Cancer Worry and Fatalism at the Intersection of Race and Hearing Status.

INTRODUCTION: The deaf and hard of hearing (DHH) community experiences lower cancer screening rates than the general population. Cancer worry and fatalism can influence cancer screening, along with race, and the interaction of intrinsic factors with DHH health behavior needs to be investigated. OBJECTIVES: The study examines the association of the intersection of race and hearing status with cancer worry and fatalism. METHODS: This study analyzed cross-sectional survey data from NCI HINTS-ASL (for DHH adults) and NCI HINTS (for hearing adults). Multivariable logistic regression models were used to assess (i) the association of race-hearing status intersection with cancer worry and fatalism, as well as (ii) the relationship between hearing status and outcomes within each race. RESULTS: The study found that the overall interaction between race and hearing status was significantly associated with both high cancer worry and fatalism, with African American (AA)/Black and Asian/Other having higher odds of worry [1.17 (0.83, 1.64); 1.19 (0.85, 1.66), respectively] and other groups having lower worry than White hearing (P < 0.0001), and all deaf having less concern about cancer fatalism (P < 0.0001). Within each racial group, White DHH respondents had lower odds of cancer worry [aOR (95% CI): 0.72 (0.58, 0.91); P < 0.01] and fatalism [0.55 (0.46, 0.67); P < 0.0001] compared to White hearing respondents, while DHH AA/Black [1.89 (1.06, 3.37); P = 0.03], Asian/Other [2.39 (1.06, 3.37); P = 0.03], and Hispanic [1.95 (1.18, 3.22); P < 0.01] respondents had significantly higher odds of cancer worry and lower odds of cancer fatalism [Black: 0.50 (0.23, 1.09); P = 0.07; Asian/Other: [0.68 (0.42, 1.09); P = 0.10]; Hispanic: [0.69 (0.40, 1.17)]; P = 0.16] compared to their hearing counterparts. CONCLUSION: DHH individuals have different odds of experiencing cancer worry and fatalism compared to their hearing counterparts. Inclusion of individuals with sensory disabilities in a larger cancer study sample enriches the diversity of perspectives, ensuring that the findings reflect a broader range of experiences and needs. More research into contributory factors in the signing DHH population is needed.

The deaf and hard of hearing (DHH) community shows lower cancer screening rates than the general population. This study explores how concerns and negative beliefs about cancer (known as cancer worry and fatalism) are different between DHH and hearing people from racial groups.

Using the Health Belief Model to Understand Why Making Oral HIV Self-Testing Available to Truck Drivers in Kenya Had Little Impact on Six-Month Testing.

Research has found that offering HIV self-testing (HIVST) to truckers in Kenya increased testing rates at baseline but not over 6-month follow-up. We explored possible explanations based on the Health Belief Model by assessing HIV risk perception, self-efficacy, and fatalism as possible effect modifiers of the impact of offering HIVST (intervention n = 150) versus standard of care (SOC n = 155) on 6-month testing on the multiplicative and additive scales using log binomial and linear binomial regression and stratifying on significant modifiers. We found significant interaction between the intervention and fatalism on both the multiplicative (p = 0.020) and additive (p = 0.020) scales. In the stratified models, the HIVST intervention was associated with higher HIV testing among participants with low fatalism but lower testing among those with high fatalism (risk ratio [RR] = 1.30, p = 0.065 versus RR = 0.74, p = 0.072; risk difference [RD] per 100 = 14.00, p = 0.080 versus RD=-14.69, p = 0.086). Truckers in Kenya are described as being highly fatalistic, feeling lack of control over their lives and health. We found that fatalistic views negated the potential benefit of offering HIVST to truckers. For HIVST to have an impact among truckers, psychosocial interventions may be needed that address fatalistic views.

