Cancer Risk Beliefs and Patient Activation in a Multilingual Primary Care Setting
Erica Lubetkin, MD, MPH and Jennifer L. Hay, PhD
The perception of being at risk for cancer is an important prerequisite for cancer screening adherence, as indicated by empirical evidence and its central role in health behavior theories. Yet existent cancer risk perception measures entail one-item assessments of perceived illness probability, a strategy with known limits to reliability and validity. There are compelling arguments that affective (emotional, feeling-based) and intuitive cognitive (automatic, non-rational) processing is important as individuals’ think about their personal cancer risk, and we have developed a questionnaire to measure these processes (Cancer Risk Beliefs Scale) This pilot proposal will extend assessment of Cancer Risk Beliefs to Spanish and Haitian-Creole speaking participants, and will examine the association of the Cancer Risk Beliefs Scale and patient activation, the extent to which patients actively participate in their own medical care. Dr. Hay (MSKCC) and Dr. Lubetkin (CCNY) have formed a working collaboration given their mutual research interests in perceptions of illness risk, and uptake of preventive behaviors in urban primary care. Our study setting is Ambulatory Care at Queens Hospital Center, an inner city primary care clinic that is highly diverse in terms of race/ethnicity, socioeconomic status,and length of time in residence in the United States. Our Specific Aims are as follows: Aim I, To examine comprehensibility of cancer risk beliefs and patient activation items in Haitian-Creole and Spanish-speaking individuals via cognitive interviewing (N=30) in an urban, primary care setting; Aim II, To examine levels of Cancer Risk Beliefs and patient activation in an urban, primary care population (N=450) and to examine potential demographic and language differences (age, racial/ethnic subgroup, language of forms [English, Spanish, Haitian-Creole], and acculturation level) in these constructs; Aim III, To examine the cross-sectional associations between Cancer Risk Beliefs and patient activation and to examine whether demographic factors and language differences (age, racial/ethnic subgroup, language of forms [English, Spanish, Haitian-Creole], and acculturation level) modify these relationships in this cohort of 450 participants. This project will support a promising academic collaboration and identify cancer communication strategies to enhance behavior change in racial and ethnic minorities, addressing important cancer disparities in prevention and screening behaviors in diverse populations.