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作为结直肠癌筛查随时间变化预测因素的审慎性和直觉性风险认知

Deliberative and intuitive risk perceptions as predictors of colorectal cancer screening over time.

作者信息

Hay Jennifer L, Ramos Marcel, Li Yuelin, Holland Susan, Brennessel Debra, Kemeny M Margaret

机构信息

Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, Seventh Floor, New York, NY, 10022, USA.

Mount Sinai Medical Center, Queens Hospital Center, New York, NY, 11432, USA.

出版信息

J Behav Med. 2016 Feb;39(1):65-74. doi: 10.1007/s10865-015-9667-9. Epub 2015 Aug 18.

Abstract

Cancer risk perceptions may involve intuitions-including both affect as well as gut-level thoughts about risk-and deliberative risk magnitudes. Yet, little research has examined the potentially diverse relations between risk perceptions and behavior across time. A highly diverse primary care sample (N = 544, aged ≥50) was utilized to compare how deliberative and intuitive perceptions of risk relate to chart-confirmed colorectal cancer screening at cross-sectional and prospective time points. At baseline, deliberative and intuitive risk perceptions were negatively associated with chart-confirmed colorectal cancer screening adherence in bivariable but not multivariable analyses. Among those who were non-adherent with colorectal cancer screening at baseline, deliberative and intuitive risk perceptions were positively associated with prospective uptake of chart-confirmed colorectal cancer screening adherence at 12-months in bivariable analyses; only deliberative risk perceptions remained significant in the multivariable model. This study indicates that diverse risk perceptions are differentially important for screening at different time points.

摘要

癌症风险认知可能涉及直觉——包括对风险的情感以及本能层面的想法——和审慎的风险程度。然而,很少有研究考察风险认知与行为随时间推移可能存在的多种关系。本研究使用了一个高度多样化的初级保健样本(N = 544,年龄≥50岁),以比较在横断面和前瞻性时间点上,审慎和直觉性的风险认知与经图表确认的结直肠癌筛查之间的关系。在基线时,在双变量分析中,审慎和直觉性风险认知与经图表确认的结直肠癌筛查依从性呈负相关,但在多变量分析中并非如此。在基线时未坚持进行结直肠癌筛查的人群中,在双变量分析中,审慎和直觉性风险认知与12个月时经图表确认的结直肠癌筛查依从性的前瞻性接受呈正相关;在多变量模型中,只有审慎的风险认知仍然显著。这项研究表明,不同的风险认知在不同时间点对筛查的重要性各不相同。

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