 15.5 (2013).
PMID
25100678
Source
scival
Published In
Journal of medical Internet research
Volume
15
Issue
5
Publish Date
2013
DOI
10.2196/mhealth.2343

Long-term physical activity outcomes of home-based lifestyle interventions among breast and prostate cancer survivors.

PURPOSE: Few studies have investigated long-term effects of physical activity (PA) interventions. The goal of this study was to evaluate whether or not increased levels of moderate to vigorous physical activity (MVPA) were maintained by cancer survivors 1 year after receipt of two home-based interventions. METHODS: The FRESH START trial randomized 543 breast and prostate cancer survivors to 1-of-2 mailed print diet and exercise interventions: sequentially-tailored vs. standardized (attention control). Each arm received eight mailings over a 1-year period, with follow-up at 1 and 2 years. This analysis focuses solely on the 400 participants who had suboptimal levels of MVPA at baseline (measured by the 7-Day Physical Activity Recall) and who completed the 2-year study. RESULTS: Median minutes of MVPA at baseline, 1-year and 2-year follow-up in the tailored intervention arm were as follows: 0, 90, and 60 min/week, respectively. The corresponding values in the attention control group were 0, 30, and 30 min/week. Significant improvements in MVPA from baseline to 2-year follow-up were observed in both study arms (p < 0.01). While significant between-arm differences were observed at 1-year follow-up (p < 0.01), there was only the suggestion of a trend (p = 0.08) at 2-year follow-up. CONCLUSIONS: This study provides evidence that mailed-print exercise interventions result in significant and sustainable improvements in MVPA among newly diagnosed cancer survivors that are observed well after the intervention is complete. While tailored interventions, as compared to standardized materials, appear to produce superior improvements in MVPA initially, these differences diminish over time.

Authors
Ottenbacher, AJ; Day, RS; Taylor, WC; Sharma, SV; Sloane, R; Snyder, DC; Lipkus, IM; Jones, LW; Demark-Wahnefried, W
MLA Citation
Ottenbacher, AJ, Day, RS, Taylor, WC, Sharma, SV, Sloane, R, Snyder, DC, Lipkus, IM, Jones, LW, and Demark-Wahnefried, W. "Long-term physical activity outcomes of home-based lifestyle interventions among breast and prostate cancer survivors." Support Care Cancer 20.10 (October 2012): 2483-2489.
PMID
22249915
Source
pubmed
Published In
Supportive Care in Cancer
Volume
20
Issue
10
Publish Date
2012
Start Page
2483
End Page
2489
DOI
10.1007/s00520-011-1370-y

Survey of genetic counselors and clinical geneticists' use and attitudes toward pharmacogenetic testing.

Pharmacogenetic (PGx) testing aims to improve therapeutic outcomes through tailoring treatment based on a patient's genetic risk for non-response and/or an adverse event. Given their expertise, geneticists could facilitate the use of PGx testing; however, the preparedness and perceived role of the clinical genetics community is unclear. To assess the attitudes, preparedness, and perceived roles of geneticists in the delivery of PGx testing, we conducted a survey of 1500 randomly selected board-certified genetic counselors and clinical geneticists in the United States [response rate: 37.8% (n = 516)]. Twelve percent of genetic counselors and 41% of clinical geneticists indicated that they had ordered or coordinated patient care for PGx testing, a seemingly high proportion at this early stage of adoption. Almost all respondents had some education on pharmacogenetics, although only 28% of counselors and 58% of clinical geneticists indicated they felt well-informed about PGx testing. About half of counselors (52%) and clinical geneticists (46%) felt they would play 'some' role in the delivery of PGx testing; 17 and 19%, respectively, felt that they would play 'no' or 'a little' role. At this early stage of PGx testing, the role of geneticists and genetic counselors is unclear. However, their experience may aid in readying PGx testing and informing delivery strategies into clinical practice.

Authors
Haga, SB; O'Daniel, JM; Tindall, GM; Mills, R; Lipkus, IM; Agans, R
MLA Citation
Haga, SB, O'Daniel, JM, Tindall, GM, Mills, R, Lipkus, IM, and Agans, R. "Survey of genetic counselors and clinical geneticists' use and attitudes toward pharmacogenetic testing." Clin Genet 82.2 (August 2012): 115-120.
PMID
22283474
Source
pubmed
Published In
Clinical Genetics
Volume
82
Issue
2
Publish Date
2012
Start Page
115
End Page
120
DOI
10.1111/j.1399-0004.2012.01848.x

Survey of US public attitudes toward pharmacogenetic testing.

To assess public attitudes and interest in pharmacogenetic (PGx) testing, we conducted a random-digit-dial telephone survey of US adults, achieving a response rate of 42% (n=1139). Most respondents expressed interest in PGx testing to predict mild or serious side effects (73±3.29 and 85±2.91%, respectively), guide dosing (91%) and assist with drug selection (92%). Younger individuals (aged 18-34 years) were more likely to be interested in PGx testing to predict serious side effects (vs aged 55+ years), as well as Whites, those with a college degree, and who had experienced side effects from medications. However, most respondents (78±3.14%) were not likely to have a PGx test if there was a risk that their DNA sample or test result could be shared without their permission. Given differences in interest among some groups, providers should clearly discuss the purpose of testing, alternative testing options (if available) and policies to protect patient privacy and confidentiality.

Authors
Haga, SB; O'Daniel, JM; Tindall, GM; Lipkus, IR; Agans, R
MLA Citation
Haga, SB, O'Daniel, JM, Tindall, GM, Lipkus, IR, and Agans, R. "Survey of US public attitudes toward pharmacogenetic testing." Pharmacogenomics J 12.3 (June 2012): 197-204.
PMID
21321582
Source
pubmed
Published In
The Pharmacogenomics Journal
Volume
12
Issue
3
Publish Date
2012
Start Page
197
End Page
204
DOI
10.1038/tpj.2011.1

It's the amount of thought that counts: when ambivalence contributes to mammography screening delay.

PURPOSE: This study examines whether ambivalence toward mammography screening, as moderated by total amount of thought given to the reasons for and against getting mammograms at recommended intervals, predicts greater delay in obtaining subsequent screening mammograms. METHODS: A sample of 3,430 insured women with recent (within the last 8-9 months) screening mammograms completed telephone interviews as part of a 5-year intervention study to achieve sustained adherence to annual-interval mammography. Delay was assessed by the number of days between mammograms. RESULTS: Controlling for demographic factors and perceived screening barriers, days between mammograms increased as ambivalence and thought increased. Thought moderated ambivalence: Among women who were most ambivalent, women obtained mammograms 1 month earlier for each unit increase in thought. CONCLUSION: Future studies should test innovative ways to resolve ambivalence and increase thought about consequences of getting mammograms as a strategy to promote mammography screening adherence.

Authors
O'Neill, SC; Lipkus, IM; Gierisch, JM; Rimer, BK; Bowling, JM
MLA Citation
O'Neill, SC, Lipkus, IM, Gierisch, JM, Rimer, BK, and Bowling, JM. "It's the amount of thought that counts: when ambivalence contributes to mammography screening delay." Womens Health Issues 22.2 (March 2012): e189-e194.
PMID
22055988
Source
pubmed
Published In
Women's Health Issues
Volume
22
Issue
2
Publish Date
2012
Start Page
e189
End Page
e194
DOI
10.1016/j.whi.2011.08.008

Overutilization of endoscopic surveillance in nondysplastic Barrett's esophagus: a multicenter study.

BACKGROUND: Guidelines suggest that patients with nondysplastic Barrett's esophagus (BE) undergo endoscopic surveillance every 3 to 5 years, but actual use of surveillance endoscopy and the determinants of variation in surveillance intervals are not known. OBJECTIVE: To measure use of surveillance endoscopy and its variation in patients with nondysplastic BE. DESIGN: Multicenter, cross-sectional study. SETTING: Three sites in Arizona, Minnesota, and North Carolina. PATIENTS: This study involved patients who had prevalent BE without a history of high-grade dysplasia or esophageal adenocarcinoma. INTERVENTION: Participants were given validated measures of quality of life, numeracy, and cancer risk perception, and the total number of prior endoscopic surveillance examinations was measured. MAIN OUTCOME MEASUREMENTS: Oversurveillance was defined as >1 surveillance examination per 3-year period. RESULTS: Among 235 patients with nondysplastic BE, 76% were male and 94% were white. The average (± standard deviation [SD]) duration of BE was 6.5 ± 5.9 years. The mean (± SD) number of endoscopies per 3-year period was 2.7 ± 2.6. Oversurveillance was present in 65% of participants, resulting in a mean of 2.3 excess endoscopies per patient. Neither numeracy skills nor patient perception of cancer risk were associated with oversurveillance. LIMITATIONS: Endoscopies were measured by patient report, which is subject to error. Results may be generalizable only to patients seen in academic centers. CONCLUSION: Most patients with nondysplastic BE had more surveillance endoscopic examinations than is recommended by published guidelines. Patient factors did not predict oversurveillance, indicating that other factors may influence decisions about the interval and frequency of surveillance examinations.

Authors
Crockett, SD; Lipkus, IM; Bright, SD; Sampliner, RE; Wang, KK; Boolchand, V; Lutzke, LS; Shaheen, NJ
MLA Citation
Crockett, SD, Lipkus, IM, Bright, SD, Sampliner, RE, Wang, KK, Boolchand, V, Lutzke, LS, and Shaheen, NJ. "Overutilization of endoscopic surveillance in nondysplastic Barrett's esophagus: a multicenter study." Gastrointest Endosc 75.1 (January 2012): 23-31.e2.
PMID
22100301
Source
pubmed
Published In
Gastrointestinal Endoscopy
Volume
75
Issue
1
Publish Date
2012
Start Page
23
End Page
31.e2
DOI
10.1016/j.gie.2011.08.042

Treatment choices based on Onco type Dx in the breast oncology care setting

Introduction. This study aimed to evaluate whether OncotypeDx test results predict receipt of adjuvant chemotherapy in breast cancer patients who received an OncotypeDx recurrence score (RS). Materials and Methods. Pathology records were used to identify breast cancer patients who had OncotypeDx testing between December 2004 and January 2009 (n = 118). Patient sociodemographic information, tumor characteristics, RS, and treatment-specific data were collected via chart review. RS was classified as follows: low (RS ≤ 17), intermediate (RS = 1830), or high (RS ≥ 31). Bivariate analyses were conducted to investigate the relationship between adjuvant chemotherapy receipt and each sociodemographic and clinical characteristic; significant sociodemographic and clinical variables were included in a multivariable logistic regression model. Results. In multivariable analysis controlling for tumor size, histologic grade, and nuclear grade, only RS remained significantly associated with chemotherapy uptake. Relative to low RS, an intermediate (adjusted odds ratio [AOR], 21.24; 95% confidence interval [CI], 3.62237.52) or high (AOR, 15.07; 95% CI, 1.28288.21) RS was associated with a greater odds of chemotherapy uptake. Discussion. Results indicate that RS was significantly associated with adjuvant chemotherapy uptake, suggesting that OncotypeDx results were used to inform treatment decision making, although it is unclear if and how the information was conveyed to patients. © 2012 Teri L. Malo et al.

Authors
Malo, TL; Lipkus, I; Wilson, T; Han, HS; Acs, G; Vadaparampil, ST
MLA Citation
Malo, TL, Lipkus, I, Wilson, T, Han, HS, Acs, G, and Vadaparampil, ST. "Treatment choices based on Onco type Dx in the breast oncology care setting." Journal of Cancer Epidemiology (2012).
Source
scival
Published In
Journal of Cancer Epidemiology
Publish Date
2012
DOI
10.1155/2012/941495

Response to Newman et al

Authors
Haga, SB; O'Daniel, JM; Tindall, GM; Mills, R; Lipkus, I; Agans, R
MLA Citation
Haga, SB, O'Daniel, JM, Tindall, GM, Mills, R, Lipkus, I, and Agans, R. "Response to Newman et al." Clinical Genetics 82.2 (2012): 203--.
Source
scival
Published In
Clinical Genetics
Volume
82
Issue
2
Publish Date
2012
Start Page
203-
DOI
10.1111/j.1399-0004.2012.01874.x

Knowledge about genomic recurrence risk testing among breast cancer survivors.

Genomic expression profiling of tumors is used to individualize early-stage breast cancer treatment. However, very little is known about patients' understanding of and desired information about these tests, such as Oncotype DX. We addressed these issues via a survey mailed to 130 early-stage breast cancer patients who received an Oncotype DX test result. The survey assessed understanding (14 items), information desired about genomic expression profiling tests, and if and where they sought information about Oncotype DX. Sixty-four surveys were returned. Overall, 54% of the knowledge items were answered correctly. Patients wanted education about genomic tests in many areas. Overall, 62% sought information about the test, primarily from the Internet (48%) and doctor or health care provider (31%). In sum, patients' misunderstanding of genomic tests abound, necessitating better educational efforts on behalf of health care systems to meet their needs for varied information through different communication channels.

Authors
Lipkus, IM; Vadaparampil, ST; Jacobsen, PB; Miree, CA
MLA Citation
Lipkus, IM, Vadaparampil, ST, Jacobsen, PB, and Miree, CA. "Knowledge about genomic recurrence risk testing among breast cancer survivors." J Cancer Educ 26.4 (December 2011): 664-669.
PMID
21688183
Source
pubmed
Published In
Journal of Cancer Education
Volume
26
Issue
4
Publish Date
2011
Start Page
664
End Page
669
DOI
10.1007/s13187-011-0248-5

Young smokers' views of genetic susceptibility testing for lung cancer risk: minding unintended consequences.

Assessment of smokers' responses to individualized feedback of genetic susceptibility has shown little or no influence on smoking cessation outcomes. One explanation is that smokers may be having unintended responses that undermine the feedback's motivational impact (e.g., fatalism or downplaying risk). In preparation for a large randomized trial with college smokers, we conducted a qualitative pilot study to explore smokers' motives for genetic testing and how these motives might influence interpretation of genetic risk feedback.Prior to reviewing informational materials describing a test for the glutathione S-transferase M1 gene, 33 college smokers (18 to 21 years) participated in a 30 minute, semi-structured, open-ended interview regarding their attitudes on health risks, genetic testing in general, genetic testing for lung cancer risk, and informational needs regarding genetics and genetic testing for lung cancer risk.Two central themes emerged from analysis of the interviews: general impressions of genetic testing and perceived value of genetic testing. Prominent in the second theme was the finding that genetic risk feedback may be unsuccessful in motivating quitting a) due to skepticism about genetic tests, b) participants dismissing genetic feedback as personally irrelevant, and c) participants receiving low risk results justifying continued smoking in light of public health messages that "it's never too late to quit". These findings require careful consideration among health professionals looking to genetic risk feedback as a vehicle to motivate disease prevention or behavior change.

Authors
Docherty, SL; McBride, CM; Sanderson, SC; O'Neill, SC; Shepperd, JA; Lipkus, IM
MLA Citation
Docherty, SL, McBride, CM, Sanderson, SC, O'Neill, SC, Shepperd, JA, and Lipkus, IM. "Young smokers' views of genetic susceptibility testing for lung cancer risk: minding unintended consequences." J Community Genet 2.3 (September 2011): 165-172.
PMID
21860660
Source
pubmed
Published In
Journal of Community Genetics
Volume
2
Issue
3
Publish Date
2011
Start Page
165
End Page
172
DOI
10.1007/s12687-011-0053-1

Public attitudes toward ancillary information revealed by pharmacogenetic testing under limited information conditions.

PURPOSE: Pharmacogenetic testing can inform drug dosing and selection by aiding in estimating a patient's genetic risk of adverse response and/or failure to respond. Some pharmacogenetic tests may generate ancillary clinical information unrelated to the drug treatment question for which testing is done-an informational "side effect." We aimed to assess public interest and concerns about pharmacogenetic tests and ancillary information. METHODS: We conducted a random-digit-dial phone survey of a sample of the US public. RESULTS: We achieved an overall response rate of 42% (n = 1139). When the potential for ancillary information was presented, 85% (±2.82%) of respondents expressed interest in pharmacogenetic testing, compared with 82% (±3.02%) before discussion of ancillary information. Most respondents (89% ± 2.27%) indicated that physicians should inform patients that a pharmacogenetic test may reveal ancillary risk information before testing is ordered. Respondents' interest in actually learning of the ancillary risk finding significantly differed based on disease severity, availability of an intervention, and test validity, even after adjusting for age, gender, education, and race. CONCLUSION: Under the limited information conditions presented in the survey, the potential of ancillary information does not negatively impact public interest in pharmacogenetic testing. Interest in learning ancillary information is well aligned with the public's desire to be informed about potential benefits and risks before testing, promoting patient autonomy.

Authors
Haga, SB; O'Daniel, JM; Tindall, GM; Lipkus, IR; Agans, R
MLA Citation
Haga, SB, O'Daniel, JM, Tindall, GM, Lipkus, IR, and Agans, R. "Public attitudes toward ancillary information revealed by pharmacogenetic testing under limited information conditions." Genet Med 13.8 (August 2011): 723-728.
PMID
21633294
Source
pubmed
Published In
Genetics in Medicine
Volume
13
Issue
8
Publish Date
2011
Start Page
723
End Page
728
DOI
10.1097/GIM.0b013e31821afcc0

Affecting perceptions of harm and addiction among college waterpipe tobacco smokers.

INTRODUCTION: The spread of waterpipe tobacco use among youth may be due in part to perceptions that waterpipe tobacco use is safer than other tobacco products, such as cigarettes. In two pilot studies, we sought to modify college waterpipe smokers' perceived risks and worry about waterpipe tobacco smoking. METHODS: We conducted two web-based studies that varied whether college waterpipe users received information on (a) spread of and use of flavored tobacco in waterpipe and (b) harms of waterpipe smoking. Study 1 (N = 91) tested the "incremental" effects on perceptions of risk and worry of adding information about harms of waterpipe smoking to information on the spread of waterpipe and use of flavorings in the tobacco. Study 2 (N = 112) tested the effects on perceptions of risk and worry of reviewing information about harms of waterpipe smoking compared to a no information control group. In Study 1 only, we assessed as part of a 6-month follow-up (n = 70) the percentage of participants who reported no longer using waterpipe. RESULTS: Pooling data from both studies, participants who received information about the harms of waterpipe smoking reported greater perceived risk and worry about harm and addiction and expressed a stronger desire to quit. In Study 1, 62% of participants in the experimental group versus 33% in the control group reported having stopped waterpipe use. Conclusions: These are the first studies to show that perceptions of addiction and harm from waterpipe use can be modified using minimally intensive interventions; such interventions show promise at decreasing waterpipe use.

Authors
Lipkus, IM; Eissenberg, T; Schwartz Bloom, RD; Prokhorov, AV; Levy, J
MLA Citation
Lipkus, IM, Eissenberg, T, Schwartz Bloom, RD, Prokhorov, AV, and Levy, J. "Affecting perceptions of harm and addiction among college waterpipe tobacco smokers." Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 13.7 (July 2011): 599-610. (Academic Article)
PMID
21471304
Source
manual
Published In
Nicotine and Tobacco Research (OUP)
Volume
13
Issue
7
Publish Date
2011
Start Page
599
End Page
610
DOI
10.1093/ntr/ntr049

Parents' attitudes toward pediatric genetic testing for common disease risk.

OBJECTIVE: To describe parents' attitudes toward pediatric genetic testing for common, adult-onset health conditions and to identify factors underlying these attitudes. PARTICIPANTS AND METHODS: Parents (n = 219) enrolled in a large, group-practice health plan were offered a "multiplex" genetic test for susceptibility to 8 common, adult-onset health conditions and completed an online survey assessing attitudes and beliefs about the risks and benefits of the test for their child, their willingness to consider having their child tested, and other psychosocial variables. RESULTS: Parents viewed the benefits of pediatric testing to outweigh its risks (positive decisional balance) and were moderately interested in pediatric testing. Variables associated with positive decisional balance included greater interest in knowing about gene-health associations in their child, anticipation of less difficulty understanding their child's genetic health risks, and more positive emotional reactions to learning about their child's decreased health risks (adjusted R(2) = 0.33, P < .0001). Similarly, variables associated with greater parental willingness to test were being a mother (versus being a father), greater perceived risk of diseases in their child, greater interest in knowing about gene-health relationships in their child, anticipating less difficulty learning about their child's genetic health risks, anticipating more positive emotional reactions to learning about their child's decreased health risks, and positive decisional balance (adjusted R(2) = 0.57, P < .0001). CONCLUSIONS: As genetic susceptibility testing for common, adult-onset health conditions proliferates, pediatricians should anticipate parents' interest in testing children and be prepared to facilitate informed decision making about such testing.

Authors
Tercyak, KP; Hensley Alford, S; Emmons, KM; Lipkus, IM; Wilfond, BS; McBride, CM
MLA Citation
Tercyak, KP, Hensley Alford, S, Emmons, KM, Lipkus, IM, Wilfond, BS, and McBride, CM. "Parents' attitudes toward pediatric genetic testing for common disease risk." Pediatrics 127.5 (May 2011): e1288-e1295.
PMID
21502235
Source
pubmed
Published In
Pediatrics
Volume
127
Issue
5
Publish Date
2011
Start Page
e1288
End Page
e1295
DOI
10.1542/peds.2010-0938

Communicating genetic and genomic information: Health literacy and numeracy considerations

Genomic research is transforming our understanding of the role of genes in health and disease. These advances, and their application to common diseases that affect large segments of the general population, suggest that researchers and practitioners in public health genomics will increasingly be called upon to translate genomic information to individuals with varying levels of health literacy and numeracy. This paper discusses the current state of research regarding public understanding of genetics and genomics, the influence of health literacy and numeracy on genetic communication, and behavioral responses to genetic and genomic information. The existing research suggests that members of the general public have some familiarity with genetic and genomic terms but have gaps in understanding of underlying concepts. Findings from the limited research base to date indicate that health literacy affects understanding of print and oral communications about genetic and genomic information. Numeracy is also likely to be an important predictor of being able to understand and apply this information, although little research has been conducted in this area to date. In addition, although some research has examined behavior change in response to the receipt of information about genetic risk for familial disorders and genomic susceptibility to common, complex diseases, the effects of health literacy and numeracy on these responses have not been examined. Potential areas in which additional research is needed are identified and practical suggestions for presenting numeric risk information are outlined. Public health genomics researchers and practitioners are uniquely positioned to engage in research that explores how different audiences react to and use genomic risk information. Copyright © 2010 S. Karger AG, Basel.

