Affective associations with behavioral practices play an important role in individuals’ uptake of a variety of health behaviors. Most work has looked at individual behavioral practices with a direct impact on health; because screening behaviors are conceptually distinct from such behaviors, it is important to examine the interplay of affect and cognition in screening decision making. The current research explored affective and cognitive predictors of testicular and breast self-examination behavior. Young adult participants (N = 184) reported cognitive beliefs and affective associations with testicular self-exam behavior (male participants) and breast self-exam behavior (female participants) and reported their own current screening behavior. In univariable models, affective associations were related to screening behavior for both testicular self-exams and breast self-exams. When examining affective associations and cognitive beliefs as simultaneous predictors, affective associations (but not cognitive beliefs) predicted testicular self-exams, and neither affective associations nor cognitive beliefs were uniquely related to breast self-exams. Moreover, for testicular self-exams, affective associations mediated the relation between cognitive beliefs and screening behavior; no mediation was present for breast self-exam behavior. These findings suggest three potential outcomes: first, that greater consideration of affective associations in testicular self-exam screening decisions may be warranted; second, that breast and testicular self-exams may have different antecedents; and third, that incorporation of affective factors in intervention design might have merit for increasing engagement in some cancer screening behaviors.
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The full set of affectively valenced words included: Hateful, love, sad, joy, annoyed, happy, tense, calm, bored, excited, angry, relaxed, disgusted, acceptance, and embarrassed.
The full set of cognitively valenced words included: Useless, useful, foolish, wise, unsafe, safe, harmful, beneficial, worthless, valuable, imperfect, perfect, unhealthy, and wholesome.
The predictor variables are measures of current affective associations and cognitive beliefs, and the behavioral measure is the number of self-exams performed over the past 12 months. This is in keeping with other cross-sectional behavioral health reports (e.g., diet over the past 30 days, visits to the doctor within the past year) and is an easily understood timeframe for reporting for screening behaviors that are relatively infrequent (i.e., monthly) and occur on a non-fixed schedule. This technique has been used for breast self-exam behaviors in several previous studies (Miller et al., 1996; Moser et al., 2007).
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Conflict of interest
Carolyn R. Brown-Kramer and Marc T. Kiviniemi declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.
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Brown-Kramer, C.R., Kiviniemi, M.T. Affective associations and cognitive beliefs relate to individuals’ decisions to perform testicular or breast self-exams. J Behav Med 38, 664–672 (2015). https://doi.org/10.1007/s10865-015-9641-6
- Screening behavior
- Cancer screening