RESUMEN: Investigaciones han encontrado que ofrecer la autoprueba del VIH (AP-VIH) a los camioneros en Kenia aumentó las tasas de pruebas al inicio pero no durante el seguimiento de 6 meses. Hemos explorado posibles explicaciones basadas en el Modelo de Creencias de Salud, evaluando la percepción de riesgo para el VIH, la autoeficacia, y el fatalismo como posibles modificadores del impacto de ofrecer la AP-VIH (intervención n = 150) versus atención estándar (AE n = 155) en la probabilidad de hacer la prueba del VIH durante 6 meses de seguimiento en la escala multiplicativa y aditiva utilizando regresión log binomial y linear binomial y estratificación en modificadores significativos. Encontramos una interacción significativa entre la intervención y el fatalismo en la escala multiplicativa (p = 0,020) y aditiva (p = 0,020). En los modelos estratificados, la intervención AP-VIH se asoció con mayor índice de prueba de VIH entre participantes con bajo fatalismo, pero con menor índice de prueba entre aquellos con alto fatalismo (riesgo relativo [RR] = 1,30, p = 0,065 versus RR = 0,74, p = 0,072; diferencia de riesgo [DR] por 100 = 14.00, p = 0.080 versus DR=-14.69, p = 0.086). Los camioneros en Kenia son descritos como muy fatalistas y sienten falta de control sobre sus vidas y su salud. Encontramos que las opiniones fatalistas niegan el beneficio potencial de ofrecer la AP-VIH entre los camioneros. Para que la AP-VIH tenga un impacto positivo entre los camioneros, intervenciones psicosociales pueden ser necesarias para abordar las opiniones fatalistas.

Partner's problematic social media use, woman's time perspective, and prenatal depression.

PURPOSE: Using social media can have negative consequences. The present study aimed to examine how the partner's problematic social media use (SMU) was related to the pregnant woman's time perspective and prenatal depression. METHODS: The study included 30 pregnant women and their 30 male partners. Research was conducted twice: in the first and third trimesters of pregnancy. Women completed online measures: the Zimbardo Time Perspective Inventory Fatalism scale (ZTPI-Fat), the Dark Future Scale (DFS), and the Edinburgh Postpartum Depression Scale (EPDS). Men completed the online Social Media Addiction Questionnaire (SMAQ). RESULTS: The woman's depressive symptoms were positively associated with fatalism (r = .35, p < .01 in the first trimester; r = .49, p < .01 in the third trimester) and future negative perspective (r = .33, p < .05 in the first trimester; r = .77, p < .001 in the third trimester). Moreover, in the third trimester, women's depressive symptoms correlated positively with their partners' problematic SMU (r = .36, p < .05) and negatively with their financial situation (r = - .37, p < .05). The results of the mediation analyses showed that the more intensive the partner's problematic SMU, the stronger the pregnant woman's fatalism and, consequently, the stronger her future negative perspective, resulting in more severe prenatal depressive symptoms in the third trimester (indirect effect: ß = .16, SE = .09, 95% CI [.021, .393]). CONCLUSIONS: Our findings show how important the behavior of the partner is for the mental health of the pregnant woman. The results suggest a possible mechanism explaining the relationship between the partner's problematic SMU and the woman's prenatal depressive symptoms. This mechanism probably consists in increasing the woman's sense of helplessness and loss of control over life, which leads to intensified future anxiety and, consequently, to depressive symptoms. Moreover, we interpreted the results to mean that the partner's time-consuming preoccupation with SMU may make the woman feel emotionally neglected. The lack of support from the partner may give rise to feelings of powerlessness, and may cause depressive symptoms.

The role of collectivism, liberty, COVID fatigue, and fatalism in public support for the zero-COVID policy and relaxing restrictions in China.