Authors
Lea, DH; Kaphingst, KA; Bowen, D; Lipkus, I; Hadley, DW
MLA Citation
Lea, DH, Kaphingst, KA, Bowen, D, Lipkus, I, and Hadley, DW. "Communicating genetic and genomic information: Health literacy and numeracy considerations." Public Health Genomics 14.4-5 (2011): 279-289.
PMID
20407217
Source
scival
Published In
Public health genomics
Volume
14
Issue
4-5
Publish Date
2011
Start Page
279
End Page
289
DOI
10.1159/000294191

Self-affirmation moderates effects of unrealistic optimism and pessimism on reactions to tailored risk feedback.

We examined whether self-affirmation would facilitate intentions to engage in colorectal cancer (CRC) screening among individuals who were off-schedule for CRC screening and who were categorised as unrealistically optimistic, realistic or unrealistically pessimistic about their CRC risk. All participants received tailored risk feedback; in addition, one group received threatening social comparison information regarding their risk factors, a second received this information after a self-affirmation exercise and a third was a no-treatment control. When participants were unrealistically optimistic about their CRC risk (determined by comparing their perceived comparative risk to calculations from a risk algorithm), they expressed greater interest in screening if they were self-affirmed (relative to controls). Non-affirmed unrealistic optimists expressed lower interest relative to controls, suggesting that they were responding defensively. Realistic participants and unrealistically pessimistic participants who were self-affirmed expressed relatively less interest in CRC screening, suggesting that self-affirmation can be helpful or hurtful depending on the accuracy of one's risk perceptions.

Authors
Klein, WMP; Lipkus, IM; Scholl, SM; McQueen, A; Cerully, JL; Harris, PR
MLA Citation
Klein, WMP, Lipkus, IM, Scholl, SM, McQueen, A, Cerully, JL, and Harris, PR. "Self-affirmation moderates effects of unrealistic optimism and pessimism on reactions to tailored risk feedback." Psychol Health 25.10 (December 2010): 1195-1208.
PMID
20204982
Source
pubmed
Published In
Psychology and Health
Volume
25
Issue
10
Publish Date
2010
Start Page
1195
End Page
1208
DOI
10.1080/08870440903261970

Breast cancer patients' treatment expectations after exposure to the decision aid program adjuvant online: the influence of numeracy.

The decision aid called ''Adjuvant Online'' (Adjuvant! for short) helps breast cancer patients make treatment decisions by providing numerical estimates of treatment efficacy (e.g., 10-y relapse or survival). Studies exploring how patients' numeracy interacts with the estimates provided by Adjuvant! are lacking. Pooling across 2 studies totaling 105 women with estrogen receptor-positive, early-stage breast cancer, the authors explored patients' treatment expectations, perceived benefit from treatments, and confidence of personal benefit from treatments. Patients who were more numerate were more likely to provide estimates of cancer-free survival that matched the estimates provided by Adjuvant! for each treatment option compared with patients with lower numeracy (odds ratios of 1.6 to 2.4). As estimates of treatment efficacy provided by Adjuvant! increased, so did patients' estimates of cancer-free survival (0.37 > r(s) > 0.48) and their perceptions of treatment benefit from hormonal therapy (r(s) = 0.28) and combined therapy (r(s) = 0.27). These relationships were significantly more pronounced for those with higher numeracy, especially for perceived benefit of combined therapy. Results suggest that numeracy influences a patient's ability to interpret numerical estimates of treatment efficacy from decision aids such as Adjuvant!.

Authors
Lipkus, IM; Peters, E; Kimmick, G; Liotcheva, V; Marcom, P
MLA Citation
Lipkus, IM, Peters, E, Kimmick, G, Liotcheva, V, and Marcom, P. "Breast cancer patients' treatment expectations after exposure to the decision aid program adjuvant online: the influence of numeracy." Med Decis Making 30.4 (July 2010): 464-473.
PMID
20160070
Source
pubmed
Published In
Medical Decision Making
Volume
30
Issue
4
Publish Date
2010
Start Page
464
End Page
473
DOI
10.1177/0272989X09360371

Women's experiences with genomic testing for breast cancer recurrence risk

BACKGROUND: Few studies have examined how patients understand and use genomic test results when deciding about treatment. This study examined how women receive and incorporate results of Oncotype DX, a genomic test that offers recurrence risk estimates, into decisions about adjuvant treatment for early stage breast cancer. METHODS: Participants in the cross-sectional study were 77 women with early stage, estrogen receptor-positive breast cancer with 0 to 3 positive lymph nodes who received Oncotype DX between 2004 and 2009. Mailed surveys, supplemented by medical chart review, assessed how women received and understood recurrence risk information based on the test. RESULTS: The most common test results were low (50%, 34 of 68) or intermediate (37%, 25 of 68) breast cancer recurrence risk. Most women accurately recalled their recurrence risk based on the test (71%) and felt they understood much of what they were told about it (67%). Approximately 25% of women recalled experiencing test-related distress. Women's perceived recurrence risk was associated with their actual genomic-based recurrence risks, having had a previous cancer diagnosis, and worry about recurrence.Women with high recurrence risk typically had chemotherapy (78%, 7 of 9), whereas only 2 with a low recurrence risk did (7%, 2 of 30). CONCLUSIONS: This is among the first studies to describe patients' experiences with genomic testing for recurrence risk. Although many women understood discussions about their genomic test results, a third reported not fully understanding these discussions, suggesting a need to aid and improve risk communication and treatment decision making. © 2010 American Cancer Society.

Authors
Tzeng, JP; Mayer, D; Richman, AR; Lipkus, I; Han, PK; Valle, CG; Carey, LA; Brewer, NT
MLA Citation
Tzeng, JP, Mayer, D, Richman, AR, Lipkus, I, Han, PK, Valle, CG, Carey, LA, and Brewer, NT. "Women's experiences with genomic testing for breast cancer recurrence risk." Cancer 116.8 (2010): 1992-2000.
PMID
20213682
Source
scival
Published In
Cancer
Volume
116
Issue
8
Publish Date
2010
Start Page
1992
End Page
2000
DOI
10.1002/cncr.24990

Understanding the role of numeracy in health: proposed theoretical framework and practical insights.

Numeracy-that is, how facile people are with mathematical concepts and their applications-is gaining importance in medical decision making and risk communication. This article proposes six critical functions of health numeracy. These functions are integrated into a theoretical framework on health numeracy that has implications for risk communication and medical decision-making processes. The authors examine practical underpinnings for targeted interventions aimed at improving such processes as a function of health numeracy. They hope that the proposed functions and theoretical framework will spur more research to determine how an understanding of health numeracy can lead to more effective communication and decision outcomes.

Authors
Lipkus, IM; Peters, E
MLA Citation
Lipkus, IM, and Peters, E. "Understanding the role of numeracy in health: proposed theoretical framework and practical insights." Health Educ Behav 36.6 (December 2009): 1065-1081.
PMID
19834054
Source
pubmed
Published In
Health Education & Behavior
Volume
36
Issue
6
Publish Date
2009
Start Page
1065
End Page
1081
DOI
10.1177/1090198109341533

Facilitating consumer clinical information seeking by maintaining referential context: evaluation of a prototypic approach.

Millions of consumers seek health information on the Internet. Unfortunately, this searching often falls short because of design limitations of many consumer-oriented Web sites. In this paper, we describe an approach that addresses several known barriers to consumer health information seeking. This approach primarily involves maintaining the referential context throughout a consumer's search for information. To maintain referential context, this approach uses multiple levels of hierarchical constructs to organize complex information, and data elements are toggled to minimize the need for scrolling. An information resource based on this approach was implemented for information about smoking using standard Web technologies. The resource was evaluated by 31 diverse consumers through standardized usability instruments. Consumers found the resource to be easy to navigate and to use. We conclude that the approach described in this manuscript could be applied more broadly to facilitate the organization and presentation of consumer health information.

Authors
Lobach, DF; Waters, A; Silvey, GM; Clark, SJ; Kalyanaraman, S; Kawamoto, K; Lipkus, I
MLA Citation
Lobach, DF, Waters, A, Silvey, GM, Clark, SJ, Kalyanaraman, S, Kawamoto, K, and Lipkus, I. "Facilitating consumer clinical information seeking by maintaining referential context: evaluation of a prototypic approach. (Published online)" AMIA Annu Symp Proc 2009 (November 14, 2009): 380-384.
PMID
20351884
Source
pubmed
Published In
AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium
Volume
2009
Publish Date
2009
Start Page
380
End Page
384

Decision making about cancer screening: an assessment of the state of the science and a suggested research agenda from the ASPO Behavioral Oncology and Cancer Communication Special Interest Group.

Authors
Kiviniemi, MT; Hay, JL; James, AS; Lipkus, IM; Meissner, HI; Stefanek, M; Studts, JL; Bridges, JFP; Close, DR; Erwin, DO; Jones, RM; Kaiser, K; Kash, KM; Kelly, KM; Craddock Lee, SJ; Purnell, JQ; Siminoff, LA; Vadaparampil, ST; Wang, C
MLA Citation
Kiviniemi, MT, Hay, JL, James, AS, Lipkus, IM, Meissner, HI, Stefanek, M, Studts, JL, Bridges, JFP, Close, DR, Erwin, DO, Jones, RM, Kaiser, K, Kash, KM, Kelly, KM, Craddock Lee, SJ, Purnell, JQ, Siminoff, LA, Vadaparampil, ST, and Wang, C. "Decision making about cancer screening: an assessment of the state of the science and a suggested research agenda from the ASPO Behavioral Oncology and Cancer Communication Special Interest Group." Cancer Epidemiol Biomarkers Prev 18.11 (November 2009): 3133-3137. (Review)
PMID
19900944
Source
pubmed
Published In
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
Volume
18
Issue
11
Publish Date
2009
Start Page
3133
End Page
3137
DOI
10.1158/1055-9965.EPI-18-11-ASPO

Responses to online GSTM1 genetic test results among smokers related to patients with lung cancer: a pilot study.

Providing smokers with personal genetic test results indicating increased lung cancer risk may increase uptake of effective smoking cessation services. Using the internet may increase reach and enable real-time assessment of how people process genetic risk information away from the clinic setting. We therefore explored smokers' responses to Web-delivered GSTM1 genetic test results indicating higher or lower lung cancer risk. Participants were smokers (n = 44) biologically related to patients with newly diagnosed lung cancer. Measures were assessed at baseline, before and immediately after receipt of online genetic test results, and at 6-month follow-up. Outcomes included accurate comprehension of results, regret about being tested, cessation-related cognitions (e.g., perceived response efficacy), and uptake of free smoking cessation services (nicotine replacement therapy, printed self-help materials, telephone counseling sessions). Twenty-two "relative smokers" received a GSTM1-missing (higher risk) and 22 a GSTM1-present (lower risk) result. All relative smokers with GSTM1-missing results and 55% of those with GSTM1-present results accurately interpreted their results. No relative smokers regretted having taken the test. Relative smokers receiving GSTM1-missing results reported lower confidence that quitting could reduce lung cancer risk (perceived response efficacy) than those receiving GSTM1-present results. There were no other significant between-group differences. Uptake of smoking cessation services was high (e.g., 91% nicotine replacement therapy uptake). Genetic test results may not influence uptake of free smoking cessation services because of ceiling effects. Further research is needed to determine the risks and benefits of Web-based disclosure of genetic test results.

Authors
Sanderson, SC; O'Neill, SC; White, DB; Bepler, G; Bastian, L; Lipkus, IM; McBride, CM
MLA Citation
Sanderson, SC, O'Neill, SC, White, DB, Bepler, G, Bastian, L, Lipkus, IM, and McBride, CM. "Responses to online GSTM1 genetic test results among smokers related to patients with lung cancer: a pilot study." Cancer Epidemiol Biomarkers Prev 18.7 (July 2009): 1953-1961.
PMID
19567511
Source
pubmed
Published In
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
Volume
18
Issue
7
Publish Date
2009
Start Page
1953
End Page
1961
DOI
10.1158/1055-9965.EPI-08-0620

College smokers' estimates of their probabilities of remaining a smoker in the near future

Community college and university smokers (N = 662) estimated their probability (0% to 100%) of remaining a smoker one and six months later and reported their confidence in their estimates. Smoking status was assessed at each time point. Analyses controlled for several correlates of both smoking status and probability estimates of remaining a smoker. Estimates of smoking status interacted with confidence to predict smoking status at one month, but only estimates predicted smoking status at six months. Findings suggest that: 1) personal estimate of future smoking status is a unique correlate of continued smoking; and 2) confidence in personal estimates is a strong moderator for short-term projections of smoking status. Copyright © 2009 SAGE Publications.

Authors
Lipkus, I; Shepperd, J
MLA Citation
Lipkus, I, and Shepperd, J. "College smokers' estimates of their probabilities of remaining a smoker in the near future." Journal of Health Psychology 14.4 (2009): 547-555.
PMID
19383655
Source
scival
Published In
Journal of Health Psychology
Volume
14
Issue
4
Publish Date
2009
Start Page
547
End Page
555
DOI
10.1177/1359105309103574

Cancer survivors' health worries and associations with lifestyle practices.

This study examined among recently diagnosed breast and prostate cancer survivors (N = 678) associations between worry about a future diagnosis of heart disease or cancer and hypothetical and actual adherence to exercise and dietary guidelines. Greater worry about future illness was reported under the hypothetical scenario of nonadherence to guidelines relative to the scenario of adherence. Worry about potential heart disease was associated with actual adherence to guidelines, whereas worry about a potential cancer diagnosis was not. Findings suggest that the motivational properties of worry should be considered when developing interventions to reduce heart disease risk among cancer survivors.

Authors
Mosher, CE; Lipkus, IM; Sloane, R; Kraus, WE; Snyder, DC; Peterson, B; Jones, LW; Demark-Wahnefried, W
MLA Citation
Mosher, CE, Lipkus, IM, Sloane, R, Kraus, WE, Snyder, DC, Peterson, B, Jones, LW, and Demark-Wahnefried, W. "Cancer survivors' health worries and associations with lifestyle practices." J Health Psychol 13.8 (November 2008): 1105-1112.
PMID
18987083
Source
pubmed
Published In
Journal of Health Psychology
Volume
13
Issue
8
Publish Date
2008
Start Page
1105
End Page
1112
DOI
10.1177/1359105308095964

Intentions to maintain adherence to mammography.

OBJECTIVE: Recent attention has focused on moving women from having initial mammograms to maintaining adherence to regular mammography schedules. We examined behavioral intentions to maintain mammography adherence, which include the likelihood of performing a behavior, and implementation intentions, specific action plans to obtain mammograms. Potential predictors were Theory of Planned Behavior constructs, previous barriers, previous mammography maintenance, and age. METHODS: Respondents were 2062 currently adherent women due for their next mammograms in 3-4 months according to American Cancer Society recommendations for annual screening. Statistical models were used to examine predictors of behavioral and two implementation intentions, including having thought about where women would get their next mammograms and having thought about making appointments. RESULTS: With the exception of pros, cons, and subjective norms, all variables predicted behavioral intentions (p

Authors
O'Neill, SC; Bowling, JM; Brewer, NT; Lipkus, IM; Skinner, CS; Strigo, TS; Rimer, BK
MLA Citation
O'Neill, SC, Bowling, JM, Brewer, NT, Lipkus, IM, Skinner, CS, Strigo, TS, and Rimer, BK. "Intentions to maintain adherence to mammography." J Womens Health (Larchmt) 17.7 (September 2008): 1133-1141.
PMID
18657041
Source
pubmed
Published In
Journal of Women's Health
Volume
17
Issue
7
Publish Date
2008
Start Page
1133
End Page
1141
DOI
10.1089/jwh.2007.0600

Differences in baseline characteristics and outcomes at 1- and 2-year follow-up of cancer survivors accrued via self-referral versus cancer registry in the FRESH START Diet and exercise trial.

Participant accrual to research studies is a challenge; oftentimes, advertisements are used to supplement cases ascertained through clinic caseloads and cancer registries. It is unknown, however, if cases ascertained through these two sources differ. In this study, we compared self-referred (n = 209) and registry-ascertained (n = 334) participants enrolled in FRESH START, a randomized controlled trial promoting a healthy diet and increased exercise among breast and prostate cancer survivors. The two groups were compared on baseline characteristics, adherence, attrition, and outcomes by study arm. Compared with participants enrolled from registries, self-referrals were significantly younger (54.1 +/- 10.4 versus 58.7 +/- 10.7 years), more likely to have later-stage disease and to have received chemotherapy (40% versus 19%), and more likely to report "fighting spirit" coping styles (50% versus 30%), lower quality-of-life (88.2 +/- 15.1 versus 92.0 +/- 12.9), fewer comorbid conditions (1.87 +/- 1.60 versus 2.24 +/- 1.78), and lower consumption of five or more daily servings of fruits and vegetables (35% versus 45%; P values <0.05). Although no differences in behavior change were observed between self-referred and registry-ascertained cases assigned to the tailored intervention arm, this was not the case within the attention control arm. Among those who received the attention control intervention of standardized materials in the public domain, self-referred versus registry-ascertained participants showed significantly greater increases in exercise at 1-year follow-up and significantly greater increases in fruit and vegetable consumption at both 1- and 2-year follow-up (P values <0.05). Several differences exist between self-referred and registry-ascertained participants, including motivation to respond to standardized educational materials, which appears significantly greater in self-referred populations.

Authors
Snyder, DC; Sloane, R; Lobach, D; Lipkus, IM; Peterson, B; Kraus, W; Demark-Wahnefried, W
MLA Citation
Snyder, DC, Sloane, R, Lobach, D, Lipkus, IM, Peterson, B, Kraus, W, and Demark-Wahnefried, W. "Differences in baseline characteristics and outcomes at 1- and 2-year follow-up of cancer survivors accrued via self-referral versus cancer registry in the FRESH START Diet and exercise trial." Cancer Epidemiol Biomarkers Prev 17.5 (May 2008): 1288-1294.
PMID
18483353
Source
pubmed
Published In
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
Volume
17
Issue
5
Publish Date
2008
Start Page
1288
End Page
1294
DOI
10.1158/1055-9965.EPI-07-0705

The feasibility of online genetic testing for lung cancer susceptibility: uptake of a web-based protocol and decision outcomes.

PURPOSE: To examine the feasibility of offering genetic susceptibility testing for lung cancer (GSTM1) via the Internet to smokers who were blood relatives of patients with lung cancer. Outcomes include proportion who logged on to the study website to consider testing, made informed decisions to log on and to be tested. METHODS: Baseline measures were assessed via telephone survey. Participants could choose to log on to the study website; those who did were offered testing. Informed decisions to log on and to be tested were indicated by concordance between the decision outcome and test-related attitudes and knowledge. RESULTS: Three hundred four relatives completed baseline interviews. One hundred sixteen eligible relatives expressed further interest in receiving information via the web. Fifty-eight logged on and 44 tested. Those logging on expressed greater quit motivation, awareness of cancer genetic testing, and were more likely to be daily Internet users than those who did not log on. Approximately half of the sample made informed decisions to log on and to be tested. CONCLUSION: Interest in a web-based protocol for genetic susceptibility testing was high. Internet-delivered decision support was as likely as other modalities to yield informed decisions. Some subgroups may need additional support to improve their decision outcomes.

Authors
O'Neill, SC; White, DB; Sanderson, SC; Lipkus, IM; Bepler, G; Bastian, LA; McBride, CM
MLA Citation
O'Neill, SC, White, DB, Sanderson, SC, Lipkus, IM, Bepler, G, Bastian, LA, and McBride, CM. "The feasibility of online genetic testing for lung cancer susceptibility: uptake of a web-based protocol and decision outcomes." Genet Med 10.2 (February 2008): 121-130.
PMID
18281920
Source
pubmed
Published In
Genetics in Medicine
Volume
10
Issue
2
Publish Date
2008
Start Page
121
End Page
130
DOI
10.1097/GIM.0b013e31815f8e06

Clinical implications of numeracy: Theory and practice

Background: Low numeracy is pervasive and constrains informed patient choice, reduces medication compliance, limits access to treatments, impairs risk communication, and affects medical outcomes; therefore, it is incumbent upon providers to minimize its adverse effects. Purpose: We provide an overview of research on health numeracy and discuss its implications in clinical contexts. Conclusions: Low numeracy cannot be reliably inferred on the basis of patients' education, intelligence, or other observable characteristics. Objective and subjective assessments of numeracy are available in short forms and could be used to tailor health communication. Low scorers on these assessments are subject to cognitive biases, irrelevant cues (e.g., mood), and sharper temporal discounting. Because prevention of the leading causes of death (e.g., cancer and cardiovascular disease) depends on taking action now to prevent serious consequences later, those low in numeracy are likely to require more explanation of risk to engage in prevention behaviors. Visual displays can be used to make numerical relations more transparent, and different types of displays have different effects (e.g., greater risk avoidance). Ironically, superior quantitative processing seems to be achieved by focusing on qualitative gist and affective meaning, which has important implications for empowering patients to take advantage of the evidence in evidence-based medicine. © 2008 Springer-Verlag.

Authors
Nelson, W; Reyna, VF; Fagerlin, A; Lipkus, I; Peters, E
MLA Citation
Nelson, W, Reyna, VF, Fagerlin, A, Lipkus, I, and Peters, E. "Clinical implications of numeracy: Theory and practice." Annals of Behavioral Medicine 35.3 (2008): 261-274.
PMID
18677452
Source
scival
Published In
Annals of Behavioral Medicine
Volume
35
Issue
3
Publish Date
2008
Start Page
261
End Page
274
DOI
10.1007/s12160-008-9037-8

The feasibility of online genetic testing for lung cancer susceptibility: Uptake of a web-based protocol and decision outcomes (Genetics in Medicine (2008) 10, (127-130))

Authors
O'Neill, SC; White, DB; Sanderson, SC; Lipkus, IM
MLA Citation
O'Neill, SC, White, DB, Sanderson, SC, and Lipkus, IM. "The feasibility of online genetic testing for lung cancer susceptibility: Uptake of a web-based protocol and decision outcomes (Genetics in Medicine (2008) 10, (127-130))." Genetics in Medicine 10.3 (2008): 228--.
Source
scival
Published In
Genetics in Medicine
Volume
10
Issue
3
Publish Date
2008
Start Page
228-
DOI
10.1097/GIM.0b013e3181634edf

Nicotine replacement and behavioral therapy for smoking cessation in pregnancy.

