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Association of cancer worry and perceived risk with doctor avoidance: an analysis of information avoidance in a nationally representative US sample

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Abstract

Fear of receiving bad news about one’s health can lead people to avoid seeking out health information that, ironically, may be crucial for health maintenance. Using a nationally representative US sample, the present study examined whether perceived likelihood of developing cancer and worry about cancer were associated with reports of avoiding visits to one’s doctor, in respondents under and over age 50. Cancer worry, but not perceived risk of cancer, predicted doctor avoidance in respondents aged 50 and older, whereas the opposite pattern held for respondents under age 50. Moreover, in respondents aged 50 and older, cancer worry and perceived cancer risk interacted such that cancer worry was linked to doctor avoidance only when respondents also perceived a high likelihood of cancer. The latter result is consistent with the notion that worry may motivate information seeking when people expect information to dispel worry and information avoidance when the information is seen as highly likely to confirm one’s fears. Findings suggest a need for communication strategies that can influence worry and perceived risk differentially. Research should also assess the effectiveness of other behavioral strategies (e.g., automatic scheduling of appointments) as a means for reducing doctor avoidance.

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Notes

  1. Lund-Nielsen et al. (2011) recently documented the tragic human costs of healthcare avoidance—what they referred to as an “avalanche of ignoring”—on a personal level in women with malignant breast cancer wounds.

  2. Analyses conducted without recoding cancer risk perceptions led to results consistent with what is reported here.

  3. Only 7.9 and 2.6 % of respondents reported worrying about cancer “often” or “all the time,” respectively. Recoding the worry item reduced skew (adjusted Fisher-Pearson standardized moment coefficient) from 1.08 to −0.03. Using an alternative transformation method such as log transformation to reduce skew has been argued to be inappropriate for Likert-type data, because the scale is interval rather than ratio and values between scale points tend to be unequal (see, e.g., Nevill & Lane, 2007). Moreover, the dichotomous coding of worry in the present study allows for a comparison between those who report worrying any with those who do not, which has been found to be a meaningful categorization (Ferrer et al., 2013; Waters et al., 2010).

  4. Simple slopes were calculated using unweighted data, which was necessary in order to generate the covariance matrix for coefficients.

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  1. Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Floor 3 East Tower, Bethesda, MD, 20892–9761, USA

    Alexander Persoskie, Rebecca A. Ferrer & William M. P. Klein

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  1. Alexander Persoskie
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  2. Rebecca A. Ferrer
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Persoskie, A., Ferrer, R.A. & Klein, W.M.P. Association of cancer worry and perceived risk with doctor avoidance: an analysis of information avoidance in a nationally representative US sample. J Behav Med 37, 977–987 (2014). https://doi.org/10.1007/s10865-013-9537-2

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