BACKGROUND: China was the last country in the world to relax COVID-19 restrictions. A successful public health policy requires public support. This analysis examined the factors associated with Chinese support for zero-COVID and relaxing COVID-19 restrictions in China. METHOD: Two online surveys were conducted among Chinese participants in mainland China on June 10-13 (N = 460) and December 2, 2022 (N = 450). These two samples were similar based on the participants' demographics. RESULTS: The results revealed that the perceived health consequences of a COVID-19 policy, perceived norms of approving a COVID-19 policy, and hope positively predicted the participants' support for the COVID-19 policy. The results further showed that collectivism and fatalism positively predicted support for zero-COVID and negatively predicted support for relaxing restrictions. COVID fatigue was negatively associated with support for zero-COVID and positively associated with support for relaxing restrictions. Liberty positively predicted support for relaxing restrictions in June and negatively predicted zero-COVID in December 2023. It did not positively or negatively predict support for the policy adopted by the government. CONCLUSION: Collectivism, liberty, COVID fatigue, and fatalistic beliefs are important considerations connected to public support for a COVID-19 policy. The role of liberty was more nuanced and depended on the survey's time and whether the government adopted the policy.

Examining the Role of Information Behavior in Linking Cancer Risk Perception and Cancer Worry to Cancer Fatalism in China: Cross-Sectional Survey Study.

BACKGROUND: Reducing cancer fatalism is essential because of its detrimental impact on cancer-related preventive behaviors. However, little is known about factors influencing individuals' cancer fatalism in China. OBJECTIVE: With a general basis of the extended parallel process model, this study aims to examine how distinct cancer-related mental conditions (risk perception and worry) and different information behaviors (information seeking vs avoidance) become associated with cancer fatalism, with an additional assessment of the moderating effect of information usefulness. METHODS: Data were drawn from the Health Information National Trends Survey in China, which was conducted in 2017 (N=2358). Structural equation modeling and bootstrapping methods were performed to test a moderated mediation model and hypothesized relationships. RESULTS: The results showed that cancer risk perception and cancer worry were positively associated with online health information seeking. In addition, cancer worry was positively related to cancer information avoidance. Moreover, online health information seeking was found to reduce cancer fatalism, while cancer information avoidance was positively associated with cancer fatalism. The results also indicated that the perceived usefulness of cancer information moderated this dual-mediation pathway. CONCLUSIONS: The national survey data indicate that cancer mental conditions should not be treated as homogeneous entities, given their varying functions and effects. Apart from disseminating useful cancer information to encourage individuals to adaptively cope with cancer threats, we advocate for health communication programs to reduce cancer information avoidance to alleviate fatalistic beliefs about cancer prevention.

Fatalism tendency and health beliefs about medication use in older adults: A predictive correlational design.

OBJECTIVE: This study was performed to investigate fatalism tendency and health beliefs about medication use and to identify predisposing factors of these variables among older adults. METHODS: A predictive correlational design was used. The study was completed with 500 older adults. A personal information form, the Fatalism Tendency Scale, and the Drug Use Health Beliefs Scale were used to collect data. Univariate and multiple linear regression analysis was performed for data analysis. RESULTS: Fatalism tendency was found to be high in older adults who used medications prescribed by the physician in different ways, used the medications more than the recommended amount, and used medications at random intervals. Older adults who used over-the-counter medications and discontinued the medications before the due date had lower health beliefs about conscious and prescription medication use. CONCLUSIONS: The study concluded that characteristics regarding medication use predicted both fatalism tendencies and medication use health beliefs. Health perception was found to be one of the predisposing factors of medication use health beliefs, whereas education level was another predictive factor of fatalism tendency.

Fatalism and metaphor in Confucianism: A qualitative study of barriers to genetic testing among first-degree relatives of hereditary cancer patients from China.