BACKGROUND: This study examines whether adding nicotine replacement therapy (NRT) to cognitive-behavioral therapy (CBT) for pregnant smokers increases rates of smoking cessation. METHODS: An open-label randomized trial (Baby Steps, n=181) of CBT-only versus CBT+NRT (choice of patch, gum, or lozenge; 1:2 randomization) was used. Data were collected from 2003 through 2005; analyses were conducted in 2006 and 2007. Outcomes were biochemically validated self-reported smoking status at 7 weeks post-randomization, 38 weeks gestation, and 3 months postpartum. RESULTS: Women in the CBT+NRT arm were almost three times more likely than women in the CBT-only arm to have biochemically validated cessation at both pregnancy time points (after 7 weeks: 24% vs 8%, p=0.02; at 38 weeks gestation: 18% vs 7%, p=0.04), but not at 3 months postpartum (20% vs 14%, p=0.55). Recruitment was suspended early by an Independent Data and Safety Monitoring Board when an interim analysis found a higher rate of negative birth outcomes in the CBT+NRT arm than in the CBT-only arm. In the final analysis, the difference between the arms in rate of negative birth outcomes was 0.09 (p=0.26), when adjusted for previous history of preterm birth. CONCLUSIONS: The addition of NRT to CBT promoted smoking cessation in pregnant women. This effect did not persist postpartum. More data are needed to determine safety parameters and to confirm the efficacy of NRT use during pregnancy.

Authors
Pollak, KI; Oncken, CA; Lipkus, IM; Lyna, P; Swamy, GK; Pletsch, PK; Peterson, BL; Heine, RP; Brouwer, RJN; Fish, L; Myers, ER
MLA Citation
Pollak, KI, Oncken, CA, Lipkus, IM, Lyna, P, Swamy, GK, Pletsch, PK, Peterson, BL, Heine, RP, Brouwer, RJN, Fish, L, and Myers, ER. "Nicotine replacement and behavioral therapy for smoking cessation in pregnancy." Am J Prev Med 33.4 (October 2007): 297-305.
PMID
17888856
Source
pubmed
Published In
American Journal of Preventive Medicine
Volume
33
Issue
4
Publish Date
2007
Start Page
297
End Page
305
DOI
10.1016/j.amepre.2007.05.006

Numeric, verbal, and visual formats of conveying health risks: suggested best practices and future recommendations.

Perception of health risk can affect medical decisions and health behavior change. Yet the concept of risk is a difficult one for the public to grasp. Whether perceptions of risk affect decisions and behaviors often relies on how messages of risk magnitudes (i.e., likelihood) are conveyed. Based on expert opinion, this article offers, when possible, best practices for conveying magnitude of health risks using numeric, verbal, and visual formats. This expert opinion is based on existing empirical evidence, review of papers and books, and consultations with experts in risk communication. This article also discusses formats to use pertaining to unique risk communication challenges (e.g., conveying small-probability events, interactions). Several recommendations are suggested for enhancing precision in perception of risk by presenting risk magnitudes numerically and visually. Overall, there are little data to suggest best practices for verbal communication of risk magnitudes. Across the 3 formats, few overall recommendations could be suggested because of 1) lack of consistency in testing formats using the same outcomes in the domain of interest, 2) lack of critical tests using randomized controlled studies pitting formats against one another, and 3) lack of theoretical progress detailing and testing mechanisms why one format should be more efficacious in a specific context to affect risk magnitudes than others. Areas of future research are provided that it is hoped will help illuminate future best practices.

Authors
Lipkus, IM
MLA Citation
Lipkus, IM. "Numeric, verbal, and visual formats of conveying health risks: suggested best practices and future recommendations." Med Decis Making 27.5 (September 2007): 696-713. (Review)
PMID
17873259
Source
pubmed
Published In
Medical Decision Making
Volume
27
Issue
5
Publish Date
2007
Start Page
696
End Page
713
DOI
10.1177/0272989X07307271

Main outcomes of the FRESH START trial: a sequentially tailored, diet and exercise mailed print intervention among breast and prostate cancer survivors.

PURPOSE: Cancer survivors are at increased risk for cardiovascular disease, diabetes, osteoporosis, and second primary tumors. Healthful lifestyle practices may improve the health and well-being of survivors. The FRESH START trial tested the efficacy of sequentially tailored versus standardized mailed materials on improving cancer survivors' diet and exercise behaviors. METHODS: Five hundred forty-three individuals with newly diagnosed locoregional breast or prostate cancer were recruited from 39 states and two provinces within North America. Participants were randomly assigned either to a 10-month program of tailored mailed print materials promoting fruit and vegetable (F&V) consumption, reducing total/saturated fat intake, and/or increasing exercise or to a 10-month program of nontailored mailed materials on diet and exercise available in the public domain. Telephone surveys conducted at baseline and 1 year assessed body mass index (BMI), dietary consumption, physical activity, and other psychosocial/behavioral indices. Clinical assessments were conducted on a 23% subsample; information was used to validate self-reports. RESULTS: Five hundred nineteen participants completed the 1-year follow-up (4.4% attrition; sample characteristics: 57 +/- 10.8 years old, 83% white, 56% female, 64% overweight/obese, and 0% underweight). Although both arms significantly improved their lifestyle behaviors (P < .05), significantly greater gains occurred in the FRESH START intervention versus the control arm (practice of two or more goal behaviors: +34% v +18%, P < .0001; exercise minutes per week: +59.3 v +39.2 minutes, P = .02; F&V per day: +1.1 v +0.6 servings, P = .01; total fat: -4.4% v -2.1%, P < .0001; saturated fat: -1.3% v -0.3%, P < .0001; and BMI: -0.3 v +0.1 kg/m2, respectively, P = .004). CONCLUSION: Mailed material interventions, especially those that are tailored, are effective in promoting healthful lifestyle changes among cancer survivors. Further study is needed to determine sustainability, cost to benefit, and generalizability to other cancer populations.

Authors
Demark-Wahnefried, W; Clipp, EC; Lipkus, IM; Lobach, D; Snyder, DC; Sloane, R; Peterson, B; Macri, JM; Rock, CL; McBride, CM; Kraus, WE
MLA Citation
Demark-Wahnefried, W, Clipp, EC, Lipkus, IM, Lobach, D, Snyder, DC, Sloane, R, Peterson, B, Macri, JM, Rock, CL, McBride, CM, and Kraus, WE. "Main outcomes of the FRESH START trial: a sequentially tailored, diet and exercise mailed print intervention among breast and prostate cancer survivors." J Clin Oncol 25.19 (July 1, 2007): 2709-2718.
PMID
17602076
Source
pubmed
Published In
Journal of Clinical Oncology
Volume
25
Issue
19
Publish Date
2007
Start Page
2709
End Page
2718
DOI
10.1200/JCO.2007.10.7094

Atypia in random periareolar fine-needle aspiration affects the decision of women at high risk to take tamoxifen for breast cancer chemoprevention.

Random periareolar fine-needle aspiration (RPFNA) is a research procedure designed to (a) evaluate short-term breast cancer risk in women at high risk for developing breast cancer, and (b) track response to chemoprevention. Of import, cellular atypia in breast RPFNA is prospectively associated with a 5.6-fold increase in breast cancer risk in women at high risk. Among 99 women attending a clinic for high-risk breast cancer, we explored the effects of RPFNA cytology results on decision making pertaining to the use of tamoxifen for breast cancer chemoprevention. No patient with nonproliferative or hyperplastic cytology subsequently elected to take tamoxifen. Only 7% of subjects with borderline atypia elected to take tamoxifen. In contrast, 50% with atypia elected to take tamoxifen. These results suggest that the provision of a biomarker of short-term risk can affect the motivation to take tamoxifen for chemoprevention. This conclusion is informative given that tamoxifen, due to its side effects, is often underused by women at high risk of developing breast cancer. Further research is needed to determine the mechanisms through which RPFNA results affect the decision to use tamoxifen, or any other breast cancer chemopreventive agent.

Authors
Goldenberg, VK; Seewaldt, VL; Scott, V; Bean, GR; Broadwater, G; Fabian, C; Kimler, B; Zalles, C; Lipkus, IM
MLA Citation
Goldenberg, VK, Seewaldt, VL, Scott, V, Bean, GR, Broadwater, G, Fabian, C, Kimler, B, Zalles, C, and Lipkus, IM. "Atypia in random periareolar fine-needle aspiration affects the decision of women at high risk to take tamoxifen for breast cancer chemoprevention." Cancer Epidemiol Biomarkers Prev 16.5 (May 2007): 1032-1034.
PMID
17507634
Source
pubmed
Published In
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
Volume
16
Issue
5
Publish Date
2007
Start Page
1032
End Page
1034
DOI
10.1158/1055-9965.EPI-06-0910

The effects of providing lung age and respiratory symptoms feedback on community college smokers' perceived smoking-related health risks, worries and desire to quit.

This study examined the effects of providing lung age, as assessed via a lung function test (spirometry), and respiratory symptoms feedback on college smokers' perceived smoking-related risks, worries and desire to quit. We also investigated whether smokers reacted defensively to this feedback. One hundred and twenty-four smokers were randomized to either receive lung age and respiratory symptoms feedback (intervention group) or a brochure containing facts about smoking only (control group). Perceived risks, worries and desire to quit did not differ between groups. In both groups, worries, but not perceived risks, were correlated with a stronger desire to quit. With increasing lung age, smokers rated the feedback as less relevant and reported exerting less effort breathing in and out while undergoing spirometry. The latter two outcomes were associated with less worry. These findings suggest that lung age and respiratory symptoms feedback does not translate readily into appreciable changes in motivation to quit as well as do other often reported mediators of change (e.g., perceived risks and worries).

Authors
Lipkus, IM; Prokhorov, AV
MLA Citation
Lipkus, IM, and Prokhorov, AV. "The effects of providing lung age and respiratory symptoms feedback on community college smokers' perceived smoking-related health risks, worries and desire to quit." Addict Behav 32.3 (March 2007): 516-532.
PMID
16824688
Source
pubmed
Published In
Addictive Behaviors
Volume
32
Issue
3
Publish Date
2007
Start Page
516
End Page
532
DOI
10.1016/j.addbeh.2006.05.018

Challenges and solutions for recruiting pregnant smokers into a nicotine replacement therapy trial.

Improvements in smoking cessation interventions for pregnant smokers are needed. One major step is to examine the potential effectiveness of nicotine replacement therapy (NRT). The potential benefits of providing pregnant women with NRT to help them quit smoking are still unknown; early interventions to test the effectiveness and efficacy are vital to advancing the field. This paper describes recruitment efforts for a multiclinic trial to test the effectiveness of NRT use in addition to behavioral therapy in promoting cessation during pregnancy. The biggest challenge is recruiting sufficient numbers of pregnant women. This paper discusses specific obstacles for recruitment and solutions. Knowing the potential pitfalls to recruiting pregnant women into these trials can lead to better studies and thus improved outcomes.

Authors
Pollak, KI; Oncken, CA; Lipkus, IM; Peterson, BL; Swamy, GK; Pletsch, PK; Lyna, P; Namenek Brouwer, RJ; Fish, LJ; Myers, ER
MLA Citation
Pollak, KI, Oncken, CA, Lipkus, IM, Peterson, BL, Swamy, GK, Pletsch, PK, Lyna, P, Namenek Brouwer, RJ, Fish, LJ, and Myers, ER. "Challenges and solutions for recruiting pregnant smokers into a nicotine replacement therapy trial." Nicotine Tob Res 8.4 (August 2006): 547-554.
PMID
16920652
Source
pubmed
Published In
Nicotine and Tobacco Research (OUP)
Volume
8
Issue
4
Publish Date
2006
Start Page
547
End Page
554
DOI
10.1080/14622200600789882

Effects of communicating social comparison information on risk perceptions for colorectal cancer.

People typically believe their health risks are lower than those of others (i.e., optimistic bias). We sought to increase perceptions of colorectal cancer (CRC) risk among adults aged 50-75 who were nonadherent to fecal occult screening (FOBT). 160 participants were randomized to receive information about the following: (1) general CRC risk factors (control), (2) general and tailored CRC risk factor feedback (absolute risk group), or (3) absolute CRC risk factor feedback plus CRC feedback as to how their total number of risk factors compared with that of others (absolute plus comparative risk group). Primary outcomes were perceived absolute and comparative risks, attitudinal ambivalence toward FOBT, and screening intentions; the secondary outcome was return of a completed FOBT. Participants who were told that they had more than the average number of risk factors believed their comparative CRC risk was higher than that of controls and of participants informed that they did not have more than the average number of risk factors. Perceived absolute risk did not vary by group. Participants who received social comparison risk factor feedback expressed greater intentions to screen via a FOBT than participants who received absolute risk feedback and controls; they also expressed less ambivalence about FOBT screening than controls. Although not statistically significant, participants informed they were at lower comparative risk had the highest proportion of completing an FOBT than any other group. These results suggest that providing social comparison CRC risk factor feedback can effectively reduce optimistic comparative risk perceptions. Contrary to findings of models of health behavior change, being informed that one does not have more than the average number of CRC risk factors, while resulting in lower evaluations of perceived comparative risk, did not result in higher ambivalence toward and lower intentions to screen using FOBT or the lowest rate of screening.

Authors
Lipkus, IM; Klein, WMP
MLA Citation
Lipkus, IM, and Klein, WMP. "Effects of communicating social comparison information on risk perceptions for colorectal cancer." J Health Commun 11.4 (June 2006): 391-407.
PMID
16720537
Source
pubmed
Published In
Journal of Health Communication
Volume
11
Issue
4
Publish Date
2006
Start Page
391
End Page
407
DOI
10.1080/10810730600671870

The teachable moment following cancer diagnosis: the FRESH START trial.

no abstract available

Authors
Demark Wahnefried, W; Clipp, EC; Lipkus, I; Kraus, WE; Sloane, R; Snyder, DC; Lobach, DF
MLA Citation
Demark Wahnefried, W, Clipp, EC, Lipkus, I, Kraus, WE, Sloane, R, Snyder, DC, and Lobach, DF. "The teachable moment following cancer diagnosis: the FRESH START trial." American Journal of Oncology Review 5.1 (January 2006): 52-57. (Academic Article)
Source
manual
Published In
American Journal of Oncology Review
Volume
5
Issue
1
Publish Date
2006
Start Page
52
End Page
57

The functions of affect in health communications and in the construction of health preferences

We examine potential roles of 4 functions of affect in health communication and the construction of health preferences. The roles of these 4 functions (affect as information, as a spotlight, as a motivator, and as common currency) are illustrated in the area of cancer screening and treatment decision making. We demonstrate that experienced affect influences information processes, judgments, and decisions. We relate the functions to a self-regulation approach and examine factors that may influence the weight of cognitive versus affective processing of information. Affect's role in health communication is likely to be nuanced, and it deserves careful empirical study of its effects on patients' well-being. © 2006 International Communication Association.

Authors
Peters, E; Lipkus, I; Diefenbach, MA
MLA Citation
Peters, E, Lipkus, I, and Diefenbach, MA. "The functions of affect in health communications and in the construction of health preferences." Journal of Communication 56.SUPPL. (2006): S140-S162.
Source
scival
Published In
Journal of Communication
Volume
56
Issue
SUPPL.
Publish Date
2006
Start Page
S140
End Page
S162
DOI
10.1111/j.1460-2466.2006.00287.x

Recruiting teen smokers in shopping malls to a smoking-cessation program using the foot-in-the-door technique

Persuading teen smokers to volunteer for smoking-cessation programs is a challenging yet understudied problem. As a method of dealing with this problem, we used and tested a foot-in-the-door (FITD) approach. Teen smokers were intercepted at malls and were assigned randomly to request compliance with a small behavior request of either (a) answering a few questions (light FITD) or (b) answering the same questions and a few additional ones, plus watching a short video about the effects of nicotine (heavy FITD). Participants were then called back by telephone several weeks later and asked to comply with a large behavior request of joining a cessation program that involved the use of self-help materials and telephone counseling. Although no differences were found in responses from the light and heavy groups, consent to enter the program was obtained from 12% of the pooled qualified intercepts and their parents (for those under 18 years). This recruitment rate was considered good, given that this is one of the only reported studies that recruited teen smokers from the general population to cessation programs. © 2006 Blackwell Publishing, Inc.

Authors
Bloom, PN; McBride, CM; Pollak, KI; Schwartz-Bloom, RD; Lipkus, IM
MLA Citation
Bloom, PN, McBride, CM, Pollak, KI, Schwartz-Bloom, RD, and Lipkus, IM. "Recruiting teen smokers in shopping malls to a smoking-cessation program using the foot-in-the-door technique." Journal of Applied Social Psychology 36.5 (2006): 1129-1144.
Source
scival
Published In
Journal of Applied Social Psychology
Volume
36
Issue
5
Publish Date
2006
Start Page
1129
End Page
1144
DOI
10.1111/j.0021-9029.2006.00034.x

Impact of customized videotape education on quality of life in patients with chronic obstructive pulmonary disease

PURPOSE: To compare the impact of a library of pulmonary rehabilitation videotapes versus an older videotape and usual care on quality of life and ability to perform activities of daily living in persons with chronic obstructive pulmonary disease. METHODS: Two hundred fourteen patients diagnosed with chronic obstructive pulmonary disease, emphysema, or chronic bronchitis were recruited and randomized to receive customized videotapes, standard videotapes, or usual care. Outcome measures included the Fatigue Impact Scale, Seattle Obstructive Lung Disease Questionnaire, and the SF-36® Health Survey. RESULTS: Differences in coping skills and emotional functioning on the Seattle Obstructive Lung Disease Questionnaire were found among the 174 subjects who completed the study. The customized videotape group improved by 8.6 and 4.8 points, respectively, whereas the score of the other groups decreased by less than 1 point for the coping skills, and the scores of the standard video and the control groups decreased by 3.0 and 2.1 points, respectively, for emotional functioning (P < .05, all comparisons). The scores using the Fatigue Impact Scale also improved for the customized videotape group, whereas the scores of the others remained unchanged. Videotape users demonstrated better conversion to and retention of exercise habits, with over 80% of customized videotape subjects who reported exercise habits at baseline continuing the habits as compared with 40% in the usual care group. Sedentary subjects at baseline were more likely to begin and maintain exercise if randomized to videotapes. CONCLUSIONS: These findings demonstrate increased quality of life, lower fatigue, and better compliance with a prescribed exercise regimen among subjects using the customized videotapes. There was a significant improvement in emotional functioning and coping skills among customized videotape subjects. Copyright © Lippincott Williams & Wilkins.

Authors
Petty, TL; Dempsey, EC; Collins, T; Pluss, W; Lipkus, I; Cutter, GR; Chalmers, R; Mitchell, A; Weil, KC
MLA Citation
Petty, TL, Dempsey, EC, Collins, T, Pluss, W, Lipkus, I, Cutter, GR, Chalmers, R, Mitchell, A, and Weil, KC. "Impact of customized videotape education on quality of life in patients with chronic obstructive pulmonary disease." Journal of Cardiopulmonary Rehabilitation 26.2 (2006): 112-117.
PMID
16569981
Source
scival
Published In
Journal of cardiopulmonary rehabilitation
Volume
26
Issue
2
Publish Date
2006
Start Page
112
End Page
117
DOI
10.1097/00008483-200603000-00012

Interest in testing for genetic susceptibility to lung cancer among Black college students "at risk" of becoming cigarette smokers.

Receptivity to genetic testing for lung cancer susceptibility was assessed among African American college freshmen, who held attitudes favorable towards or had experimented with cigarette smoking. Students (n = 95) completed a telephone survey that assessed beliefs about genetics and lung cancer risk, interest in genetic testing, and expectations about the test outcome. Interest in being tested was moderately high (mean, 5; SD, 2.2; scale of 1-7) and highest among those who believed lung cancer was influenced by genetics (r = 0.22, P < 0.05) and those who expected to be at high risk (r = 0.27, P < 0.05). Overall, 34% thought if tested, the result would show high risk for lung cancer. In multivariate analyses, students' test result expectation was the only significant predictor of interest in testing. Those who believed the test would show them to be at higher risk were thrice more likely to be interested in testing than those who thought the test would show that they were at lower risk (odds ratio, 2.99; confidence interval, 1.03-8.64; P = 0.04). Future research is needed to understand how young adults will respond to genetic susceptibility feedback that confirms or contradicts their expectations about personal risks of smoking.

Authors
McBride, CM; Lipkus, IM; Jolly, D; Lyna, P
MLA Citation
McBride, CM, Lipkus, IM, Jolly, D, and Lyna, P. "Interest in testing for genetic susceptibility to lung cancer among Black college students "at risk" of becoming cigarette smokers." Cancer Epidemiol Biomarkers Prev 14.12 (December 2005): 2978-2981.
PMID
16365020
Source
pubmed
Published In
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
Volume
14
Issue
12
Publish Date
2005
Start Page
2978
End Page
2981
DOI
10.1158/1055-9965.EPI-05-0269

Ambivalence over emotional expression in patients with gastrointestinal cancer and their caregivers: associations with patient pain and quality of life.

This study examined the role of patient and caregiver ambivalence over emotional expression (AEE) in pain and quality of life (QOL) in a sample of 78 patients with gastrointestinal (GI) cancer. Measures of ambivalence over emotional expression as well as ratings of patient pain and pain behavior were collected from patients and caregivers. Measures of pain catastrophizing, perceptions of social support, and QOL were obtained from patients. Data analyses revealed that patients high in AEE engaged in more catastrophizing and reported higher levels of pain behaviors and poorer QOL. In addition, patients whose caregivers were high in AEE engaged in more catastrophizing, had higher levels of pain and pain behavior, and reported lower emotional well-being. Patient catastrophizing mediated the effects of both patient and caregiver AEE on some patient outcomes. Taken together, these findings suggest that emotional regulation in both patients and their caregivers may be an important factor in understanding cancer patients' experience of and coping with symptoms such as pain.

Authors
Porter, LS; Keefe, FJ; Lipkus, I; Hurwitz, H
MLA Citation
Porter, LS, Keefe, FJ, Lipkus, I, and Hurwitz, H. "Ambivalence over emotional expression in patients with gastrointestinal cancer and their caregivers: associations with patient pain and quality of life." Pain 117.3 (October 2005): 340-348.
PMID
16153771
Source
pubmed
Published In
PAIN
Volume
117
Issue
3
Publish Date
2005
Start Page
340
End Page
348
DOI
10.1016/j.pain.2005.06.021

Increasing colorectal cancer screening among individuals in the carpentry trade: test of risk communication interventions.

BACKGROUND: Individuals in the carpentry trade, due to lifestyle habits and occupational exposures, may be at above-average risk for colorectal cancer (CRC). Based on the literature which suggests that increasing perceived risk motivates behavior change, we report on the effectiveness of four risk-communication interventions targeted to increase initial, yearly and repeat fecal occult screening (FOBT) among carpenters (N = 860) over a 3-year period. METHODS: Our 2 x 2 factorial design intervention study varied two dimensions of providing CRC risk factor information: (1) type of risk factor-one set of interventions emphasized three basic risk factors (age, family history and polyps); the other set emphasized a comprehensive set of risk factors including basic, lifestyle, and occupational factors, and (2) tailoring/not tailoring risk factor information. Participants were provided FOBTs. Outcomes were the proportion of returned FOBTs. RESULTS: Varying the amount and intensity of delivering CRC risk factors information affected neither risk perceptions nor initial, yearly, or repeat screening. However, yearly and repeat screening rates were greater among participants who received interventions addressing comprehensive set of risk factors, especially with increasing age. CONCLUSIONS: Tailoring on several CRC risk factors appears insufficient to increase and sustain elevated perceptions of CRC risks to promote screening.

Authors
Lipkus, IM; Skinner, CS; Dement, J; Pompeii, L; Moser, B; Samsa, GP; Ransohoff, D
MLA Citation
Lipkus, IM, Skinner, CS, Dement, J, Pompeii, L, Moser, B, Samsa, GP, and Ransohoff, D. "Increasing colorectal cancer screening among individuals in the carpentry trade: test of risk communication interventions." Prev Med 40.5 (May 2005): 489-501.
PMID
15749130
Source
pubmed
Published In
Preventive Medicine
Volume
40
Issue
5
Publish Date
2005
Start Page
489
End Page
501
DOI
10.1016/j.ypmed.2004.09.019

Multiple tailored messages are effective in increasing fruit and vegetable consumption among callers to the Cancer Information Service

Results are reported from a large (n = 3,402) four-group randomized trial to increase fruit and vegetable consumption among callers to the National Cancer Institute's (NCI's) Cancer Information Service (CIS) using tailored print materials. Following a baseline telephone interview, which included a brief educational message (BEM), participants were assigned randomly within CIS offices to one of four groups: single untailored (SU) group - one untailored set of materials; single tailored (ST) group - one tailored booklet; multiple tailored (MT) group - four tailored materials; and multiple retailored (MRT) group - four tailored materials with retailoring based on new information obtained at 5 months follow-up. Follow-up telephone interviews were conducted at 5 (n = 2,233) and 12 months (n = 1,927) after baseline. The main outcome measure was self-reported fruit and vegetable consumption using a seven-item food frequency questionnaire. At 12 months follow-up, there was a significant linear trend across groups of 0.21 servings (p = 0.0002). Specific nested hypotheses then were tested and revealed significant mean serving differences between SU (5.07) vs. MT (5.64) (p = 0.002) and SU vs. MRT (5.71; p < 0.001). Although the mean for ST (5.40) was greater than that for SU (5.07), the difference was not statistically significant (p = 0.07), and no difference was found between MT vs. MRT (p = 0.69). A higher proportion of recipients of tailored materials reported reading all of the materials and believing that they were written especially for them. No differences by experimental condition were found for the perceived usefulness or motivational impact of the print materials. In this trial, MT print materials were more effective at increasing fruit and vegetable (FV) consumption than were SU materials. The intervention mechanisms responsible for this effect merit further research. Retailoring did not produce a significant difference when compared with longitudinal baseline tailoring. Copyright © Taylor & Francis Inc.

Authors
Heimendinger, J; O'Neill, C; Marcus, AC; Wolfe, P; Julesburg, K; Morra, M; Allen, A; Davis, S; Mowad, L; Perocchia, RS; Ward, JD; Strecher, V; Warnecke, R; Nowak, M; Graf, I; Fairclough, D; Bryant, L; Lipkus, I
MLA Citation
Heimendinger, J, O'Neill, C, Marcus, AC, Wolfe, P, Julesburg, K, Morra, M, Allen, A, Davis, S, Mowad, L, Perocchia, RS, Ward, JD, Strecher, V, Warnecke, R, Nowak, M, Graf, I, Fairclough, D, Bryant, L, and Lipkus, I. "Multiple tailored messages are effective in increasing fruit and vegetable consumption among callers to the Cancer Information Service." Journal of Health Communication 10.SUPPL. 1 (2005): 65-82.
PMID
16377601
Source
scival
Published In
Journal of Health Communication
Volume
10
Issue
SUPPL. 1
Publish Date
2005
Start Page
65
End Page
82
DOI
10.1080/10810730500263646

The efficacy of tailored print materials in promoting colorectal cancer screening: results from a randomized trial involving callers to the National Cancer Institute's Cancer Information Service.

In this large randomized trial among callers to the Cancer Information Service (CIS), tailored print materials were tested for efficacy in promoting colorectal cancer (CRC) screening (fecal occult blood test [FOBT], flexible sigmoidoscopy, or colonoscopy). All participants completed baseline interviews at the end of their usual service calls to the CIS, as well as short-term (6-month) and longer-term (14-month) telephone follow-up interviews. The study sample (n = 4,014) was restricted to English-speaking CIS callers 50 + years of age, who would be eligible for CRC screening at 14 months follow-up and did not call the CIS about CRC or CRC screening. Four experimental conditions were compared: a single untailored (SU) mailout of print material (the control condition); a single tailored (ST) mailout of print material; four (multiple) tailored (MT) mailouts of print materials spanning 12 months, all of which were tailored to information obtained at baseline; and four (multiple) retailored (MRT) mailouts also spanning 12 months, with retailoring of the print materials (mailouts 2, 3, and 4) based on updated information obtained from the 6-month follow-up interviews. Consistent with the main hypothesis of this trial, a significant linear trend across the SU, ST, MT, and MRT groups was found at 14 months (42%, 44%, 51%, and 48%, respectively, p = 0.05). Only for MT was there a significant difference compared with SU (p = 0.03) for the sample as a whole, while no differences were found for MT vs. MRT at 14 months. Significant moderator effects in the predicted direction were found among females, younger participants, and among those with a history of CRC screening, all of which involved the SU vs. MT MRT comparisons. Only among younger participants (ages 50-59) was there a difference between SU vs. ST at 14 months. Given these results, we conclude from this trial the following: (1) the MRT intervention failed to show added benefit beyond the MT intervention, (2) the significant intervention effects involving the MT and MRT conditions can be explained by tailoring and/or the longitudinal nature of both interventions, and (3) the most compelling evidence in support of tailoring was found for the ST condition among younger participants, where a significant need for interventions exists at the national level. Directions for future research are discussed in light of the results summarized above.

Authors
Marcus, AC; Mason, M; Wolfe, P; Rimer, BK; Lipkus, I; Strecher, V; Warneke, R; Morra, ME; Allen, AR; Davis, SW; Gaier, A; Graves, C; Julesberg, K; Nguyen, L; Perocchia, R; Speyer, JB; Wagner, D; Thomsen, C; Bright, MA
MLA Citation
Marcus, AC, Mason, M, Wolfe, P, Rimer, BK, Lipkus, I, Strecher, V, Warneke, R, Morra, ME, Allen, AR, Davis, SW, Gaier, A, Graves, C, Julesberg, K, Nguyen, L, Perocchia, R, Speyer, JB, Wagner, D, Thomsen, C, and Bright, MA. "The efficacy of tailored print materials in promoting colorectal cancer screening: results from a randomized trial involving callers to the National Cancer Institute's Cancer Information Service." J Health Commun 10 Suppl 1 (2005): 83-104.
PMID
16377602
Source
pubmed
Published In
Journal of Health Communication
Volume
10 Suppl 1
Publish Date
2005
Start Page
83
End Page
104
DOI
10.1080/10810730500257754

Breast cancer risk perceptions and breast cancer worry: What predicts what?

This longitudinal study explored the relationship between perceived breast cancer risk and worry. We measured both absolute and comparative risk perceptions, and also used the Gail algorithm to assess the accuracy of participants' risk perceptions. Three hundred and one women ages 40-75 participated in a two-part study assessing how format of breast cancer risk presentation affected perceptions of risk. Relative to their Gail scores, women were biased pessimistically about their own absolute breast cancer risk and yet largely accurate about their comparative breast cancer risk. Perceived comparative risk, but not perceived absolute risk or biases in absolute or comparative risk, predicted subsequent worry. Worry predicted subsequent perceived absolute risk and biases in absolute and comparative risk. These results suggest that women's emotional reactions to breast cancer risk are based on accurate (unbiased) perceptions of their comparative risks. In turn, greater worry prompts a re-evaluation of absolute risk as well as changes in risk biases. Implications for screening are discussed.

Authors
Lipkus, I; Klein, W; Skinner, CS; Rimer, B
MLA Citation
Lipkus, I, Klein, W, Skinner, CS, and Rimer, B. "Breast cancer risk perceptions and breast cancer worry: What predicts what?." Journal of Risk Research 8.5 (2005): 439-452.
Source
scival
Published In
Journal of Risk Research
Volume
8
Issue
5
Publish Date
2005
Start Page
439
End Page
452
DOI
10.1080/1366987042000311018

Assessing attitudinal ambivalence towards smoking and its association with desire to quit among teen smokers

Most smokers have some conflicting thoughts and feelings about their smoking; that is, they feel ambivalent. Whether felt ambivalence can be adequately measured and then used to predict the desire to quit among teen smokers has yet to be explored. Hence, among 402 teen smokers involved in a smoking cessation intervention, we first examined the psychometric properties of an eight-item ambivalence scale via exploratory and confirmatory analyses. After excluding one item, the scale was internally consistent and formed a single factor. We also report on whether felt ambivalence towards smoking assessed at baseline and at four and eight months post-baseline was related to the desire to quit in cross-sectional and prospective analyses. In all cross-sectional and prospective analyses, smokers who felt increasingly ambivalent reported a stronger desire to quit. These results suggest that ambivalence might be a useful construct to explore further and experimentally induce to assess its effects on desire to quit. © 2005 Taylor & Francis Group Ltd.

Authors
Lipkus, IM; Pollak, KI; McBride, CM; Schwartz-Bloom, R; Lyna, P; Bloom, PN
MLA Citation
Lipkus, IM, Pollak, KI, McBride, CM, Schwartz-Bloom, R, Lyna, P, and Bloom, PN. "Assessing attitudinal ambivalence towards smoking and its association with desire to quit among teen smokers." Psychology and Health 20.3 (2005): 373-387.
Source
scival
Published In
Psychology and Health
Volume
20
Issue
3
Publish Date
2005
Start Page
373
End Page
387
DOI
10.1080/08870440512331333988

Agreement between a brief mailed screener and an in-depth telephone survey: observations from the Fresh Start study.

Brief screening instruments can roughly characterize individual behavior and target those most in need of change. However, the level of agreement between abbreviated and full-scale instruments is often unknown. We determined agreement between a brief screener and an in-depth survey for assessing eligibility into a randomized controlled trial to improve lifestyle behaviors among cancer survivors who consumed diets with >or=30% total energy from fat or fewer than five servings of fruits and vegetables per day, and/or who exercised <150 min/wk. Responses of 203 subjects to mailed screeners, which included scales from the National Cancer Institute (NCI)Percent Energy from Fat Screener and 5-A-Day trials, and one item on exercise, were compared with data from telephone interviews using the Diet History Questionnaire and the 7-Day Physical Activity Recall. Moderate correlations and fair agreement existed between screener and survey for intakes of fat [ r =0.54 ( P <.0001)/kappa statistic (ks)=0.35] and fruits and vegetables [ r =0.50 ( P <.0001)/ks=0.32], whereas agreement was low for exercise (ks=0.15). NCI and 5-A-Day screening instruments perform relatively well in targeting cancer survivors most in need of dietary change. Decisions to use brief screening instruments should be based on available resources and tolerance for misclassification.

Authors
Snyder, DC; Sloane, R; Lobach, D; Lipkus, I; Clipp, E; Kraus, WE; Demark-Wahnefried, W; Fresh Start study,
MLA Citation
Snyder, DC, Sloane, R, Lobach, D, Lipkus, I, Clipp, E, Kraus, WE, Demark-Wahnefried, W, and Fresh Start study, . "Agreement between a brief mailed screener and an in-depth telephone survey: observations from the Fresh Start study." J Am Diet Assoc 104.10 (October 2004): 1593-1596.
PMID
15389420
Source
pubmed
Published In
Journal of the American Dietetic Association
Volume
104
Issue
10
Publish Date
2004
Start Page
1593
End Page
1596
DOI
10.1016/j.jada.2004.07.024

Testing the interaction between parent-child relationship factors and parent smoking to predict youth smoking.

PURPOSE: To examine if parental smoking modifies the association between parent-child connectedness and parental disapproval of youth smoking with smoking behavior among minority youth. METHODS: Baseline data from an urban Seattle, Washington neighborhood-based intervention trial to reduce risk behaviors among minority males and females aged 11-15 years were used to identify 428 minority youth-parent/guardian pairs. Parental smoking status, assessed by telephone interview, and youth reports of connectedness and parental disapproval, assessed by questionnaire, were tested in Chi-squared stratified analysis and logistic regression to predict youth smoking. RESULTS: The majority (86%) of the parents/guardians were the natural parent of the surveyed child (67% mother; 19% father). Parental mean age was 41 years, 54% reported household incomes less than $30K, and 26% were current smokers. Youth had a mean age of 13 years, 28% self-identified as African-American, 37% as Asian, and 35% as "Multiethnic"; 41% reported ever smoking, and 9% reported smoking within the past 30 days. Perceived parental disapproval of smoking was not associated with youth smoking behavior. Among youth whose parent did not smoke, those who reported low level of parent-child connectedness were two times more likely to report ever having smoked than those who reported high levels of connectedness. Among youth whose parent smoked, connectedness was not associated with youth smoking. The interaction between connectedness and parental smoking status and its relationship to youth smoking remained significant after controlling for covariates. CONCLUSION: Overall, high levels of parent-child connectedness are protective against youth smoking. However, family connectedness may not protect children from becoming smokers when parents smoke.

Authors
Tilson, EC; McBride, CM; Lipkus, IM; Catalano, RF
MLA Citation
Tilson, EC, McBride, CM, Lipkus, IM, and Catalano, RF. "Testing the interaction between parent-child relationship factors and parent smoking to predict youth smoking." J Adolesc Health 35.3 (September 2004): 182-189.
PMID
15313499
Source
pubmed
Published In
Journal of Adolescent Health
Volume
35
Issue
3
Publish Date
2004
Start Page
182
End Page
189
DOI
10.1016/j.jadohealth.2003.09.014

A randomized trial comparing the effects of self-help materials and proactive telephone counseling on teen smoking cessation.

We conducted a 2-arm randomized trial to test the efficacy of self-help materials with or without proactive telephone counseling to increase cessation among teen smokers. Teen smokers (N = 402) recruited from 11 shopping malls and 1 amusement park in the southeastern United States were randomized to 1 of 2 groups: written self-help material plus video; or written self-help material, video, and telephone counseling. Cessation rates based on 7-day point-prevalent abstinence for the self-help and counseling arms were 11% and 16%, respectively (p = .25), at 4 months postbaseline and 19% and 21%, respectively (p = .80), at 8 months postbaseline. Sustained abstinence, reflecting 7-day abstinence at both time points, in the self-help and counseling arms was 7% and 9% (p = .59). Results suggest that minimal self-help cessation approaches that target youth have comparable success to that shown among adult smokers. However, refinements in telephone-counseling approaches may be needed to achieve the success observed in adult populations.

Authors
Lipkus, IM; McBride, CM; Pollak, KI; Schwartz-Bloom, RD; Tilson, E; Bloom, PN
MLA Citation
Lipkus, IM, McBride, CM, Pollak, KI, Schwartz-Bloom, RD, Tilson, E, and Bloom, PN. "A randomized trial comparing the effects of self-help materials and proactive telephone counseling on teen smoking cessation." Health Psychol 23.4 (July 2004): 397-406.
PMID
15264976
Source
pubmed
Published In
Health Psychology
Volume
23
Issue
4
Publish Date
2004
Start Page
397
End Page
406
DOI
10.1037/0278-6133.23.4.397

Modifying attributions of colorectal cancer risk.

We report how a four-group risk communication intervention targeted to individuals in the carpentry trade affected their perceived causes (i.e., attributions) for increased colorectal cancer (CRC) risk. The intervention varied the amount of information presented on CRC risk factors and whether participants received tailored feedback on their risk factors. In baseline and 3-month follow-up telephone surveys, carpenters (N = 860) reported their perceived absolute and comparative CRC risks, perceived causes for increased CRC risk, and knowledge of CRC risk factors. At follow-up, neither the type or amount of information provided, nor the use of tailoring, appreciably and consistently affected whether participants mentioned their specific risk factor (e.g., lifestyle, occupational) emphasized in their intervention information. Furthermore, attributions did not affect CRC risk perceptions. These results suggest that participants do not integrate sufficiently CRC risk factor information into their conceptualizations of CRC risk, and that more effective methods are needed to contextualize risk factors information to achieve the goal of modifying CRC risk perceptions.

Authors
Lipkus, IM; Skinner, CS; Green, LSG; Dement, J; Samsa, GP; Ransohoff, D
MLA Citation
Lipkus, IM, Skinner, CS, Green, LSG, Dement, J, Samsa, GP, and Ransohoff, D. "Modifying attributions of colorectal cancer risk." Cancer Epidemiol Biomarkers Prev 13.4 (April 2004): 560-566.
PMID
15066920
Source
pubmed
Published In
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
Volume
13
Issue
4
Publish Date
2004
Start Page
560
End Page
566

Interpretation of genetic risk feedback among African American smokers with low socioeconomic status.

The authors report on factors related to interpretation of feedback on genetic susceptibility to lung cancer among 371 African American smokers receiving care in a community health clinic, with a focus on whether smokers were interpreting feedback consistent with a defensive processing or an accuracy orientation. Smokers were given feedback on the absence (indicating increased risk) or presence (indicating average risk) of the gene for the mu isoform of glutathione S-transferase. Smokers who were told they were at higher risk were more likely to inaccurately recall the result than those deemed at average risk. Smokers who inaccurately recalled the result, regardless of risk status, were most likely to misinterpret the meaning of the result. Perceived lung cancer risks and worries were not associated with comprehension of the test result. The authors suggest additional research is needed to develop more effective strategies for communicating genetic risk feedback to motivate smoking cessation.

Authors
Lipkus, IM; McBride, CM; Pollak, KI; Lyna, P; Bepler, G
MLA Citation
Lipkus, IM, McBride, CM, Pollak, KI, Lyna, P, and Bepler, G. "Interpretation of genetic risk feedback among African American smokers with low socioeconomic status." Health Psychol 23.2 (March 2004): 178-188.
PMID
15008663
Source
pubmed
Published In
Health Psychology
Volume
23
Issue
2
Publish Date
2004
Start Page
178
End Page
188
DOI
10.1037/0278-6133.23.2.178

Accuracy of self-reports of fecal occult blood tests and test results among individuals in the carpentry trade.

BACKGROUND: Inaccuracy in self-reports of colorectal cancer (CRC) screening procedures (e.g., over- or underreporting) may interfere with individuals adhering to appropriate screening intervals, and can blur the true effects of physician recommendations to screen and the effects of interventions designed to promote screening. We assessed accuracy of self-report of having a fecal occult blood test (FOBT) within a 1-year window based on receipt of FOBT kits among individuals aged 50 and older in the carpentry trade (N = 658) who were off-schedule for having had a FOBT. METHOD: Indices of evaluating accuracy of self-reports (concordance, specificity, false-positive and false-negative rates) were calculated relative to receipt of a mailed FOBT. Among those who mailed a completed FOBT, we assessed accuracy of reporting the test result. RESULTS: Participants underestimated having performed a FOBT (false-negative rate of 44%). Accuracy was unrelated to perceptions of getting or worrying about CRC or family history. Self-reports of having a negative FOBT result more consistently matched the laboratory result (specificity 98%) than having a positive test result (sensitivity 63%). CONCLUSIONS: Contrary to other findings, participants under- rather than over reported FOBT screening. Results suggest greater efforts are needed to enhance accurate recall of FOBT screening.

Authors
Lipkus, IM; Samsa, GP; Dement, J; Skinner, CS; Green, LSG; Pompeii, L; Ransohoff, DF
MLA Citation
Lipkus, IM, Samsa, GP, Dement, J, Skinner, CS, Green, LSG, Pompeii, L, and Ransohoff, DF. "Accuracy of self-reports of fecal occult blood tests and test results among individuals in the carpentry trade." Prev Med 37.5 (November 2003): 513-519.
PMID
14572436
Source
pubmed
Published In
Preventive Medicine
Volume
37
Issue
5
Publish Date
2003
Start Page
513
End Page
519

Reminder letter, tailored stepped-care, and self-choice comparison for repeat mammography.