OBJECTIVE: Despite the benefits, the rate of genetic testing among first-degree relatives (FDRs; parents, children, and siblings) remains low, and the barriers to undergoing testing among FDRs in China are not clear. We explored the reasons why FDRs refused genetic testing. METHODS: Semi-structured face-to-face interviews were conducted with 22 patients and 27 FDRs. Participants were recruited at an urban tertiary hospital in Guangzhou, South China. We used qualitative content analysis to analyse the transcripts of audio recordings and identify major themes and subthemes. RESULTS: Three major themes emerged related to FDRs' low rate of participation in genetic testing. First, there is cognitive distance from genetic testing/cancer and a lack of knowledge of preventive medicine that deepens the 'fatalistic' attitude towards cancer among FDRs, which leads to an enormous gap between their knowledge and understanding of genetic testing. Second, medical consultation is not valued in Confucianism, and the view of cancer as 'bad news' and the risk of cancer as a curse makes cancer a metaphor, which leads to exhausting arguments when persuading FDRs to undergo genetic testing. Third, physical distance from the hospital, loss of privacy, possible discrimination in many social activities and genetic testing as a source of stress and anxiety lead FDRs to fear the disruption of their daily lives. CONCLUSIONS: There are many barriers to genetic testing among the FDRs of hereditary cancer patients originating from the national social and cultural context. Healthcare professionals should develop interventions rooted in culture and promote cancer risk communication between hereditary cancer patients and FDRs.

Global Breast Cancer Initiative: A platform to address the psycho-oncology of cancer in low- and middle-income countries for improving global breast cancer outcomes.

BACKGROUND: Psycho-oncology is a clinical specialty in which the humanistic aspects of cancer diagnoses and treatment are addressed to reduce the psychological burden for patients and their caregivers to optimize patient participation, cancer outcomes and quality-of-life, which is especially critical in cultures where cancer is perceived as invariably fatal. Psycho-oncology programs face multiple barriers in low- and middle-income countries, including limited resource allocation and lack of training, both of which have been impediments to psycho-oncology programs becoming recognized as core competencies in cancer management and part of a standard medical curriculum. PURPOSE: This paper discusses the role of the Global Breast Cancer Initiative (GBCI) in helping to overcome inequities in breast cancer care and improve clinical outcomes from a psycho-oncology perspective as a model for improved cancer care in limited resource settings. FINDINGS: GBCI applies a comprehensive framework encompassing all phases of cancer care (defined through three pillars spanning the continuum of cancer management) and includes addressing the physical, psychological, and social needs of women throughout the life-course. Efforts to promote policies that increase access to early detection and treatment programs and improve health literacy among the public are important strategies to mitigate the most common emotional and physical challenges reported by people with cancer accessing care. CONCLUSIONS: Future efforts will focus on the integration of culturally appropriate guidance to promote early cancer detection and treatment completion through training programs for clinicians to establish core competencies in psycho-oncology. Emerging advocacy efforts in the oncology arena may help guide the integration of psycho-oncology services into routine care in countries where these services are not already integrated into the standard curriculum.

Fatalism and Psychological Distress Among Chinese American Breast Cancer Survivors: Mediating Role of Perceived Self-control and Fear of Cancer Recurrence.

BACKGROUND: Extant literature on the relationship between cancer fatalism and psychological distress among Chinese American breast cancer survivors has been mixed, and few studies have examined potential mediators of this relationship. The current study examined how cancer fatalism is associated with psychological distress by investigating perceived personal control and fear of cancer recurrence as mediators, and acculturation as a moderator of these relationships. METHOD: A total of 220 Chinese American women diagnosed with stage 0-III breast cancer were recruited from California cancer registries and completed a telephone survey. The measurement of cancer fatalism examined one's view of health as a result of destiny. Validated measures of psychological distress (i.e., depressive and anxiety symptoms), fear of cancer recurrence, and perceived personal control were used. Acculturation was defined by English proficiency, preferred interview language, and number of years lived in the USA. RESULTS: Higher cancer fatalism was directly associated with greater depressive and anxiety symptoms after controlling for covariates. This association was also mediated by higher fear of cancer recurrence, but not by perceived control. The mediation was not moderated by acculturation. CONCLUSION: Our findings suggest that Chinese American breast cancer survivors' fatalistic beliefs may exacerbate fear of cancer recurrence, and, in turn, depressive and anxiety symptoms. Fear of recurrence was more salient than perceived control in their associations with psychological distress among Chinese American cancer survivors. Future intervention research may adopt cognitive approaches to alter Chinese survivors' fatalistic views of health outcomes to reduce their psychological distress.

A barrier to participation in cervical cancer screenings: fatalism.

Cervical cancer is a significant disease affecting women's health in terms of its incidence and is one of the most preventable cancers. However, participation in early cervical cancer-screening programs has been unsatisfactory for various reasons. In this descriptive, relationship-seeking study, we examined the relationship between fatalism tendency, an individual barrier to participation in early cancer screening programs, and women's attitudes toward the early diagnosis of cervical cancer and undergoing the Pap smear test. Research data were collected between August 1, 2019 and December 1, 2019, in a city in northern Turkey from 602 women using a participant information form, the Attitudes Toward Early Diagnosis in Cervical Cancer Scale, and the Fatalism Tendency Scale. We found that fatalistic tendencies in women were a predictor of their attitudes toward the early diagnosis of cervical cancer (odds ratio [OR] = -0.64, ß = .47, p < .001) and undergoing the Pap smear test (OR = 1.01, ß = -.15, p < .001). Women with high fatalism tendencies had a more negative attitude toward the early diagnosis of cervical cancer and their participation rate in Pap smear screening programs was low. Therefore, nurses must consider women's fatalistic tendencies and attitudes toward cancer when organizing educational and informational programs that encourage participation in cervical cancer screening.

Association of health anxiety, fatalism and medication adherence among geriatric clients: An exploratory study.

OBJECTIVES: This study explored the relationship between health anxiety, fatalistic beliefs, and medication adherence among geriatric clients. Also, it determines the extent to which health anxiety and fatalism can predict the variance in medication adherence among the same population of geriatric clients. DESIGN: A cross-sectional analytical survey on 200 eligible participants using the Arabic Version of the Short Health Anxiety Inventory, Fatalism Scale, and Morisky Medication Adherence Scale-8 items. RESULTS: The study found a statistically significant negative relationship between the studied geriatric clients' fatalism and health anxiety and their medication adherence (r = -0.160, - 0.187, and P = 0.024, 0.008), respectively. CONCLUSION: This study highlights the importance of considering psychological factors such as health anxiety and fatalistic beliefs in addressing medication adherence among geriatric clients. By addressing these factors, healthcare providers can develop more effective strategies to improve medication adherence and ultimately improve the health outcomes of geriatric clients.

Religious Coping and Fatalism on Perception of Care Burden in Caregivers of Patients with Cerebral Palsy in Turkey: A Cross-Sectional and Correlational Study.

Providing care to a patient with cerebral palsy can have many negative impacts upon caregivers. This study was carried out to define caregiving burden in the caregivers of cerebral palsy patients and determine the relationships between religious coping, fatalism, and burden of care. This cross-sectional and correlational study included 132 caregivers. Data were obtained using the Religious Coping Scale, the Fatalism Scale, and the Caregiver Burden Scale. It was determined that 18.9% of the participants experienced a heavy care burden. The luck and pessimism dimensions of the Fatalism Scale were positively and weakly correlated with caregiving burden (p < 0.01), while there was no correlation between caregiving burden and positive or negative religious coping styles (p > 0.05). Perception of fatalism explained 10% of the total variance in caregiving burden (R = 0.329, R2 = 0.109, F = 5.195, p = 0.002). It is recommended that caregivers be supported by religious experts to strengthen positive religious coping styles and advisable fatalism perceptions.

"There is a God or There is No God-It is in the Hands of God:" Fatalistic Beliefs Among Israeli People About Cancer and Their Impact on Behavioral Outcomes.