BACKGROUND: The main benefits of mammography come from regular on-schedule screening. However, few studies have examined interventions to achieve repeat screening. SETTING AND PARTICIPANTS: Participants were women aged 50 to 74, recruited through one setting in Rhode Island and another in North Carolina. Participants had a mammogram already scheduled at recruitment, and had to keep that appointment in order to be eligible for the repeat mammography intervention. A total of 1614 women were in the intervention sample. DESIGN: A four-group randomized design was used: Group 1, a simple reminder letter; Group 2, a 2-month, tailored, stepped intervention delivered 2 months after the completed mammogram; Group 3, a 10-month, tailored, stepped intervention delivered 2 months before the repeat mammogram was due; and Group 4, self-choice of one of the above three strategies. INTERVENTION: The intervention took place between June 1996 and May 1997. The reminder letter and two levels of the stepped intervention were delivered by mail. The third level of the stepped strategy was a counselor telephone call. Groups 2 and 3 were identical, except for timing. OUTCOME MEASURE: Obtaining the next due mammogram within 15 months, based on clinic records. RESULTS: There were no statistically significant differences among the four groups, both in the total sample and at the two sites separately. CONCLUSIONS: On average, a simple reminder may be as effective as more complex strategies for women with a prior on-schedule exam. However, attention is still needed to identify women at risk of lapsing from screening. Some women may require more-intensive interventions.

Authors
Rakowski, W; Lipkus, IM; Clark, MA; Rimer, BK; Ehrich, B; Lyna, PR; Kornguth, PJ
MLA Citation
Rakowski, W, Lipkus, IM, Clark, MA, Rimer, BK, Ehrich, B, Lyna, PR, and Kornguth, PJ. "Reminder letter, tailored stepped-care, and self-choice comparison for repeat mammography." Am J Prev Med 25.4 (November 2003): 308-314.
PMID
14580632
Source
pubmed
Published In
American Journal of Preventive Medicine
Volume
25
Issue
4
Publish Date
2003
Start Page
308
End Page
314

Cancer incidence among union carpenters in New Jersey.

A cohort of 13,354 male union carpenters in New Jersey was linked to cancer registry data to investigate cancer incidence during 1979 through 2000. Surveillance, Epidemiology and End Results data were used to calculate standardized incidence ratios (SIRs). A total of 592 incident cancers were observed among this cohort (SIR=1.07), which was not statistically in excess. However, significant excesses were observed for cancers of the digestive system and peritoneum (SIR=1.24) and the respiratory system (SIR=1.52). Workers in the union more than 30 years were at significant risk for cancers of the digestive organs and peritoneum (SIR=3.98), rectum (SIR=4.85), trachea, bronchus, and lung (SIR=4.56), and other parts of the respiratory system (SIR=11.00). Testicular cancer was significantly in excess (SIR=2.48) in analyses that lagged results 15 years from initial union membership. Additional etiologic research is needed to evaluate possible occupational and nonoccupational risk factors for testicular cancer.

Authors
Dement, J; Pompeii, L; Lipkus, IM; Samsa, GP
MLA Citation
Dement, J, Pompeii, L, Lipkus, IM, and Samsa, GP. "Cancer incidence among union carpenters in New Jersey." J Occup Environ Med 45.10 (October 2003): 1059-1067.
PMID
14534447
Source
pubmed
Published In
Journal of Occupational and Environmental Medicine
Volume
45
Issue
10
Publish Date
2003
Start Page
1059
End Page
1067
DOI
10.1097/01.jom.0000085892.01486.6a

The social context of gastrointestinal cancer pain: a preliminary study examining the relation of patient pain catastrophizing to patient perceptions of social support and caregiver stress and negative responses.

A number of studies have shown that catastrophizing is an important predictor of pain and disability in persons having persistent pain conditions. The newly developed communal model of catastrophizing maintains that catastrophizing is a part of broader, interpersonal style of coping in which coping efforts are directed at interpersonal goals, rather than solely at pain reduction. This study examined the potential interpersonal correlates of pain catastrophizing in a sample of 70 patients having gastrointestinal cancers and their caregivers. Measures of pain catastrophizing, perceptions of social support, pain level, and pain behavior were obtained from patients. Caregivers completed measures that included their judgments about the patient's pain level, caregiver stress, and their tendency to engage in negative responses (critical or avoidant behaviors). Overall, patients who engaged in catastrophizing reported receiving higher levels of instrumental support. Caregivers of patients who catastrophized, rated the patient as having more pain and engaging in more pain behavior. Caregivers of patients who catastrophized, also reported higher levels of caregiver stress and critical behaviors. Taken together, these preliminary findings suggest that pain catastrophizing has interpersonal correlates and support the need for additional research examining the social context of pain catastrophizing.

Authors
Keefe, FJ; Lipkus, I; Lefebvre, JC; Hurwitz, H; Clipp, E; Smith, J; Porter, L
MLA Citation
Keefe, FJ, Lipkus, I, Lefebvre, JC, Hurwitz, H, Clipp, E, Smith, J, and Porter, L. "The social context of gastrointestinal cancer pain: a preliminary study examining the relation of patient pain catastrophizing to patient perceptions of social support and caregiver stress and negative responses." Pain 103.1-2 (May 2003): 151-156.
PMID
12749969
Source
pubmed
Published In
PAIN
Volume
103
Issue
1-2
Publish Date
2003
Start Page
151
End Page
156

Manipulating perceptions of colorectal cancer threat: implications for screening intentions and behaviors.

Affecting peoples' perceptions of the health threat of colorectal cancer (CRC), that is, the probability of the cancer's occurrence multiplied by the severity of the outcomes, has not been experimentally manipulated as a means to increase CRC screening intentions and behaviors. As an exploratory pilot study to inform a larger randomized trial on CRC screening, we used a four-group pre-post longitudinal design to test whether providing information about: 1) colorectal cancer risks (no/yes) and, 2) the severity of treatment and illness consequences (no/yes) affected CRC screening intentions (i.e., fecal occult blood test/sigmoidoscopy) and behaviors at a six-month follow-up. The sample consisted of 119 men and women aged 50 and older who were off schedule for having a fecal occult blood test (FOBT). Although perceptions of CRC risks were not affected by the experimental manipulations, perceived severity increased screening intentions for FOBT and lowered felt ambivalence towards FOBT. At the six-month follow-up, 31% participants had a FOBT. Participants who received severity information were significantly more likely to report having had a FOBT. These results suggest that: 1) more attention needs to be given to developing strategies to affect perception of CRC risk, and 2) increasing the perceived severity of CRC is an important construct to increase FOBT screening.

Authors
Lipkus, IM; Green, LG; Marcus, A
MLA Citation
Lipkus, IM, Green, LG, and Marcus, A. "Manipulating perceptions of colorectal cancer threat: implications for screening intentions and behaviors." J Health Commun 8.3 (May 2003): 213-228.
PMID
12857652
Source
pubmed
Published In
Journal of Health Communication
Volume
8
Issue
3
Publish Date
2003
Start Page
213
End Page
228
DOI
10.1080/10810730305684

Understanding the potential of teachable moments: the case of smoking cessation.

The label 'teachable moment' (TM) has been used to describe naturally occurring health events thought to motivate individuals to spontaneously adopt risk-reducing health behaviors. This manuscript summarizes the evidence of TMs for smoking cessation, and makes recommendations for conceptual and methodological refinements to improve the next generation of related research. TM studies were identified for the following event categories: office visits, notification of abnormal test results, pregnancy, hospitalization and disease diagnosis. Cessation rates associated with pregnancy, hospitalization and disease diagnosis were high (10-60 and 15-78%, respectively), whereas rates for clinic visits and abnormal test results were consistently lower (2-10 and 7-21%, respectively). Drawing from accepted conceptual models, a TM heuristic is outlined that suggests three domains underlie whether a cueing event is significant enough to be a TM for smoking cessation: the extent to which the event (1) increases perceptions of personal risk and outcome expectancies, (2) prompts strong affective or emotional responses, and (3) redefines self-concept or social role. Research in TMs could be improved by giving greater attention to assessment of conceptually grounded cognitive and emotional variables, appropriately timed assessment and intervention, and inclusion of appropriate target and comparison samples.

Authors
McBride, CM; Emmons, KM; Lipkus, IM
MLA Citation
McBride, CM, Emmons, KM, and Lipkus, IM. "Understanding the potential of teachable moments: the case of smoking cessation." Health Educ Res 18.2 (April 2003): 156-170.
PMID
12729175
Source
pubmed
Published In
Health Education Research
Volume
18
Issue
2
Publish Date
2003
Start Page
156
End Page
170

Design of FRESH START: a randomized trial of exercise and diet among cancer survivors.

PURPOSE: FRESH START is a randomized controlled trial that will test whether a personally tailored, distance-medicine-based program will increase exercise and fruit and vegetable consumption, and decrease fat intake of individuals recently diagnosed with breast or prostate cancer. METHODS: Early-stage breast and prostate cancer cases (N= 530) will be identified within 9 months of diagnosis from hospital cancer registries and large oncologic practices throughout the United States. These individuals will be sent a letter of invitation and screened for eligibility. After a baseline telephone interview, participants will be randomized into one of two arms that receive materials aimed at increasing exercise and fruit and vegetable intake, and decreasing dietary fat: 1). an experimental arm that receives a workbook and a series of six 4-page newsletters delivered every 7 wk and personally tailored on type of cancer, cancer coping style, race, age, self-efficacy, stage of readiness, and barriers and/or progress toward goal behavior (i.e., >or= 30 min of exercise at least 5 d.wk, >or= 5 servings of vegetables and fruit per day, and

Authors
Demark-Wahnefried, W; Clipp, EC; McBride, C; Lobach, DF; Lipkus, I; Peterson, B; Clutter Snyder, D; Sloane, R; Arbanas, J; Kraus, WE
MLA Citation
Demark-Wahnefried, W, Clipp, EC, McBride, C, Lobach, DF, Lipkus, I, Peterson, B, Clutter Snyder, D, Sloane, R, Arbanas, J, and Kraus, WE. "Design of FRESH START: a randomized trial of exercise and diet among cancer survivors." Med Sci Sports Exerc 35.3 (March 2003): 415-424.
PMID
12618570
Source
pubmed
Published In
Medicine and Science in Sports and Exercise
Volume
35
Issue
3
Publish Date
2003
Start Page
415
End Page
424
DOI
10.1249/01.MSS.0000053704.28156.0F

Affect, framing, and persuasion

The authors conduct two experiments that indicate that the effectiveness of loss-versus gain-framed messages depends on the affective state of the message recipient. In Experiment 1, the authors find that participants induced with a positive mood are more persuaded by the loss-framed message, whereas participants induced with a negative mood are more persuaded by the gain-framed message. In addition, the authors observe that participants in a positive mood have higher risk estimates and lower costs in response to the loss frame than the gain frame, whereas the reverse is true for participants in a negative mood. The authors replicate these effects in Experiment 2 in which they measure rather than induce the participants' affective state.

Authors
Keller, PA; Lipkus, IM; Rimer, BK
MLA Citation
Keller, PA, Lipkus, IM, and Rimer, BK. "Affect, framing, and persuasion." Journal of Marketing Research 40.1 (2003): 54-64.
Source
scival
Published In
Journal of Marketing Research
Volume
40
Issue
1
Publish Date
2003
Start Page
54
End Page
64
DOI
10.1509/jmkr.40.1.54.19133

Evaluating participants' use of a hormone replacement therapy decision-making intervention.

BACKGROUND: Associations between optimal use of a tailored decision-aid and levels of accuracy of perceived breast cancer risk, confidence in decision-making, and satisfaction with decisions about HRT were evaluated in a randomized intervention trial with a community sample of women aged 45-54. METHODS: Data are from 289 women randomized to receive a computer-tailored three-step decision-aid. RESULTS: Forty-seven percent of participants reported optimal use of the intervention materials. African American women and those with low confidence in decision-making were less likely to use the intervention optimally than white women and those with higher confidence (P<0.05). Optimal use of the decision-aid was associated with increased accuracy of perceived risk and confidence to make a decision. DISCUSSION: When used optimally, self-directed decision-aids can improve women's ability to make decisions about HRT. Additional refinement of these aids is needed. For some subgroups of women, adjuncts such as telephone counseling also might be considered.

Authors
Bastian, LA; McBride, CM; Fish, L; Lyna, P; Farrell, D; Lipkus, IM; Rimer, BK; Siegler, IC
MLA Citation
Bastian, LA, McBride, CM, Fish, L, Lyna, P, Farrell, D, Lipkus, IM, Rimer, BK, and Siegler, IC. "Evaluating participants' use of a hormone replacement therapy decision-making intervention." Patient Educ Couns 48.3 (December 2002): 283-291.
PMID
12477613
Source
pubmed
Published In
Patient Education and Counseling
Volume
48
Issue
3
Publish Date
2002
Start Page
283
End Page
291

Reported cessation advice given to African Americans by health care providers in a community health clinic.

Physician smoking cessation advice has been shown to be effective in encouraging patients to attempt cessation. Few studies have examined factors associated with patient-reported physician advice in an inner city community health clinic. Smokers identified via chart review and provider referral met with a study "smoking specialist." Eligible participants self-identified as African American, smoked at least 1 cigarette per day in the prior 7 days, were 18 or older, had access to a telephone, and agreed to consider blood testing for genetic susceptibility to lung cancer. Of the 869 smokers identified, 487 were eligible and completed a brief in-person and a more extensive follow-up telephone survey within one week after their visit. Patient reports of smoking cessation advice by providers were regressed on patient demographic, smoking, health, and social support variables. Seventy percent of participants reported that they had been advised to quit smoking. Smokers who were older, did not smoke menthol cigarettes, were in poorer health, and who had a regular health care provider were most likely to report having received advice. Patients in this community health setting reported high rates of provider advice to quit smoking. Yet, even in this optimal condition, young healthy smokers did not report receiving advice, even when they were ready to quit smoking. Providers may need additional training and prompting to counsel young healthy smokers about the importance of cessation.

Authors
Pollak, KI; Taiwo, B; Lyna, P; Baldwin, M; Lipkus, IM; Bepler, G; McBride, CM
MLA Citation
Pollak, KI, Taiwo, B, Lyna, P, Baldwin, M, Lipkus, IM, Bepler, G, and McBride, CM. "Reported cessation advice given to African Americans by health care providers in a community health clinic." J Community Health 27.6 (December 2002): 381-393.
PMID
12458781
Source
pubmed
Published In
Journal of Community Health
Volume
27
Issue
6
Publish Date
2002
Start Page
381
End Page
393

A tailored intervention to aid decision-making about hormone replacement therapy.

Authors
McBride, CM; Bastian, LA; Halabi, S; Fish, L; Lipkus, IM; Bosworth, HB; Rimer, BK; Siegler, IC
MLA Citation
McBride, CM, Bastian, LA, Halabi, S, Fish, L, Lipkus, IM, Bosworth, HB, Rimer, BK, and Siegler, IC. "A tailored intervention to aid decision-making about hormone replacement therapy." Am J Public Health 92.7 (July 2002): 1112-1114.
PMID
12084693
Source
pubmed
Published In
American journal of public health
Volume
92
Issue
7
Publish Date
2002
Start Page
1112
End Page
1114

Incorporating genetic susceptibility feedback into a smoking cessation program for African-American smokers with low income.

PURPOSE: Markers of genetic susceptibility to tobacco-related cancers could personalize harms of smoking and motivate cessation. Our objective was to assess whether a multicomponent intervention that included feedback about genetic susceptibility to lung cancer increased risk perceptions and rates of smoking cessation compared with a standard cessation intervention. EXPERIMENTAL DESIGN: Our design was a two-arm trial with eligible smokers randomized in a 1:2 ratio to Enhanced Usual Care or Biomarker Feedback (BF). Surveys were conducted at baseline, 6, and 12 months later. The setting was an inner city community health clinic. African-American patients who were current smokers (n = 557) were identified by chart abstraction and provider referral. All smokers received a self-help manual and, if appropriate, nicotine patches. Smokers in the BF arm also were offered a blood test for genotyping the GST(3) gene (GSTM1), sent a test result booklet, and called up to four times by a health educator. Prevalent abstinence was assessed by self-report of having smoked no cigarettes in the prior 7 days at the 6- and 12-month follow-ups and sustained abstinence, i.e., not smoking at either follow-up or in-between. RESULTS: Smoking cessation was greater for the BF arm than the Enhanced Usual Care arm (19% versus 10%, respectively; P < 0.006) at 6 months but not at 12 months. CONCLUSIONS: Smokers agreed to genetic feedback as part of a multicomponent cessation program. Although the program increased short-term cessation rates compared with standard intervention, genetic feedback of susceptibility may not benefit smokers with high baseline risk perceptions.

Authors
McBride, CM; Bepler, G; Lipkus, IM; Lyna, P; Samsa, G; Albright, J; Datta, S; Rimer, BK
MLA Citation
McBride, CM, Bepler, G, Lipkus, IM, Lyna, P, Samsa, G, Albright, J, Datta, S, and Rimer, BK. "Incorporating genetic susceptibility feedback into a smoking cessation program for African-American smokers with low income." Cancer Epidemiol Biomarkers Prev 11.6 (June 2002): 521-528.
PMID
12050092
Source
pubmed
Published In
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
Volume
11
Issue
6
Publish Date
2002
Start Page
521
End Page
528

Factors associated with patient-recalled smoking cessation advice in a low-income clinic.

It is recommended that providers advise cessation to their patients who smoke. However, patients' reports of cessation advice indicate disparities based on patients' race, gender, age, and smoking level. Providers' reports do not corroborate these disparities. We investigated whether smokers who receive their care in a community health center recalled their providers advising them to quit smoking when their providers documented such advice. We examined 219 patient-provider dyads to assess factors associated with lack of agreement between providers' documentation and patient recall. Patients were asked to recall any provider advice to quit smoking in the post 2 years. After every visit, providers completed a form to record the content of the visit. Most of the patients were African American, married, and uninsured. Sixty-eight percent of the dyads agreed in their documentation/recall. Patient race was the only factor associated with lack of agreement; African-American patients were more likely than white patients to provide discrepant reports. Although this study can not disentangle the racial difference in patient-provider recall/documentation, results may indicate an important area in which health disparities exist. Future studies should address the dynamics of patient-provider communication about smoking cessation, especially in populations that include ethnically diverse patients.

Authors
Pollak, KI; Yarnall, KSH; Rimer, BK; Lipkus, I; Lyna, PR
MLA Citation
Pollak, KI, Yarnall, KSH, Rimer, BK, Lipkus, I, and Lyna, PR. "Factors associated with patient-recalled smoking cessation advice in a low-income clinic." J Natl Med Assoc 94.5 (May 2002): 354-363.
PMID
12069216
Source
pubmed
Published In
Journal of the National Medical Association
Volume
94
Issue
5
Publish Date
2002
Start Page
354
End Page
363

Effects of a mammography decision-making intervention at 12 and 24 months.

BACKGROUND: Most women are not getting regular mammograms, and there is confusion about several mammography-related issues, including the age at which women should begin screening. Numerous groups have called for informed decision making about mammography, but few programs have resulted. Our research is intended to fill this gap. METHODS: We conducted a randomized controlled trial, which ran from 1997 to 2000. Women aged 40 to 44 and 50 to 54, who were enrolled in Blue Cross Blue Shield of North Carolina, were randomly assigned to one of three groups: usual care (UC), tailored print (TP) materials, or TP plus tailored telephone counseling (TP+TC). We assessed the impact of tailored interventions on knowledge about breast cancer and mammography, accuracy of breast cancer risk perceptions, and use of mammography at two time points after intervention-12 and 24 months. RESULTS: At 12 and 24 months, women who received TP+TC had significantly greater knowledge and more accurate breast cancer risk perceptions. Compared to UC, they were 40% more likely to have had mammograms (odds ratio=0.9-2.1). The effect was primarily for women in their 50s. TP had significant effects for knowledge and accuracy, but women who received TP were less likely to have had mammography. CONCLUSIONS: Decision-making interventions, comprised of two tailored print interventions (booklet and newsletter), delivered a year apart, with or without two tailored telephone calls, significantly increased knowledge and accuracy of perceived breast cancer risk at 12 and 24 months post-intervention. The effect on mammography use was significant in bivariate relationships but had a much more modest impact in multivariate analyses.

Authors
Rimer, BK; Halabi, S; Sugg Skinner, C; Lipkus, IM; Strigo, TS; Kaplan, EB; Samsa, GP
MLA Citation
Rimer, BK, Halabi, S, Sugg Skinner, C, Lipkus, IM, Strigo, TS, Kaplan, EB, and Samsa, GP. "Effects of a mammography decision-making intervention at 12 and 24 months." Am J Prev Med 22.4 (May 2002): 247-257.
PMID
11988381
Source
pubmed
Published In
American Journal of Preventive Medicine
Volume
22
Issue
4
Publish Date
2002
Start Page
247
End Page
257

Effectiveness of telephone counseling for mammography: results from five randomized trials.

BACKGROUND: Women over age 50 continue to be underscreened for breast cancer. The purpose of this report is to compare the effectiveness of a barrier-specific telephone counseling intervention across the five study sites of the Breast Cancer Screening Consortium (BCSC). METHODS: Each of the BCSC projects was a randomized study of the effectiveness of telephone counseling (TC) in comparison to a control condition. Eligible underusers were identified and surveyed by telephone before and after the implementation of the interventions. Data from a total of 3,461 underusers were analyzed. We tested whether significantly more women randomized to TC than to control were regular mammography users at the follow-up survey. Data were analyzed separately by site. RESULTS: Overall, TC was not significantly more effective than control in encouraging regular mammography. The pooled consortium-wide odds ratio was 1.08 (95% confidence interval: 0.91 to 1.27). CONCLUSIONS: TC has the potential to support maintenance of mammogram use. Modifications are needed to maximize this potential and additional methods should be used in conjunction with TC to reach women who are underusers of mammography.