This qualitative study examined fatalistic beliefs and cancer causal attributions among people without cancer. Participants were 30 Israeli women and men aged 51-70 from diverse sociocultural backgrounds who participated in four focus groups. Three main themes emerged, referring to the variability in fatalistic beliefs of cancer occurrence and cancer outcome, the duality in attributing causality to divine providence and mere luck or chance, and the connection between distinct fatalistic beliefs and health behaviors. Data analysis enabled an expansion of the understanding of cancer fatalism as a multidimensional structure, whereby interactions between causality attribution and different fatalistic beliefs are related to prevention and screening behaviors.

Fatalism and Suicidal Behaviors Among Chinese College Students: The Mediating Role of Depressive Symptoms and the Moderating Role of Coping Strategies.

The aim of this study was to investigate the relationship between fatalism and suicidal behaviors, the mediating role of depressive symptoms, and the moderating effect of coping strategies on the mediating process. A total of 519 participants completed the Multidimensional Fatalism Scale for General Life Events, the Center for Epidemiologic Studies-Depression scale, the Simplified Coping Style Questionnaire, and the Suicidal Behaviors Questionnaire-Revised. Results suggest that depressive symptoms partially mediated the relationship between fatalism and suicidal behaviors. Active coping moderated the mediating effect of depressive symptoms. The higher the active coping level, the weaker the mediating effect. The findings revealed that the mechanism of fatalism affecting suicidal behaviors, and had theoretical and empirical value for the prevention and intervention of suicide among college students.

Explaining cancer information avoidance comparing people with and without cancer experience in the family.

OBJECTIVES: Cancer information avoidance (CIA) serves as a barrier to preventive efforts. To learn how to combat this barrier, we aim to examine predictors of CIA in populations with and without cancer experience in the family, which are addressed differently in cancer prevention, according to specific informational barriers. METHODS: A subsample of people with and without cancer in the family (n = 2,757) of an online survey with a sample stratified for the German population by age, gender, education, and region was conducted via an online access panel. The survey instrument was adapted from the Health Information National Trends Survey. Separate stepwise regression analyses were conducted. RESULTS: Only a comparatively small proportion of the variance in CIA was explained by the predictors, ranging from R2  = .148 for people without cancer experience to R2  = .180 for participants with cancer experience in their family. Across the groups, the findings showed that people who were fatalistic about the risk of cancer, less health literate, who perceived less social pressure to be informed, and were less trusting in information sources more often avoided cancer information. CONCLUSIONS: Our findings identify relevant target groups to be addressed and barriers to be removed for cancer communication efforts. Adequate information provision can be supported by programs for fostering health literacy and social network diffusion strategies.

Evaluation of nursing students' health fatalism, knowledge, and attitudes toward patients with epilepsy.

AIM: This study was conducted to determine the relationship between nursing students' health fatalism, epilepsy knowledge, attitudes, and some sociodemographic variables. METHODS: The descriptive cross-sectional study was conducted with 423 nursing department students who were studying at a state university and who agreed to participate in the study in the Elazig province in eastern Turkey during the 2020-2021 academic year. The data were collected using a Sociodemographic Information Form, the Health Fatalism Scale (HFS), the Epilepsy Knowledge Scale (EKS), and the Epilepsy Attitude Scale (EAS). RESULTS: The nursing students had total mean scores of 46.95 ±â€¯12.98, 6.94 ±â€¯3.81, and 50.19 ±â€¯8.47 for the HFS, EKS, and EAS, respectively. A positive and significant correlation was found between the EKS and EAS scores. First-year students had lower HFS scores than students in their second and fourth years. Third- and fourth-year students, those living in rural areas, and those who had patients with epilepsy in their families or immediate environments had higher EKS scores. Female students and those who had patients with epilepsy in their families or immediate environments had higher EKS and EAS scores. A significant positive correlation was found between age and the EKS score, whereas a significant negative correlation was found between age and the EAS score. CONCLUSION: While nursing students generally had low levels of epilepsy knowledge, they had positive attitudes toward epilepsy and moderate levels of health fatalism. The study found that students' positive attitudes toward epilepsy increased as their levels of knowledge about the disorder increased. Age, gender, educational status, place of residence, the presence of a chronic disease, and knowing someone with epilepsy all affected HFS, EKS, and EAS scores.

Beliefs associated with cancer screening behaviors among African Americans and Sub-Saharan African immigrant adults: a cross-sectional study.

BACKGROUND: Beliefs influence cancer screening. However, there are conflicting findings about how belief influence cancer screening among Black adults. The aim of this study was to evaluate the relationships between beliefs (religiosity, fatalism, temporal orientation, and acculturation) and cervical, breast, and colorectal cancer screening behaviors among African Americans and sub-Saharan African immigrants. METHODS: We conducted a cross-sectional survey of 73 African American and 59 English speaking Sub-Saharan immigrant adults recruited from Lexington and surrounding cities in Kentucky. Data collected included sociodemographic variables, cancer screening behaviors, and several instruments that characterize beliefs, including religiosity, fatalism, temporal orientation, and acculturation. RESULTS: Participants' mean age was 43.73 years (SD = 14.0), 83% were females, and 45% self-identified as sub-Saharan immigrants. Based on eligibility for each screening modality, 64% reported having ever had a Pap test, 82% reported ever having mammogram, and 71% reported ever having a colonoscopy. Higher education (OR = 2.62, 95% CI = 1.43-4.80) and being insured (OR = 4.09, 95% CI = 1.10 - 15.18) were associated with increased odds of cervical cancer screening (pap test), while cancer fatalism (OR = 0.24, 95% CI = 0.07 - 0.88) was associated with decreased odds. Increased age (OR = 1.57, 95% CI = 1.06 - 2.32) and reduced present orientation (OR = 0.42, 95% CI = 0.22 - 0.80) were associated with receipt of a mammogram. Nativity was the only factor associated with colonoscopy screening. Compared to African Americans, sub-Saharan African immigrants were 90% less likely to have had a colonoscopy (OR = 0.10, 95% CI = 0.02 - 0.66). CONCLUSION: This study contributes to the existing literature by confirming that beliefs are important in cancer screening behaviors among African American and sub-Saharan African immigrants. These findings should inform the development of cancer control and prevention programs for Black adults. TRIAL REGISTRATION: US National Library of Science identifier NCT04927494. Registered June 16, 2021, www. CLINICALTRIALS: gov.

Fatalistic cancer beliefs and self-reported cancer screening behaviors among diverse urban residents.

Cancer fatalism-the belief that death is inevitable when cancer is present-has been identified as a barrier to cancer screening, detection, and treatment. Our study examined the relationship between self-reported cancer fatalism and adherence to cancer screening guidelines of the breasts, cervix, colon, and prostate among a diverse sample of urban-dwelling adults in Brooklyn, New York. Between May 2019 and August 2020, we conducted a cross-sectional survey of adults 40 + years of age (n = 2,341) residing in Brooklyn neighborhoods with high cancer mortality. Multivariable logistic regression models were used to assess the odds of reporting cancer screening completion across three fatalistic cancer belief categories (low, med, high). Participants' median age was 61 (IQR 51, 71) years, 61% were women, 49% self-identified as non-Hispanic black, 11% Hispanic, 4% Asian, and 6% more than one race. There were no statistically significant differences in the proportion of low, some, or high fatalistic beliefs identified among male respondents compared to women. Among women, we observed that high fatalistic cancer beliefs were associated with higher odds (OR 2.01; 95% CI 1.10-3.65) of completing breast but not cervical (1.04; CI 0.55-1.99) or colon (1.54; CI 0.88-2.69) cancer screening. Men with high fatalistic cancer beliefs had a trend towards lower odds of prostate screening (OR 0.53: 95% CI 0.18-1.57) compared to men with low fatalistic beliefs, but neither was statistically significant. Findings suggest that high fatalistic cancer beliefs may be an important factor in cancer screening utilization among women. Further examination in longitudinal cohorts with a larger sample of men may be needed in order to identify any significant effect.