Authors
Stoddard, AM; Fox, SA; Costanza, ME; Lane, DS; Andersen, MR; Urban, N; Lipkus, I; Rimer, BK; NCI Breast Screening Consortium,
MLA Citation
Stoddard, AM, Fox, SA, Costanza, ME, Lane, DS, Andersen, MR, Urban, N, Lipkus, I, Rimer, BK, and NCI Breast Screening Consortium, . "Effectiveness of telephone counseling for mammography: results from five randomized trials." Prev Med 34.1 (January 2002): 90-99.
PMID
11749101
Source
pubmed
Published In
Preventive Medicine
Volume
34
Issue
1
Publish Date
2002
Start Page
90
End Page
99
DOI
10.1006/pmed.2001.0960

Depressive Realism and Health Risk Accuracy: The Negative Consequences of Positive Mood

We examine the role of level of depression on updating of health-related risk estimates. Participants provided their risk of getting breast cancer before (baseline) and after (follow-up) receiving personalized (experiment 1) or standard (experiment 2) medical risk feedback. Although there were no significant differences in risk estimates at baseline, the follow-up risk estimates indicate that compared to non- depressives, depressives lowered their risk estimates such that they were more accurate or closer to the medical estimates provided in the risk feedback. In contrast to depressives, nondepressives with higher baseline risk estimates did not revise their follow-up risk estimates because they were in a positive mood after receiving the risk feedback.

Authors
Keller, PA; Lipkus, IM; Rimer, BK
MLA Citation
Keller, PA, Lipkus, IM, and Rimer, BK. "Depressive Realism and Health Risk Accuracy: The Negative Consequences of Positive Mood." Journal of Consumer Research 29.1 (2002): 57-69.
Source
scival
Published In
Journal of Consumer Research
Volume
29
Issue
1
Publish Date
2002
Start Page
57
End Page
69
DOI
10.1086/339921

Influence of stereotyping in smoking cessation counseling by primary care residents.

This study examined racial differences in primary care residents' rates of addressing smoking cessation. We expected residents to have higher rates of addressing cessation with White female patients as compared with African-American or Hispanic female patients, due, in part, to residents having higher outcome expectancies, self-efficacy, lower barriers, and less reliance on stereotypes. Residents (N = 90) were an average of 31 years old; two-thirds were White internal medicine residents. Residents viewed a video of a lower-middle class White, African-American, or Hispanic female interacting with her physician about stomach pain. Results indicate that residents were very likely to address smoking cessation, regardless of patients' race. Compared to residents assigned to an ethnic minority patient, residents assigned to the White patient were less likely to believe the patient would follow their advice (P < .03) and also perceived more barriers to address smoking cessation (P < .04). Reliance on the stereotype of Whites mediated the racial difference in outcome expectancies. Implications are that residents may be relying on stereotypes when they assess lower-middle class White female patients' receptivity to smoking cessation advice. Future research on the role of stereotyping in medical settings is warranted.

Authors
Pollak, KI; Arredondo, EM; Yarnall, KSH; Lipkus, I; Myers, E; McNeilly, M; Costanzo, P
MLA Citation
Pollak, KI, Arredondo, EM, Yarnall, KSH, Lipkus, I, Myers, E, McNeilly, M, and Costanzo, P. "Influence of stereotyping in smoking cessation counseling by primary care residents." Ethn Dis 12.4 (2002): 578-585.
PMID
12477145
Source
pubmed
Published In
Ethnicity & disease
Volume
12
Issue
4
Publish Date
2002
Start Page
578
End Page
585

American Society of Clinical Oncology technology assessment of pharmacologic interventions for breast cancer risk reduction including tamoxifen, raloxifene, and aromatase inhibition

Objective: To update an evidence-based technology assessment of chemoprevention strategies for breast cancer risk reduction. Potential Interventions: Tamoxifen, raloxifene, aromatase inhibition, and fenretinide. Outcomes: Outcomes of interest include breast cancer incidence, breast cancer-specific survival, overall survival, and net health benefit. Evidence: A comprehensive, formal literature review was conducted for relevant topics. Testimony was collected from invited experts and interested parties. The American Society of Clinical Oncology (ASCO) prescribed technology assessment procedure was followed. Values: More weight was given to published randomized trials. Benefits/Harms: A woman's decision regarding breast cancer risk reduction strategies is complex and will depend on the importance and weight attributed to information regarding both cancer- and noncancer-related risks and benefits. Conclusions: For women with a defined 5-year projected breast cancer risk of ≥ 1.66%, tamoxifen (at 20 mg/d for 5 years) may be offered to reduce their risk. Risk/benefit models suggest that greatest clinical benefit with least side effects is derived from use of tamoxifen in younger (premenopausal) women (who are less likely to have thromboembolic sequelae and uterine cancer), women without a uterus, and women at higher breast cancer risk. Data do not as yet suggest that tamoxifen provides an overall health benefit or increases survival. In all circumstances, tamoxifen use should be discussed as part of an informed decision making process with careful consideration of individually calculated risks and benefits. Use of tamoxifen combined with hormone replacement therapy or use of raloxifene, any aromatase inhibitor or inactivator, or fenretinide to lower the risk of developing breast cancer is not recommended outside of a clinical trial setting. This technology assessment represents an ongoing process and recommendations will be updated in a timely matter. Validation: The conclusions were endorsed by the ASCO Health Services Research Committee and the ASCO Board of Directors. Sponsor: American Society of Clinical Oncology. © 2002 by American Society of Clinical Oncology.

Authors
Chlebowski, RT; Col, N; Winer, EP; Collyar, DE; Cummings, SR; III, VGV; Burstein, HJ; Eisen, A; Lipkus, I; Pfister, DG
MLA Citation
Chlebowski, RT, Col, N, Winer, EP, Collyar, DE, Cummings, SR, III, VGV, Burstein, HJ, Eisen, A, Lipkus, I, and Pfister, DG. "American Society of Clinical Oncology technology assessment of pharmacologic interventions for breast cancer risk reduction including tamoxifen, raloxifene, and aromatase inhibition." Journal of Clinical Oncology 20.15 (2002): 3328-3343.
PMID
12149307
Source
scival
Published In
Journal of Clinical Oncology
Volume
20
Issue
15
Publish Date
2002
Start Page
3328
End Page
3343
DOI
10.1200/JCO.2002.06.029

How do residents prioritize smoking cessation for young "high-risk" women? Factors associated with addressing smoking cessation.

BACKGROUND: Sixty-seven percent of physicians report advising their smoking patients to quit. Primary care residents' priorities for preventive health for a young "high-risk" female are unknown. Factors related to residents addressing smoking also need examining. METHODS: One hundred residents completed a survey about preventive health issues for a woman in her 20s "who leads a high-risk lifestyle." Residents indicated which topics they would address, and the likelihood that they would address each of 12 relevant preventive health topics, their outcome expectancies that the patient would follow their advice on each topic, their confidence that they could address the topic, and perceived barriers for addressing the topic. RESULTS: Residents listed STD prevention most frequently. Drug use and smoking cessation were second and third most frequently listed. Residents who believed that the patient would follow their advice were more likely to list smoking cessation than residents who had lower outcome expectancies for that patient. Higher barriers were negatively related to addressing smoking cessation. CONCLUSIONS: When time is not a barrier, residents are likely to address smoking cessation. Teaching residents how to incorporate this subject into their clinical practice is needed. Raising residents' outcome expectancies may increase their likelihood of addressing smoking cessation.

Authors
Pollak, KI; Arredondo, EM; Yarnall, KS; Lipkus, I; Myers, E; McNeilly, M; Costanzo, P
MLA Citation
Pollak, KI, Arredondo, EM, Yarnall, KS, Lipkus, I, Myers, E, McNeilly, M, and Costanzo, P. "How do residents prioritize smoking cessation for young "high-risk" women? Factors associated with addressing smoking cessation." Prev Med 33.4 (October 2001): 292-299.
PMID
11570833
Source
pubmed
Published In
Preventive Medicine
Volume
33
Issue
4
Publish Date
2001
Start Page
292
End Page
299
DOI
10.1006/pmed.2001.0884

Communicating breast cancer risks to women using different formats.

Using a pre-post test design with a baseline, laboratory, and a 6-month follow-up, we communicated women's objective breast cancer risks, based on the Gail Model, using two formats: (a) range of risks (e.g., risk of breast cancer can be as low as 1% and as high as 5%); and (b) as a point estimate (e.g., your risk of breast cancer is 3%). We examined how these presentations individually and jointly affected women's perceived lifetime breast cancer risks. Overall, providing risk estimates either as a range of risks or as a point estimate lowered women's perceived lifetime risks compared with women who did not get information presented this way shortly after receipt of this information relative to baseline. At the 6-month follow-up, perceptions of lifetime risks generally returned to their baseline values. Overall, women viewed their risk feedback, whether presented as a point estimate or as a range of risks, as equally credible, trustworthy, accurate, and personally relevant. These results suggest that women evaluate risk feedback containing either point estimates or range of risks as equally acceptable. Both formats lead to short-term reductions in perceived risk (i.e., greater accuracy).

Authors
Lipkus, IM; Klein, WM; Rimer, BK
MLA Citation
Lipkus, IM, Klein, WM, and Rimer, BK. "Communicating breast cancer risks to women using different formats." Cancer Epidemiol Biomarkers Prev 10.8 (August 2001): 895-898.
PMID
11489757
Source
pubmed
Published In
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
Volume
10
Issue
8
Publish Date
2001
Start Page
895
End Page
898

Women's interest in chemoprevention for breast cancer.

BACKGROUND: Chemoprevention is the use of pharmacologic or natural agents to inhibit the development of cancer. Tamoxifen citrate is the only approved chemopreventive agent for breast cancer. We sought to determine whether women are interested in taking a drug to prevent breast cancer and to assess the relationship between objective and subjective breast cancer risk and interest in chemoprevention. METHODS: We conducted telephone interviews (November 3, 1997, to May 6, 1998) among a community sample of women aged 40 to 45 and 50 to 55 years enrolled in a randomized controlled trial to evaluate the efficacy of a tailored mammography decision aid. Objective breast cancer risk was measured using the 5-year Gail score. Subjective breast cancer risk was measured using perceptions of absolute risk, perceptions of comparative risk, and worry about getting breast cancer. At 12-month follow-up (November 2, 1998, to July 20, 1999), we measured interest in taking a drug to prevent breast cancer. RESULTS: Among the 1273 women surveyed, 23% were interested in taking a drug to prevent breast cancer; 8% were potentially eligible for tamoxifen therapy (5-year Gail score > or = 1.66%). Eligibility for chemoprevention, based on the 5-year Gail score, was not associated with interest in taking a drug to prevent breast cancer. Women who were worried about breast cancer were 3 times more likely to be interested in taking a drug to prevent breast cancer than those who were not worried. CONCLUSION: Women's interest in chemoprevention might arise more from worries about getting breast cancer than from their objective risk factors.

Authors
Bastian, LA; Lipkus, IM; Kuchibhatla, MN; Weng, HH; Halabi, S; Ryan, PD; Skinner, CS; Rimer, BK
MLA Citation
Bastian, LA, Lipkus, IM, Kuchibhatla, MN, Weng, HH, Halabi, S, Ryan, PD, Skinner, CS, and Rimer, BK. "Women's interest in chemoprevention for breast cancer." Arch Intern Med 161.13 (July 9, 2001): 1639-1644.
PMID
11434796
Source
pubmed
Published In
Archives of internal medicine
Volume
161
Issue
13
Publish Date
2001
Start Page
1639
End Page
1644

The short-term impact of tailored mammography decision-making interventions.

BACKGROUND: We assessed the short-term impact of decision-making interventions on knowledge about mammography, accuracy of women's breast cancer risk perceptions, attitudes toward mammography, satisfaction with decisions, and mammography use since the intervention. METHODS: The study was conducted among women who were members of Blue Cross Blue Shield of North Carolina and were in their 40s or 50s at the time the study began in 1997. Women were randomly assigned to usual care (UC), tailored print booklets (TP) alone, or TP plus telephone counseling (TP+TC ). RESULTS: 12-month interviews were completed by 1127 women to assess short-term intervention effects. Generally, women who received TP+TC were significantly more knowledgeable about mammography and breast cancer risk and were more accurate in their breast cancer risk perceptions than women in the TP and UC groups. They also were more likely to have had a mammogram since the baseline interview. In multivariable analyses, we found significant benefits of the combination of TP+TC compared to TP and to UC for knowledge, accuracy of risk perceptions, and mammography use. DISCUSSION: For complex decision-making tasks, such as women's decisions about mammography in the face of controversy, the combination of TP and TC may be more effective than TP alone, and certainly more effective than UC. It is critical that investigators determine the topics for which TP is appropriate and the situations that require additional supportive interventions.

Authors
Rimer, BK; Halabi, S; Sugg Skinner, C; Kaplan, EB; Crawford, Y; Samsa, GP; Strigo, TS; Lipkus, IM
MLA Citation
Rimer, BK, Halabi, S, Sugg Skinner, C, Kaplan, EB, Crawford, Y, Samsa, GP, Strigo, TS, and Lipkus, IM. "The short-term impact of tailored mammography decision-making interventions." Patient Educ Couns 43.3 (June 2001): 269-285.
PMID
11384825
Source
pubmed
Published In
Patient Education and Counseling
Volume
43
Issue
3
Publish Date
2001
Start Page
269
End Page
285

General performance on a numeracy scale among highly educated samples.

BACKGROUND: Numeracy, how facile people are with basic probability and mathematical concepts, is associated with how people perceive health risks. Performance on simple numeracy problems has been poor among populations with little as well as more formal education. Here, we examine how highly educated participants performed on a general and an expanded numeracy scale. The latter was designed within the context of health risks. METHOD: A total of 463 men and women aged 40 and older completed a 3-item general and an expanded 7-item numeracy scale. The expanded scale assessed how well people 1) differentiate and perform simple mathematical operations on risk magnitudes using percentages and proportions, 2) convert percentages to proportions, 3) convert proportions to percentages, and 4) convert probabilities to proportions. RESULTS: On average, 18% and 32% of participants correctly answered all of the general and expanded numeracy scale items, respectively. Approximately 16% to 20% incorrectly answered the most straightforward questions pertaining to risk magnitudes (e.g., Which represents the larger risk: 1%, 5%, or 10%?). A factor analysis revealed that the general and expanded risk numeracy items tapped the construct of global numeracy. CONCLUSIONS: These results suggest that even highly educated participants have difficulty with relatively simple numeracy questions, thus replicating in part earlier studies. The implication is that usual strategies for communicating numerical risk may be flawed. Methods and consequences of communicating health risk information tailored to a person's level of numeracy should be explored further.

Authors
Lipkus, IM; Samsa, G; Rimer, BK
MLA Citation
Lipkus, IM, Samsa, G, and Rimer, BK. "General performance on a numeracy scale among highly educated samples." Med Decis Making 21.1 (January 2001): 37-44.
PMID
11206945
Source
pubmed
Published In
Medical Decision Making
Volume
21
Issue
1
Publish Date
2001
Start Page
37
End Page
44
DOI
10.1177/0272989X0102100105

A just and an unjust world: Structure and validity of different world beliefs

In three studies, we tested the hypothesis that the belief in a just and an unjust world are distinct constructs. The two-factor model was supported through the use of structural equation modeling and the pattern of correlations with religiosity, well-being, and political ideology. Specifically, only the belief in a just world correlated positively with religiosity, three indicators of well being (life satisfaction, mood level, and affect), and preferring a well-established political party. A comparison between prisoners and guards revealed further differences. Prisoners endorsed more strongly the belief in an unjust world, but both guards and prisoners equally endorsed the belief in a just world. We discuss the differences between the belief in a just and an unjust world, and the implications of believing in an unjust world for social behavior. © 2001 Elsevier Science Ltd. All rights reserved.

Authors
Dalbert, C; Lipkus, IM; Sallay, H; Goch, I
MLA Citation
Dalbert, C, Lipkus, IM, Sallay, H, and Goch, I. "A just and an unjust world: Structure and validity of different world beliefs." Personality and Individual Differences 30.4 (2001): 561-577.
Source
scival
Published In
Personality and Individual Differences
Volume
30
Issue
4
Publish Date
2001
Start Page
561
End Page
577
DOI
10.1016/S0191-8869(00)00055-6

The relationship between attitudinal ambivalence and desire to quit smoking among college smokers

Growing evidence shows that attitudes can exist on a bivariate rather than a bipolar plane. This conceptualization provides a more dynamic approach to studying how attitudinal ambivalence (i.e., evaluating an attitude object as both positive and negative) affects smoking-related behaviors. Based on a sample of 157 college smokers, we obtained preliminary validational support for a smoking-specific felt attitudinal ambivalence scale. Felt attitudinal ambivalence correlated positively with potential for ambivalence, negative attitudes, and negative as well as positive outcome expectancies related to smoking. Smokers who felt more ambivalent reported a greater desire to quit and were more likely to be contemplators, as defined by the transtheoretical model of behavioral change. In multivariate analyses, felt ambivalence toward smoking predicted desire to quit after controlling for positive and negative attitudes and negative smoking consequences. These results provide promising support for the smoking-specific felt-ambivalence scale, and suggest that attitudinal ambivalence should be investigated further as a motivational mechanism to affect smoking cessation.

Authors
Lipkus, IM; Feaganes, JR; Green, JD; Sedikides, C
MLA Citation
Lipkus, IM, Feaganes, JR, Green, JD, and Sedikides, C. "The relationship between attitudinal ambivalence and desire to quit smoking among college smokers." Journal of Applied Social Psychology 31.1 (2001): 113-133.
Source
scival
Published In
Journal of Applied Social Psychology
Volume
31
Issue
1
Publish Date
2001
Start Page
113
End Page
133

Informing women about their breast cancer risks: truth and consequences.

We assessed the extent to which informing women about their risk for breast cancer affected their perceived 10-year and lifetime risks for getting breast cancer, their emotional reactions toward getting breast cancer, and their intentions to get mammograms. In a pre- to posttest design, 121 women were given their 10-year risk of getting breast cancer with or without being compared with women their age and race at lowest risk. Women's perceptions of their 10-year risks became more congruent (i.e., more accurate) with their actual risk. Participants were more accurate when they received their own risk without being compared with women at lowest risk. Women who received only their own risk estimate reported being at lower risk than other women. Overall, women reported that obtaining their 10-year risk estimate either did not affect or increased their intentions to get mammograms. These results suggest that giving women their individual risk of getting breast cancer improves accuracy while also enhancing their feelings that they are at lower risk than other women. Counter to many theories of health behavior, reducing women's perceived risk of breast cancer did not lower their intentions to get mammograms. Implications for the communication of breast cancer risk are discussed.

Authors
Lipkus, IM; Biradavolu, M; Fenn, K; Keller, P; Rimer, BK
MLA Citation
Lipkus, IM, Biradavolu, M, Fenn, K, Keller, P, and Rimer, BK. "Informing women about their breast cancer risks: truth and consequences." Health Commun 13.2 (2001): 205-226.
PMID
11451105
Source
pubmed
Published In
Health Communication
Volume
13
Issue
2
Publish Date
2001
Start Page
205
End Page
226
DOI
10.1207/S15327027HC1302_5

Colorectal cancer risk perceptions and screening intentions in a minority population.

This is a 2-year follow-up to a previously reported baseline paper. We focused on a predominantly low-income African-American population from a community health center and investigated the relationships among perceptions of perceived risks for colorectal cancer (CRC), concerns about getting CRC, screening intentions, and whether participants had a fecal occult blood test (FOBT) on schedule at follow-up. Baseline absolute risk did not predict screening intentions or being on schedule (15% of sample), nor did it predict follow-up perceived absolute risk, comparative risk, or CRC concerns. Participants who expressed greater perceived absolute risk, comparative risk, and concerns at follow-up were more likely to report thinking about or definitely planning to get an FOBT within the next 2 years (49% of the sample). In addition, baseline absolute risk and whether or not a person had an FOBT on schedule at baseline did not predict being on schedule at follow-up. A significant percentage of the population (20%) were not able to state whether their CRC risk was below average, average, or above average. In addition, 44% of the population viewed their risks as lower than their peers, and 58% reported being not at all or slightly concerned about getting CRC. These results suggest that educational efforts are needed especially for low-income minority populations to enhance knowledge and accuracy of risk perceptions for CRC and interventions that explicitly manipulate risk are needed to assess to what extent risk perceptions can be modified and subsequently affect screening.

Authors
Lipkus, IM; Lyna, PR; Rimer, BK
MLA Citation
Lipkus, IM, Lyna, PR, and Rimer, BK. "Colorectal cancer risk perceptions and screening intentions in a minority population." J Natl Med Assoc 92.10 (October 2000): 492-500.
PMID
11105730
Source
pubmed
Published In
Journal of the National Medical Association
Volume
92
Issue
10
Publish Date
2000
Start Page
492
End Page
500

Relationships among breast cancer perceived absolute risk, comparative risk, and worries.

When trying to predict breast cancer screening, it may be important to understand the relationships between perceived breast cancer risks and worries about getting breast cancer. This study examines the extent to which women's worries about breast cancer correlate with perceptions of both absolute (assessment of own) and comparative (self versus other) 10-year and lifetime risks. As part of a larger randomized intervention trial concerning hormone replacement therapy, 581 women participated in a telephone baseline survey to assess their perceptions of breast cancer risks and worries. Worries about getting breast cancer in the next 10 years and in one's lifetime were related positively to both absolute and comparative 10-year and lifetime risks. The magnitude of these relationships did not differ by time frame. Worry about breast cancer is a function of both how a woman views her own risk and how she compares her risk with that of other women. Some practitioners may encourage women to get screened for breast cancer by using emotional appeals, such as heightening women's worries about breast cancer by using risk information. Our data suggest that they should give careful consideration how best to combine, if at all, information about absolute and comparative risks. For example, if the motivation to screen is based on a sequential assessment of risk beginning with comparative and then absolute risk, creating communications that heighten perceived risk on both of these risk dimensions may be needed to evoke sufficient worry to initiate breast cancer screening.

Authors
Lipkus, IM; Kuchibhatla, M; McBride, CM; Bosworth, HB; Pollak, KI; Siegler, IC; Rimer, BK
MLA Citation
Lipkus, IM, Kuchibhatla, M, McBride, CM, Bosworth, HB, Pollak, KI, Siegler, IC, and Rimer, BK. "Relationships among breast cancer perceived absolute risk, comparative risk, and worries." Cancer Epidemiol Biomarkers Prev 9.9 (September 2000): 973-975.
PMID
11008917
Source
pubmed
Published In
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
Volume
9
Issue
9
Publish Date
2000
Start Page
973
End Page
975

Psychological impact of diagnosis and risk reduction among cancer survivors.