Associations Between Cancer Fatalism, Causal Attributions, and Perceptions of Benefits and Barriers to Screening for Colorectal Cancer.

BACKGROUND: The aim of the study was to assess the associations between cancer causal attributions (divine providence, chance or luck, environmental or genetic factors, weak personal resilience), cancer fatalistic beliefs (cancer occurrence and outcome beliefs), and benefits of and barriers to screening for early detection of colorectal cancer. METHODS: It was a cross-sectional study of 252 individuals (46% men and 54% women) aged 50-75. Participants completed measures of cancer causal attributions, Powe's cancer fatalism questionnaire, and the benefits and barriers to colorectal cancer screening subscales of the health belief model. The study model was assessed using path analysis and mediation tests. RESULTS: Participants expressed moderate levels of occurrence and outcome of fatalistic beliefs, moderate levels of causal attributions, a high level of perception of the benefits of screening, and a moderate level of barriers to screening. The path model showed good fit measures (χ2 = 17.38, df = 14, p = .24; χ2/df = 1.24; NFI = .98; TLI = .99; CFI = .99; RMSEA = .03, 90% CI = .01, .07). Outcome fatalism mediated the relationship between each causal attribution and perceived barriers, whereas occurrence fatalism mediated only the relationship between the causal attribution of divine providence and the perceived benefits of screening. CONCLUSIONS: The results add to our understanding of the effects of causal attributions and fatalistic beliefs on perceptions of benefits and barriers to screening; hence, these factors should be the focus of change to reduce barriers to screening for early detection of cancer.

Demand for mitigating the risk of COVID-19 infection in public transport: The role of social trust and fatalistic beliefs.

The rapid surge of COVID-19 cases worldwide drew attention to COVID-19 infection as a new source of risk in transport. The virus introduced a need for viral transmission mitigation as a major priority when selecting a mode of travel, and caused a significant drop in public transport use. The recovery of public transport use in the post-COVID period requires that the transport authorities favourably address people's demand for mitigation of the risk of COVID-19 transmission in public transport. The present study aims to explore the role of risk perception, worry and priority of COVID-19 risk reduction along with fatalistic beliefs and public trust in authorities in explaining public demand for risk mitigation. The present study is among the first to investigate the role of fatalistic beliefs, social trust and risk perception for public transport and public demand for risk mitigation. The link between priority of infection prevention and demand for risk mitigation has also been less explored in public transport research. An online survey was conducted among university students in Iran between 19th April and 16th June 2020, during the first wave of the pandemic, when the country was a major epicentre of the disease. A total of 271 out of 370 respondents whose dominant mode on university travels was public transport were included in the analysis. Results of structural equation modelling confirmed the paradox of trust, indicating that social trust is negatively associated with perceived risk of COVID-19 infection, which in turn may lead people to place less importance on COVID-19 prevention as a priority in travel mode choice, and consequently demand less risk mitigation efforts to prevent COVID-19 infection in public transport. Dissimilar to trust, however, the results revealed no relationship between fatalistic beliefs and risk perception, but a significant direct effect of fatalistic beliefs on demand for risk mitigation. To reinforce public demand for mitigating the risk of COVID-19 in public transport, the study calls on policymakers to exploit public trust resources for more effective risk communication, through disseminating the gradually accumulating evidence-based information regarding the infectivity and the virulence of COVID-19 and the scientific risk of infection. The study also underlined the potential importance of considering fatalistic beliefs when developing effective risk communication policies and practices to enhance public support for COVID-19 risk mitigation in public transport.