Life-threatening health events prompt psychological distress that may motivate individuals to reduce health risks. If so, interventions timed to take advantage of these 'teachable moments' could be particularly effective. To explore this association, early stage prostate and breast cancer patients were identified from a hospital-based tumor registry within 6 years of diagnosis. These patients (n=920) completed a mailed survey assessing the Horowitz impact of events scale, risk behaviors and readiness to change the behaviors. Breast cancer patients, younger patients and those reporting poor health status reported the greatest impact of the cancer diagnosis. Impact was inversely associated with time from diagnosis for prostate, but not breast cancer patients. Prostate patients who reported exercising regularly had lower impact scores than those who were not exercising (medians: 0.13 vs 0.56, respectively; p=0.02). Breast patients who were eating five or more fruits and vegetables reported lower impact scores than those who were not eating the recommended servings (0.75 vs 1.06, respectively; p=0.03). Breast patients who were non-smokers reported lower impact scores than smokers (0.88 vs 1.31, respectively; p=0. 02). Prospective studies are needed to understand the psychological impact of cancer diagnosis and how it might facilitate or impede the adoption of health promoting behaviors.

Authors
McBride, CM; Clipp, E; Peterson, BL; Lipkus, IM; Demark-Wahnefried, W
MLA Citation
McBride, CM, Clipp, E, Peterson, BL, Lipkus, IM, and Demark-Wahnefried, W. "Psychological impact of diagnosis and risk reduction among cancer survivors." Psychooncology 9.5 (September 2000): 418-427.
PMID
11038480
Source
pubmed
Published In
Psycho-Oncology
Volume
9
Issue
5
Publish Date
2000
Start Page
418
End Page
427

The impact of abnormal mammograms on psychosocial outcomes and subsequent screening.

Few studies have examined the impact of abnormal mammograms on subsequent mammography screening and psychosocial outcomes specifically as a function of the length of time that has passed since the abnormal test result. This cross-sectional report compared breast cancer screening practices and psychosocial outcomes among three groups of women. These groups were women who (1) never had an abnormal mammogram, (2) had an abnormal mammogram 2 or more years prior to the study's baseline interview, and (3) had an abnormal mammogram within 2 years prior to the study's baseline interview. Women who had an abnormal mammogram at least 2 years prior to the baseline interview expressed greater 10-year and lifetime risks of getting breast cancer than women who never had an abnormal mammogram. Women who had abnormal mammograms, independent of when they occurred, were substantially more worried about getting breast cancer than were women who never had abnormal mammograms. Women who had an abnormal mammogram within 2 years prior to the baseline interview were more likely to be on schedule for mammography, compared with women who never had an abnormal mammogram.

Authors
Lipkus, IM; Halabi, S; Strigo, TS; Rimer, BK
MLA Citation
Lipkus, IM, Halabi, S, Strigo, TS, and Rimer, BK. "The impact of abnormal mammograms on psychosocial outcomes and subsequent screening." Psychooncology 9.5 (September 2000): 402-410.
PMID
11038478
Source
pubmed
Published In
Psycho-Oncology
Volume
9
Issue
5
Publish Date
2000
Start Page
402
End Page
410

Maximizing the motivational impact of feedback of lung cancer susceptibility on smokers' desire to quit.

This two-by-two factorially designed study evaluate approaches for communicating feedback of lung cancer susceptibility to smokers as a method for motivating smoking cessation. The study factors were: method of communicating feedback (by mail with telephone follow-up or in-person) and carbon monoxide feedback (yes or no). One-hundred-forty-four smokers were stratified on race and randomized to one of four conditions. Participants were surveyed at baseline and 2-month follow-up. Polymerase chain reaction (PCR) testing for the absence of the glutathione S transferase mu (GSTM1) gene was the susceptibility marker. Regardless of counseling method or carbon monoxide (CO) feedback, the majority (90%) of smokers accurately recalled the test result and 66% accurately interpreted the meaning of the test result. Smokers who received their result in person were significantly less likely to have read the result booklet than those in the telephone counseling group (OR = .28, 95%; CI .12-.62; p < .05). Neither counseling method nor CO feedback increased smokers' perceived risks for lung cancer. However, at the counseling session those who received in-person counseling were significantly less frightened by the test result than those who received telephone counseling (OR = .42, 95%; CI .20-86; p < .05) and at the 2-month follow-up those who received a CO test were significantly less frightened by their susceptibility result (OR = .40, 95%; CI .17-.92; p < .05) than those who did not have a CO test. Evaluation of further refinements in communicating the meaning of susceptibility results to motivate smoking cessation is warranted.

Authors
McBride, CM; Halabi, S; Bepler, G; Lyna, P; McIntyre, L; Lipkus, I; Albright, J; O'Briant, K
MLA Citation
McBride, CM, Halabi, S, Bepler, G, Lyna, P, McIntyre, L, Lipkus, I, Albright, J, and O'Briant, K. "Maximizing the motivational impact of feedback of lung cancer susceptibility on smokers' desire to quit." J Health Commun 5.3 (July 2000): 229-241.
PMID
11185023
Source
pubmed
Published In
Journal of Health Communication
Volume
5
Issue
3
Publish Date
2000
Start Page
229
End Page
241
DOI
10.1080/10810730050131406

Current health behaviors and readiness to pursue life-style changes among men and women diagnosed with early stage prostate and breast carcinomas.

BACKGROUND: Cancer survivors are at increased risk for developing secondary tumors, diabetes, osteoporosis, and cardiovascular disease, thus making them an important target population for health-related interventions. However, little is known regarding cancer survivors' behaviors and their interest in pursuing healthier diets, exercise, and smoking cessation. METHODS: A 65-item survey was mailed to 1667 patients diagnosed with early stage carcinoma of the breast or prostate that requested data regarding demographics, health behaviors, stage of readiness for smoking cessation, exercise, increased fruit and vegetable (F&V) consumption, and decreased fat intake, as well as interest in specific health programs and when, relative to diagnosis, these programs should be offered. RESULTS: Responses from 978 cancer survivors suggested that the overwhelming majority (85%) reported their health as good to excellent. The majority of respondents (55%) ate fewer than 5 daily servings of F&Vs, with prostate carcinoma patients reporting eating significantly fewer servings than patients with breast carcinoma (P < 0.001). In contrast, 69% of respondents reported adherence to a low fat diet, again with lower practice rates among prostate carcinoma patients than patients with breast carcinoma (P = 0.006). The majority of respondents (58%) reported routine exercise and 8% were current smokers. Significantly more breast carcinoma patients than prostate carcinoma patients were current smokers (P = 0.03). There was strong interest in health promotion programs across behaviors, and a fair amount of concordance between low fat dietary behaviors and exercise, as well as consumption of five daily servings of F&Vs. The majority of patients expressed a preference for programs that could be delivered via mailed brochure, with 57% of respondents indicating that programs should be initiated at the time of diagnosis or soon after (within 6 months). CONCLUSIONS: The results of the current study suggest that although many cancer survivors already practice healthy life-style behaviors, there is a substantial proportion who do not. Interventions especially are needed to increase daily F&V intake; however, given the fair degree of clustering between dietary and exercise behaviors, multiple risk factor interventions also may be warranted. Among cancer survivors, receptivity is high for health promotion programs, especially those that can be delivered by mail and soon after diagnosis.

Authors
Demark-Wahnefried, W; Peterson, B; McBride, C; Lipkus, I; Clipp, E
MLA Citation
Demark-Wahnefried, W, Peterson, B, McBride, C, Lipkus, I, and Clipp, E. "Current health behaviors and readiness to pursue life-style changes among men and women diagnosed with early stage prostate and breast carcinomas." Cancer 88.3 (February 1, 2000): 674-684.
PMID
10649263
Source
pubmed
Published In
Cancer
Volume
88
Issue
3
Publish Date
2000
Start Page
674
End Page
684

Can tailored interventions increase mammography use among HMO women?

BACKGROUND: Telephone counseling and tailored print communications have emerged as promising methods for promoting mammography screening. However, there has been little research testing, within the same randomized field trial, of the efficacy of these two methods compared to a high-quality usual care system for enhancing screening. This study addressed the question: Compared to usual care, is tailored telephone counseling more effective than tailored print materials for promoting mammography screening? DESIGN: Three-year randomized field trial. PARTICIPANTS: One thousand ninety-nine women aged 50 and older recruited from a health maintenance organization in North Carolina. INTERVENTION: Women were randomized to 1 of 3 groups: (1) usual care, (2) tailored print communications, and (3) tailored telephone counseling. MAIN OUTCOME: Adherence to mammography screening based on self-reports obtained during 1995, 1996, and 1997. RESULTS: Compared to usual care alone, telephone counseling promoted a significantly higher proportion of women having mammograms on schedule (71% vs 61%) than did tailored print (67% vs 61%) but only after the first year of intervention (during 1996). Furthermore, compared to usual care, telephone counseling was more effective than tailored print materials at promoting being on schedule with screening during 1996 and 1997 among women who were off-schedule during the previous year. CONCLUSIONS: The effects of the intervention were most pronounced after the first intervention. Compared to usual care, telephone counseling seemed particularly effective at promoting change among nonadherent women, the group for whom the intervention was developed. These results suggest that telephone counseling, rather than tailored print, might be the preferred first-line intervention for getting nonadherent women on schedule for mammography screening. Many questions would have to be answered about why the tailored print intervention was not more powerful. Nevertheless, it is clear that additional interventions will be needed to maintain women's adherence to mammography. Medical Subject Headings (MeSH): mammography screening, telephone counseling, tailored print communications, barriers.

Authors
Lipkus, IM; Rimer, BK; Halabi, S; Strigo, TS
MLA Citation
Lipkus, IM, Rimer, BK, Halabi, S, and Strigo, TS. "Can tailored interventions increase mammography use among HMO women?." Am J Prev Med 18.1 (January 2000): 1-10.
PMID
10808977
Source
pubmed
Published In
American Journal of Preventive Medicine
Volume
18
Issue
1
Publish Date
2000
Start Page
1
End Page
10

Testing different formats for communicating colorectal cancer risk.

This study assessed the extent to which different formats of informing men and women age 50 and over of the risks of colorectal cancer (CRC) affected their perceptions of their absolute and comparative (self versus other) 10-year and lifetime risks; emotional reactions about getting CRC; and screening intentions. Forty-four men and 78 women received information about the absolute lifetime risk of getting CRC. In addition, participants either did or did not receive information about (1) lifetime risk of getting CRC compared with other cancers, and (2) risk factors for CRC (age and polyps). Participants who received risk factors information were more likely to increase their perceived absolute 10-year and lifetime risks of getting CRC compared with participants who did not receive risk factors information. In addition, participants who received risk factors information were more likely to believe age was related to getting CRC and felt at greater risk for having polyps compared with participants who did not receive this information. None of the experimental conditions affected how worried, anxious, and fearful participants felt about getting CRC, nor did they affect screening intentions. Independent of experimental condition, participants tended to increase their intentions to get screened for CRC in the next year or two. Intention to be screened was more pronounced among participants who had been screened via a fecal occult blood test (FOBT) or sigmoidoscopy (SIG). Implications for the design of interventions involving the communication of CRC risks are discussed.

Authors
Lipkus, IM; Crawford, Y; Fenn, K; Biradavolu, M; Binder, RA; Marcus, A; Mason, M
MLA Citation
Lipkus, IM, Crawford, Y, Fenn, K, Biradavolu, M, Binder, RA, Marcus, A, and Mason, M. "Testing different formats for communicating colorectal cancer risk." J Health Commun 4.4 (October 1999): 311-324.
PMID
10790787
Source
pubmed
Published In
Journal of Health Communication
Volume
4
Issue
4
Publish Date
1999
Start Page
311
End Page
324
DOI
10.1080/108107399126841

The impact of tailored interventions on a community health center population.

We conducted a 4-year randomized study in a community health center that serves primarily low income Blacks in Durham, North Carolina. Patients (1318 at baseline) were assigned randomly to one of three study groups: provider prompting intervention alone, provider prompting and tailored print materials or the previous group and tailored telephone counseling. The purpose of the study was to determine whether increasingly intensive, tailored print and telephone interventions also were increasingly effective in promoting adherence to mammograms, Pap tests and overall cancer screening compliance. Thus, the combination of tailored print interventions (print and telephone) should have been more effective than the provider prompting intervention alone, or the print intervention and prompting combination. This is one of the few studies to examine a measure of overall cancer screening compliance and to assess the benefit of combinations of tailored interventions in promoting adherence to cancer screening. Patients gave extremely high ratings to the interventions. At the bivariate level, we found a significant effect of the most intensive group (provider prompting intervention, tailored print communications and tailored telephone counseling) on Pap test compliance (P = 0.05) and borderline significance at the multivariate level (P = 0.06) as well on overall screening compliance (P = 0.06). There was not a significant effect on mammography, probably because a majority of the patients were receiving regular mammograms. We also found some important subgroup differences. For example, a larger proportion of women reported Pap tests in the tailored print and counseling group when they believed the materials were 'meant for me.' These results show that a combination of tailored interventions may have potential for reaching the women who have too often been labeled the 'hard to reach.'

Authors
Rimer, BK; Conaway, M; Lyna, P; Glassman, B; Yarnall, KS; Lipkus, I; Barber, LT
MLA Citation
Rimer, BK, Conaway, M, Lyna, P, Glassman, B, Yarnall, KS, Lipkus, I, and Barber, LT. "The impact of tailored interventions on a community health center population." Patient Educ Couns 37.2 (June 1999): 125-140.
PMID
14528540
Source
pubmed
Published In
Patient Education and Counseling
Volume
37
Issue
2
Publish Date
1999
Start Page
125
End Page
140

Relationships among breast cancer concern, risk perceptions, and interest in genetic testing for breast cancer susceptibility among African-American women with and without a family history of breast cancer.

There has been very little research exploring the relationships among perceptions of, and concern about, getting breast cancer and interest in genetic testing for breast cancer among African-American women with and without a family history of breast cancer. This study explored these issues among 130 and 136 African-American women with and without a family history of breast cancer, respectively. Women with a family history reported having greater perceived breast cancer risks and concerns than women without a family history of breast cancer. Knowledge of breast cancer risk factors was very poor and correlated weakly with perceptions of risk and concern. In attributional analyses, acknowledging one's family history status was the strongest predictor of perceived risk only among women with a family history. Women with a family history of breast cancer expressed greater interest in genetic testing for breast cancer susceptibility than women without a family history, although interest in testing was high overall. Increasing perceptions of breast cancer risks and concerns were related to a greater interest in genetic testing, and this relationship was not moderated by family history status. Attributions of risk and knowledge of breast cancer risk factors generally were not related to interest in testing. Overall, these results suggest that: (a) African-American women with a family history are more concerned about and do recognize their greater risk of breast cancer; (b) knowledge of risk factors and attributions of risk are not directly related to interest in genetic testing; and (c) concerns, rather than beliefs about one's risk, are more powerfully related to interest in genetic testing, independent of family history status.

Authors
Lipkus, IM; Iden, D; Terrenoire, J; Feaganes, JR
MLA Citation
Lipkus, IM, Iden, D, Terrenoire, J, and Feaganes, JR. "Relationships among breast cancer concern, risk perceptions, and interest in genetic testing for breast cancer susceptibility among African-American women with and without a family history of breast cancer." Cancer Epidemiol Biomarkers Prev 8.6 (June 1999): 533-539.
PMID
10385144
Source
pubmed
Published In
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
Volume
8
Issue
6
Publish Date
1999
Start Page
533
End Page
539

Confusion about mammography: prevalence and consequences.

Over the last decade, there has been significant controversy about the schedule on which women, particularly women in their 40s, should have mammograms. The purpose of the analysis reported here was to assess whether women in their 40s and 50s were confused as a result of the controversy following the January 1997 National Institutes of Health Consensus Development Conference on Breast Cancer Screening For Women Ages 40-49. We also examined if confusion was related to being off schedule for mammography. The study sample included 1287 women recruited from a random sample of 2165 Blue Cross/Blue Shield of North Carolina members. The data described in this analysis were derived from a baseline telephone interview conducted as part of a larger intervention trial. Study measures included a variety of sociodemographic, medical, belief, and behavioral variables. Overall, 28% of women were confused, and 35% were off schedule. Although a higher proportion of women in their 40s than 50s were confused, more women in their 50s were off schedule. Confusion was a significant predictor for the outcome being off schedule. Predictors of confusion included several belief variables, risk perceptions, age (40s), whether the woman had a regular physician, and whether she had enough information about mammography. Healthcare providers should ask some simple questions to determine if women are confused and then seek to meet their information needs.

Authors
Rimer, BK; Halabi, S; Strigo, TS; Crawford, Y; Lipkus, IM
MLA Citation
Rimer, BK, Halabi, S, Strigo, TS, Crawford, Y, and Lipkus, IM. "Confusion about mammography: prevalence and consequences." J Womens Health Gend Based Med 8.4 (May 1999): 509-520.
PMID
10839706
Source
pubmed
Published In
Journal of Women's Health & Gender-Based Medicine
Volume
8
Issue
4
Publish Date
1999
Start Page
509
End Page
520
DOI
10.1089/jwh.1.1999.8.509

Using tailored interventions to enhance smoking cessation among African-Americans at a community health center.

This prospective randomized study examined the impact of three tailored intervention approaches to increase quitting rates among African-American smokers who were clients of a community health center that serves primarily low-income and indigent persons. Smokers were randomized to one of three groups: (1) health care provider prompting intervention alone, (2) health care provider prompting intervention with tailored print communications, and (3) health care provider prompting intervention with tailored print communications and tailored telephone counseling. Among the 160 smokers who completed the study, 35 (21.8%) had quit smoking at follow-up. Smokers who received the provider prompting intervention with tailored print materials were more likely to report having quit than smokers who received the provider intervention alone (32.7% vs. 13.2%, p < 0.05). Smokers who received all three intervention components were not more likely to report having quit at follow-up than those who only received the provider intervention (19.2% vs. 13.2%). Smokers who at baseline were less educated, smoked less than half a pack of cigarettes per day, had a stronger desire to quit, felt more efficacious, and had thought about quitting were more likely to report having quit at follow-up. These results provide support for continued refinement of tailored communications to aid smoking cessation among African-American smokers.

Authors
Lipkus, IM; Lyna, PR; Rimer, BK
MLA Citation
Lipkus, IM, Lyna, PR, and Rimer, BK. "Using tailored interventions to enhance smoking cessation among African-Americans at a community health center." Nicotine Tob Res 1.1 (March 1999): 77-85.
PMID
11072391
Source
pubmed
Published In
Nicotine and Tobacco Research (OUP)
Volume
1
Issue
1
Publish Date
1999
Start Page
77
End Page
85

The visual communication of risk.

This paper 1) provides reasons why graphics should be effective aids to communicate risk; 2) reviews the use of visuals, especially graphical displays, to communicate risk; 3) discusses issues to consider when designing graphs to communicate risk; and 4) provides suggestions for future research. Key articles and materials were obtained from MEDLINE(R) and PsychInfo(R) databases, from reference article citations, and from discussion with experts in risk communication. Research has been devoted primarily to communicating risk magnitudes. Among the various graphical displays, the risk ladder appears to be a promising tool for communicating absolute and relative risks. Preliminary evidence suggests that people understand risk information presented in histograms and pie charts. Areas that need further attention include 1) applying theoretical models to the visual communication of risk, 2) testing which graphical displays can be applied best to different risk communication tasks (e.g., which graphs best convey absolute or relative risks), 3) communicating risk uncertainty, and 4) testing whether the lay public's perceptions and understanding of risk varies by graphical format and whether the addition of graphical displays improves comprehension substantially beyond numerical or narrative translations of risk and, if so, by how much. There is a need to ascertain the extent to which graphics and other visuals enhance the public's understanding of disease risk to facilitate decision-making and behavioral change processes. Nine suggestions are provided to help achieve these ends.

Authors
Lipkus, IM; Hollands, JG
MLA Citation
Lipkus, IM, and Hollands, JG. "The visual communication of risk." J Natl Cancer Inst Monogr 25 (1999): 149-163. (Review)
PMID
10854471
Source
pubmed
Published In
Journal of the National Cancer Institute. Monographs
Issue
25
Publish Date
1999
Start Page
149
End Page
163

Underusers of mammogram screening: Stage of adoption in five U.S. subpopulations

Background. The purpose of this report is to describe the characteristics of women ages 50 to 80 who do not follow commonly accepted mammography screening guidelines. It provides unique understanding of the robustness of characteristics of underusers across five different U.S. subpopulations. Methods. The data are from the baseline surveys of the five studies of the NCI Breast Cancer Screening Consortium. Stage of adoption of mammography screening and other characteristics of underusers are presented. Polytomous logistic regression analysis was used to explore multivariable associations with stage of adoption in each study site. Results. The five samples studied by the Consortium range in size from 259 to 4,477 women (n = 11,292). The relationship of the perceptions of the pros and cons of mammography with stage of adoption was strikingly similar across the five samples. Other variables consistently associated with stage were a recent receipt of a breast physical examination and recommendation for mammography by a physician. Conclusions. The findings suggest a need to encourage regular screening through effective communication from a health care provider. Intervention messages should be designed to increase the pros of mammography, decrease the cons, and highlight these differentially according to the woman's stage of adoption.

Authors
Stoddard, AM; Rimer, BK; Lane, D; Fox, SA; Lipkus, I; Luckmann, R; Avrunin, JS; Sprachman, S; Costanza, M; Urban, N
MLA Citation
Stoddard, AM, Rimer, BK, Lane, D, Fox, SA, Lipkus, I, Luckmann, R, Avrunin, JS, Sprachman, S, Costanza, M, and Urban, N. "Underusers of mammogram screening: Stage of adoption in five U.S. subpopulations." Preventive Medicine 27.3 (1998): 478-487.
PMID
9612839
Source
scival
Published In
Preventive Medicine
Volume
27
Issue
3
Publish Date
1998
Start Page
478
End Page
487
DOI
10.1006/pmed.1998.0310

A field experiment using the foot-in-the-door technique to recruit teen smokers to smoking cessation programs

Behavioral compliance approaches such as the foot-in-the-door technique (Freedman & Fraser, 1966; Pliner, Hart, Kohl & Saari, 1974) have been tested and used in several social marketing programs (Scott, 1977; Ford & Spekman, 1981). However, much more needs to be learned about where and how to use these approaches most effectively. Little is known about the usefulness of these approaches for facilitating changes in behavior within highly resistant target markets. We conducted a field experiment to evaluate the promise of the foot-in-the-door technique (FITD) as a tool for addressing a very troublesome public health problem - how to recruit teenagers into a smoking cessation program. Previous recruitment efforts that have targeted teen smokers without using FITD have had very little success; only 2 to 6 % have agreed to enter programs (Peltier, Telch, & Coates, 1982). We examined whether the FITD approach of requesting teens to engage in a small behavior first, before asking them to engage in larger behaviors (i.e., agreeing to receive and/or help prepare smoking cessation materials), increased the likelihood that they would engage in the larger behaviors.

Authors
Bloom, PN; Lipkus, I; Schwartz-Bloom, RD; McBride, C; Feaganes, J
MLA Citation
Bloom, PN, Lipkus, I, Schwartz-Bloom, RD, McBride, C, and Feaganes, J. "A field experiment using the foot-in-the-door technique to recruit teen smokers to smoking cessation programs." Social Marketing Quarterly 4.4 (1998): 61-63.
Source
scival
Published In
Social Marketing Quarterly
Volume
4
Issue
4
Publish Date
1998
Start Page
61
End Page
63
DOI
10.1080/15245004.1998.9961020

Relationships among objective and subjective risk for breast cancer and mammography stages of change.

This study examined the relationships among objective and subjective risk for breast cancer and mammography stages of change as defined by the Transtheoretical Model. Women who had higher objective risk of breast cancer, as defined by the Gail et al. algorithm (M. H. Gail et al., J. Natl. Cancer Inst., 81: 1879-1886, 1989), were more likely to perceive themselves at greater subjective risk for breast cancer. Among the components of objective risk, family history of breast cancer was the only significant predictor of subjective risk. Both objective and subjective risk individually predicted stages of change, such that higher objective and subjective risk were associated with an increased probability of being in a later stage of adopting mammography. However, when objective and subjective risk were included in a multivariate model, only subjective risk predicted stages of change. In additional multivariate analyses, subjective risk continued to predict mammography stages of change when "con" and "decisional balance" scores were included in separate models. These results suggest that future research may benefit from the explicit integration of personal risk perceptions with elements of the Transtheoretical Model to provide more powerful accounts of behavioral change processes.

Authors
Lipkus, IM; Rimer, BK; Strigo, TS
MLA Citation
Lipkus, IM, Rimer, BK, and Strigo, TS. "Relationships among objective and subjective risk for breast cancer and mammography stages of change." Cancer Epidemiol Biomarkers Prev 5.12 (December 1996): 1005-1011.
PMID
8959324
Source
pubmed
Published In
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
Volume
5
Issue
12
Publish Date
1996
Start Page
1005
End Page
1011

Colorectal screening patterns and perceptions of risk among African-American users of a community health center.

This study investigated risk perceptions and screening patterns for colorectal cancer among predominately low-income African-Americans age 50 and older who used a community health center. The majority of respondents either rated their risk as below average (36%) or did not know their risk (37%) for colorectal cancer. Individuals who provided a risk estimate versus those who did not know their risk were younger and held more accurate beliefs about colorectal cancer. Attributions of perceived risk best distinguished respondents who evaluated their risk to be below average versus average and above average. Compared to respondents who could not explain their risk, those who provided psychological, personal action, and heredity causes were more likely to view their risk as below average than average or above average. In comparison to national norms, these subjects reported higher frequencies of ever having had a digital rectal exam (DRE, 90%), fecal occult blood test (FOBT, 75%) and sigmoidoscopy (SIG, 33%). Moreover, 63%, 53%, and 81% reported their most recent screening for DRE, FOBT, and SIG, respectively, in accordance with ACS and NCI recommended guidelines. However, a subsequent medical audit failed to confirm these self-reports. These results suggest that: 1) educational efforts are needed to enhance knowledge and accuracy of risk perceptions for colorectal cancer; 2) further studies on attributions of risk are needed that may prove useful for developing intervention programs, and 3) studies need to interpret self-report data for colorectal cancer with caution.

Authors
Lipkus, IM; Rimer, BK; Lyna, PR; Pradhan, AA; Conaway, M; Woods-Powell, CT
MLA Citation
Lipkus, IM, Rimer, BK, Lyna, PR, Pradhan, AA, Conaway, M, and Woods-Powell, CT. "Colorectal screening patterns and perceptions of risk among African-American users of a community health center." J Community Health 21.6 (December 1996): 409-427.
PMID
8912118
Source
pubmed
Published In
Journal of Community Health
Volume
21
Issue
6
Publish Date
1996
Start Page
409
End Page
427

Relationships among belief in a just world, willingness to accommodate, and marital well-being

The relationship between willingness to accommodate and belief in a just world (JW), possible mediators of this relationship, and their impact on marital satisfaction and perceived conflict were examined among older and younger married couples. In both samples, JW predicted greater willingness to accommodate. Among older couples, the relationship of JW to own accommodation was mediated by perceptions of spousal accommodation. Among younger couples, the relationship of JW to own accommodation was not explained by perceived spousal accommodation, trust, or partner perspective taking. Further, only among older couples did JW predict greater marital satisfaction and lower frequency of conflict. For older couples, the relationship of JW to satisfaction was not explained by own or perceived spousal accommodation; however, own and perceived spousal accommodation accounted for the relationship of JW to frequency of conflict. These studies suggest that belief in a just world contributes positively to interpersonal processes and marital well-being.

Authors
Lipkus, IM; Bissonnette, VL
MLA Citation
Lipkus, IM, and Bissonnette, VL. "Relationships among belief in a just world, willingness to accommodate, and marital well-being." Personality and Social Psychology Bulletin 22.10 (1996): 1043-1056.
Source
scival
Published In
Personality and Social Psychology Bulletin
Volume
22
Issue
10
Publish Date
1996
Start Page
1043
End Page
1056

The importance of distinguishing the belief in a just world for self versus for others: Implications for psychological well-being

Studies have shown that the belief in a just world (BJW) is related to psychological well-being. The authors suggest that studies exploring this relationship might benefit by making the distinction between the BJW for self versus for others or in general. In two studies, the authors assessed subjects' perceptions of depression, stress, and life satisfaction for self and for others. Subjects also completed measures of the five-factor model of personality. As predicted, the BJW for self most strongly and consistently predicted decreases in depression and stress, and increases in life satisfaction. When the five personality dimensions were included in the analyses, the BJW for self and for others continued to predict life satisfaction but not depression and stress. The implications of these results concerning the relationship between the BJW and psychological well-being, and how the just world is conceptualized, are discussed.

Authors
Lipkus, IM; Dalbert, C; Siegler, IC
MLA Citation
Lipkus, IM, Dalbert, C, and Siegler, IC. "The importance of distinguishing the belief in a just world for self versus for others: Implications for psychological well-being." Personality and Social Psychology Bulletin 22.7 (1996): 666-677.
Source
scival
Published In
Personality and Social Psychology Bulletin
Volume
22
Issue
7
Publish Date
1996
Start Page
666
End Page
677

The dissociation of catecholamine and hypothalamic-pituitary-adrenal responses to daily stressors using dexamethasone.

The hypothalamic-pituitary-adrenal (HPA) and sympathetic-adrenal-medullary (SAM) systems are implicated in the human stress response. One characterization of these systems is that they are nonspecific in their response, but differ in activation threshold and time course. Additionally, they have been found to be affected commonly by strong metabolic stressors and infusions of CRH, and a hypothesis has been developed primarily from animal research that CRH stimulates both the HPA and SAM systems. To determine whether CRH was significantly involved in tonic as well as psychological stress-induced catecholamine levels in man, we infused 24 normal male undergraduate students with either saline (n = 12) or dexamethasone (DEX; n = 12) and evaluated their subsequent plasma levels of ACTH, cortisol, epinephrine (EPI), and not epinephrine (NEPI). DEX produced a dramatic decrease in ACTH and cortisol levels, but no significant changes in EPI or NEPI occurred over a 4-h sampling interval. After the administration of math and speech stressors in a controlled laboratory setting, DEX inhibited the ACTH and cortisol release that was noted in the saline group, but stress-induced increases in EPI and NEPI were comparable in both groups. Thus, our study suggests that there is a difference in the neural pathways for tonic and stress-induced stimulation of the SAM and HPA systems.

Authors
Malarkey, WB; Lipkus, IM; Cacioppo, JT
MLA Citation
Malarkey, WB, Lipkus, IM, and Cacioppo, JT. "The dissociation of catecholamine and hypothalamic-pituitary-adrenal responses to daily stressors using dexamethasone." J Clin Endocrinol Metab 80.8 (August 1995): 2458-2463.
PMID
7629242
Source
pubmed
Published In
Journal of Clinical Endocrinology and Metabolism
Volume
80
Issue
8
Publish Date
1995
Start Page
2458
End Page
2463
DOI
10.1210/jcem.80.8.7629242

Do comparative self-appraisals during young adulthood predict adult personality?

Archival data from the University of North Carolina Alumni Heart Study were used to assess whether positive, neutral, and negative social comparisons assessed during college predicted the expression of personality during adulthood. College students in 1966 rated themselves relative to peers on several personal attributes. For men and women, these attributes produced 3 similar yet distinct variables reflecting gregariousness, achievement striving, and expressiveness. These students were contacted 20 years later and completed the NEO Personality Inventory and M. Rosenberg's (1965) self-esteem measure. In general, persons with comparatively positive self-evaluations during college viewed themselves as possessing more positive and less negative personality traits during adulthood and were also less likely to report poorer self-esteem during middle adulthood. The implications of social comparison processes for personality development are discussed.

Authors
Lipkus, IM; Siegler, IC
MLA Citation
Lipkus, IM, and Siegler, IC. "Do comparative self-appraisals during young adulthood predict adult personality?." Psychol Aging 10.2 (June 1995): 229-237.
PMID
7662182
Source
pubmed
Published In
Psychology and Aging
Volume
10
Issue
2
Publish Date
1995
Start Page
229
End Page
237

A short MMPI scale to identify people likely to begin smoking.

An item analysis of the Minnesota Multiphasic Personality Inventory (MMPI) was conducted to develop questionnaires that best discriminated (a) individuals who ever smoked versus those who never smoked and (b) ex-smokers from current smokers. The analyses were based on a sample of subjects who took the MMPI during 1964-1967 and reported their smoking status during 1987. Although no items distinguished individuals who quit versus continued to smoke, several items discriminated people who ever smoked from nonsmokers. These items formed two factors: Extraversion and Unconventionalism. These results provide support for the importance of extraversion, impulsivity, and antisocial tendencies as personality predictors of smoking initiation. The utility of this MMPI scale is discussed.

Authors
Lipkus, IM; Barefoot, JC; Feaganes, J; Williams, RB; Siegler, IC
MLA Citation
Lipkus, IM, Barefoot, JC, Feaganes, J, Williams, RB, and Siegler, IC. "A short MMPI scale to identify people likely to begin smoking." J Pers Assess 62.2 (April 1994): 213-222.
PMID
8189332
Source
pubmed
Published In
Journal of Personality Assessment
Volume
62
Issue
2
Publish Date
1994
Start Page
213
End Page
222
DOI
10.1207/s15327752jpa6202_4

Personality measures as predictors of smoking initiation and cessation in the UNC Alumni Heart Study.

MMPI data collected from a sample of college men and women during 1964-1967 were used to predict smoking initiation and cessation over a 20-year follow-up period. People who subsequently began smoking were more rebellious, impulsive, sensation seeking, and hostile; were less likely to present a positive self-image; and were socially extraverted while in college. People who continued to smoke 20 years later were more hostile and sensation seeking. The personality variables that predicted smoking initiation and cessation were the same for men and women. Discussion centers on the potential role of hostility as a predictor of smoking cessation.

Authors
Lipkus, IM; Barefoot, JC; Williams, RB; Siegler, IC
MLA Citation
Lipkus, IM, Barefoot, JC, Williams, RB, and Siegler, IC. "Personality measures as predictors of smoking initiation and cessation in the UNC Alumni Heart Study." Health Psychol 13.2 (March 1994): 149-155.
PMID
8020458
Source
pubmed
Published In
Health Psychology
Volume
13
Issue
2
Publish Date
1994
Start Page
149
End Page
155

The belief in a just world and perceptions of discrimination.

We examined the relationship between the belief in a just world and frequency of self-reported acts of personal discrimination. American adults with a strong belief in a just world reported fewer acts of personal discrimination against themselves than those with a weak belief in a just world. Among the various domains of discrimination, the belief in a just world correlated most strongly with religious discrimination. People with a strong belief in a just world felt that they would be less likely to provide special programs and funding based solely on a person's age; they did not feel that age discrimination was prevalent in American society.

Authors
Lipkus, IM; Siegler, IC
MLA Citation
Lipkus, IM, and Siegler, IC. "The belief in a just world and perceptions of discrimination." J Psychol 127.4 (July 1993): 465-474.
PMID
8254564
Source
pubmed
Published In
The Journal of psychology
Volume
127
Issue
4
Publish Date
1993
Start Page
465
End Page
474
DOI
10.1080/00223980.1993.9915583

Reactions to individuals who are consistently positive or negative: The impact of differing interaction goals.

Exposed 191 undergraduates to 1 of 2 interaction goals, and examined their attraction to interaction partners who differed in valence and variability. Ss evaluated the desirability of potential interaction partners who were positive vs negative in their evaluations of people and objects, and who exhibited high vs low variability in their evaluations. Also, the S's interaction goal was manipulated: Half of the Ss were led to desire self-enhancement or to receive information increasing their self-regard; the other half were led to desire cognitive clarity or to receive information to increase their accurate understanding of everyday experiences. Consistent with predictions, Ss were more attracted to interaction partners who were positive and highly variable. Thus, in everyday life, interpersonal goals and needs are frequently a blend of the needs for approval and knowledge.

Authors
Lipkus, I; Rusbult, C
MLA Citation
Lipkus, I, and Rusbult, C. "Reactions to individuals who are consistently positive or negative: The impact of differing interaction goals." Human Relations 46.4 (April 1993): 481-499. (Academic Article)
Source
manual
Published In
Human Relations
Volume
46
Issue
4
Publish Date
1993
Start Page
481
End Page
499
DOI
10.1177/001872679304600404

Age differences in hostility among middle-aged and older adults.

Multiple measures of hostility were administered to middle-aged and older volunteers. There was a positive association between age and self-report measures reflecting hostile beliefs about others, including cynicism and suspiciousness. There was a weak inverse relationship between age and self-report measures of the overt expression of anger and aggression, but no association between age and measures of covert hostility was found. There was a positive relationship between age and an assessment of hostile behavior that was based on the respondent's interaction style during an interview. The magnitude of these age trends did not differ between men (n = 50) and women (n = 75). These findings illustrate the multidimensional nature of hostility. They also have practical implications for older people because hostility is associated with psychological well-being and has been shown to have consequences for health and longevity.

Authors
Barefoot, JC; Beckham, JC; Haney, TL; Siegler, IC; Lipkus, IM
MLA Citation
Barefoot, JC, Beckham, JC, Haney, TL, Siegler, IC, and Lipkus, IM. "Age differences in hostility among middle-aged and older adults." Psychol Aging 8.1 (March 1993): 3-9.
PMID
8461112
Source
pubmed
Published In
Psychology and Aging
Volume
8
Issue
1
Publish Date
1993
Start Page
3
End Page
9

Do optimists distort their predictions for future positive and negative events?

Trait optimism as measured by the Life Orientation Test was explored as a predictor of judgemental distortions for positive and negative events within varying time-frames. Subjects were asked to predict their absolute or relative chances of experiencing positive and negative events within 3 months, 3 months to 1 year, or 1-5 years. It was predicted that optimists would report the likelihood of experiencing more positive and less negative events relative to other people. While optimists did expect to experience more positive and less negative events, they did not give themselves more favorable predictions compared to other individuals. Being an optimist influenced judgements made within varying time-frames, especially within 3 months and 3 months to 1 year, for negative events only. Discussion highlights the need to differentiate trait measures of optimism with judgemental biases that serve to categorize individuals as optimists. © 1993.

Authors
Lipkus, IM; Martz, JM; Panter, AT; Drigotas, SM; Feaganes, JR
MLA Citation
Lipkus, IM, Martz, JM, Panter, AT, Drigotas, SM, and Feaganes, JR. "Do optimists distort their predictions for future positive and negative events?." Personality and Individual Differences 15.5 (1993): 577-589.
Source
scival
Published In
Personality and Individual Differences
Volume
15
Issue
5
Publish Date
1993
Start Page
577
End Page
589

What Do We Really Want?: Mental Models of Ideal Romantic Involvement Explored through Multidimensional Scaling

Three studies extended the comparison level construct by exploring young adults′ mental models of ideal romantic involvement. Studies 1 and 2 were three-phase multidimensional scaling studies. In Phase 1 subjects′ descriptions of ideal involvement were solicited. In Phase 2 subjects judged the dissimilarities among Phase 1 descriptions, and multidimensional scaling solutions were computed in one through six dimensions. In Phase 3 a list of potential labels for the Phase 2 configurations was developed, and trained judges rated each Phase 1 description with respect to each label. These data were used to interpret the Phase 2 configurations. Two dimensions effectively described the derived configurations-Intimate versus Superficial and Romantic-Traditional versus Practical-Nontraditional. These dimensions defined four quadrants, or types of ideal: Picturebook Fantasy, Marital Bliss, Utilitarian Involvement, and Companionship. A third study asked whether these ideals are relevant to the ways in which subjects think about potential or actual relationships. Relationship descriptions were solicited under one of three instructional sets-ideal involvement, realistic standard, or actual relationship. Judges′ ratings of descriptions revealed few substantive differences across instructional sets, either in mean levels of labels or in the structure of relationships among labels. Thus, the issues that are salient when describing ideal romantic involvement do not differ substantively from those that are salient when thinking about realistic standards or actual, ongoing relationships. This work also demonstrated that women′s ideals exhibit greater Intimacy and Romance-Traditionalism than men′s. © 1993 Academic Press. All rights reserved.

Authors
Rusbult, CE; Onizuka, RK; Lipkus, I
MLA Citation
Rusbult, CE, Onizuka, RK, and Lipkus, I. "What Do We Really Want?: Mental Models of Ideal Romantic Involvement Explored through Multidimensional Scaling." Journal of Experimental Social Psychology 29.6 (1993): 493-527.
Source
scival
Published In
Journal of Experimental Social Psychology
Volume
29
Issue
6
Publish Date
1993
Start Page
493
End Page
527
DOI
10.1006/jesp.1993.1023

A heuristic model to explain perceptions of unjust events

A heuristic model was proposed to explain the dimensions people use to evaluate an event as unjust. The model predicted that people will use three main dimensions to evaluate an event as unjust: (i) issues of entitlement (i.e., deservingness) (ii) interactional justice, and (iii) issues that question a person's image as a fair and worthy being. To test this model, subjects read accounts of severe and mild unjust events and grouped these events into piles based on their degree of similarity. These data were then analyzed via multidimensional scaling. Three dimensions emerged which provided encouraging support for the model: (i) procedural inadequacy vs. personal incompetence/greed, (ii) unequal status/norm violations vs. equal status/interpersonal violations, and (iii) characterological-based mistreatment vs. behavioral-other mistreatment. The implications of these findings for the phenomenology of injustice are discussed. © 1992 Plenum Publishing Corporation.

Authors
Lipkus, IM
MLA Citation
Lipkus, IM. "A heuristic model to explain perceptions of unjust events." Social Justice Research 5.4 (1992): 359-384.
Source
scival
Published In
Social Justice Research
Volume
5
Issue
4
Publish Date
1992
Start Page
359
End Page
384
DOI
10.1007/BF01050755

Accommodation Processes in Close Relationships: Theory and Preliminary Empirical Evidence

A theory of accommodation processes is advanced, and the results of 6 studies are reported. Accommodation refers to the willingness, when a partner has engaged in a potentially destructive act, to inhibit impulses to react destructively and instead react constructively. Studies 1 and 2 demonstrated that accommodation is lower under conditions of reduced social concern and lower interdependence. Studies 3, 4, and 5 revealed that accommodation is associated with greater satisfaction, commitment, investment size, centrality of relationship, psychological femininity, and partner perspective taking and with poorer quality alternatives. Commitment plays a fairly strong role in mediating willingness to accommodate. Study 6 showed that couple functioning is associated with greater joint and mutual tendencies to inhibit destructive reactions. Study 6 also demonstrated that self-reports of accommodation are related to relevant behavioral measures.

Authors
Rusbult, CE; Verette, J; Whitney, GA; Slovik, LF; Lipkus, I
MLA Citation
Rusbult, CE, Verette, J, Whitney, GA, Slovik, LF, and Lipkus, I. "Accommodation Processes in Close Relationships: Theory and Preliminary Empirical Evidence." Journal of Personality and Social Psychology 60.1 (1991): 53-78.
Source
scival
Published In
Journal of Personality and Social Psychology
Volume
60
Issue
1
Publish Date
1991
Start Page
53
End Page
78

The construction and preliminary validation of a global belief in a just world scale and the exploratory analysis of the multidimensional belief in a just world scale

The goal of the present study was to create and validate a global belief in a just world scale and to assess the psychometric properties of the multidimensional just world scale using subjects in the United States. The desirable psychometric properties of the global belief in a just world scale make it a viable alternative to Rubin and Peplau's (Journal of Social Issues, 31, 65-90, 1975) just world scale. Analysis of the multidimensional just world scale suggests that the scale consists of three factors-interpersonal justice, socio-political justice, and cynicism/fatalism-and has poor psychometric properties. Both the global and multidimensional belief in a just world scale correlate positively with trust and internal locus of control. © 1991.

Authors
Lipkus, I
MLA Citation
Lipkus, I. "The construction and preliminary validation of a global belief in a just world scale and the exploratory analysis of the multidimensional belief in a just world scale." Personality and Individual Differences 12.11 (1991): 1171-1178.
Source
scival
Published In
Personality and Individual Differences
Volume
12
Issue
11
Publish Date
1991
Start Page
1171
End Page
1178
DOI
10.1016/0191-8869(91)90081-L
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