Abstract
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.
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References
Davis R, Campbell R, Hildon Z, Hobbs L, Michie S. Theories of behaviour and behaviour change across the social and behavioural sciences: a scoping review. Health Psychol Rev. 2015;9(3):323–44. https://doi.org/10.1080/17437199.2014.941722.
Glanz K, Bishop DB. The role of behavioral science theory in development and implementation of public health interventions. Ann Rev Public Health. 2010;31:399–418. https://doi.org/10.1146/annurev.publhealth.012809.103604.
Hall S, French DP, Marteau TM. Causal attributions following serious unexpected negative events: systematic review. J Soc Clin Psychol. 2003;22(5):515–36. https://doi.org/10.1521/jscp.22.5.515.22924.
Green EC, Murphy E. Health belief model. In: Cockerham WC, Dingwall R, Quah S, eds. The Wiley Blackwell Encyclopedia of Health, Illness, Behavior, and Society. Hoboken, NJ, US: John Wiley & Sons; 2014: 766–769. https://doi.org/10.1002/9781118410868.wbehibs410
Carpenter C. A meta-analysis of the effectiveness of health belief model variables in predicting behavior. Health Commun. 2010;25(8):661–9. https://doi.org/10.1080/10410236.2010.521906.
Bai Y, Wong CL, Peng X, So WKW. Colonoscopy screening behaviour and associated factors amongst first-degree relatives of people with colorectal cancer in China: testing the health belief model using a cross-sectional design. Int J Environ Res Public Health. 2020;17(14):4927. https://doi.org/10.3390/ijerph17144927.
He L, Gao S, Tao S, et al. Factors associated with colonoscopy compliance based on health belief model in a community-based colorectal cancer screening program Shanghai. China Int Q Community Health Educ. 2020;41(1):25–33. https://doi.org/10.1177/0272684X19897356.
von Wagner C, Bonello B, Stoffel ST, Skrobanski H, Kerrison R, McGregor LM. Predictors of intention translation in flexible sigmoidoscopy screening for colorectal cancer. Health Psychol. 2019;38(12):1083–95. https://doi.org/10.1037/hea0000793.
Khani Jeihooni A, Kashfi SM, Shokri A, Kashfi SH, Karimi S. Investigating factors associated with FOBT screening for colorectal cancer based on the components of health belief model and social support. Asian Pac J Cancer Prev. 2017; 18(8): 2163–2169. https://doi.org/10.22034/APJCP.2017.18.8.2163
Williams RM, Wilkerson T, Holt CL. The role of perceived benefits and barriers in colorectal cancer screening in intervention trials among African Americans. Health Educ Res. 2018;33(3):205–17. https://doi.org/10.1093/her/cyy013.
Champion VL, Miller T. Predicting mammography utilization through model generation. Psychol Health Med. 1996;1(3):273–83. https://doi.org/10.1080/13548509608402224.
Azaiza F, Cohen M, Awad M, Daoud F. Factors associated with low screening for breast cancer in the Palestinian authority: relations of availability, barriers fatalism. Cancer. 2010;116(19):4646–55. https://doi.org/10.1002/cncr.25378.
Cohen M, Azaiza F. Early breast cancer detection practices, health beliefs, and cancer worries in Jewish and Arab women. Prev Med. 2005;41(5–6):852–8. https://doi.org/10.1016/j.ypmed.2005.07.001.
Tanner-Smith EE, Brown TN. Evaluating the health belief model: a critical review of studies predicting mammographic and pap screening. Soc Theor Health. 2010;8(1):95–125. https://doi.org/10.1057/sth.2009.23.
Tari Selcuk K, Avci D, Yilmaz Dundar G, Marcan Y. Breast cancer screening behaviors in women aged 40 years and over in a semi-urban region in Turkey: relationships with health beliefs. Healthcare. 2020;8(2):171. https://doi.org/10.3390/healthcare8020171.
Vadaparampil ST, Champion VL, Miller TK, Menon U, Skinner CS. Using the health belief model to examine differences in adherence to mammography among African-American and Caucasian women. J Psychosoc Oncol. 2004;21(4):59–79. https://doi.org/10.1300/J077v21n04_04.
Azaiza F, Cohen M. Colorectal cancer screening, intentions, and predictors in Jewish and Arab Israelis: a population-based study. Health Educ Behav. 2008;35(4):478–93. https://doi.org/10.1177/1090198106297045.
Beydoun HA, Beydoun MA. Predictors of colorectal cancer screening behaviors among average-risk older adults in the United States. Cancer Causes Control. 2008;19(4):339–59. https://doi.org/10.1007/s10552-007-9100-y.
Honda K, Kagawa-Singer M. Cognitive mediators linking social support networks to colorectal cancer screening adherence. J Behav Med. 2006;29(5):449–60. https://doi.org/10.1007/s10865-006-9068-1.
Houlihan S. Dual-process models of health-related behaviour and cognition: a review of theory. Public Health. 2018;156:52–9. https://doi.org/10.1016/j.puhe.2017.11.002.
Cohen M. An integrated view of cultural perceptions of cancer among Arab people in Israel. Health Psychol Rev. 2014;8(4):490–508. https://doi.org/10.1080/17437199.2013.816205.
Powe BD. Fatalism among elderly African American: effects on colorectal cancer screening. Cancer Nurs. 1995;18(5):385–92. https://doi.org/10.1097/00002820-199510000-00008.
Powe BD, Finnie R. Cancer fatalism: the state of the science. Cancer Nurs. 2003;26(6):454–65. https://doi.org/10.1097/00002820-200312000-00005.
Powe BD, Hamilton J, Brooks P. Perceptions of cancer fatalism and cancer knowledge: a comparison of older and younger African American women. J Psychosoc Oncol. 2006;24(4):1–13. https://doi.org/10.1300/J077v24n04_01.
Baron-Epel O, Friedman N, Lernau O. Fatalism and mammography in a multicultural population. Oncol Forum. 2009;36(3):353–61. https://doi.org/10.1188/09.ONF.353-361.
Straughan PT, Seow A. Fatalism conceptualized: a concept to predict health screening behavior. J Gender Culture Health. 1998;3(2):85–100. https://doi.org/10.1023/A:1023278230797.
Espinosa LMK, Gallo LC. The relevance of fatalism in the study of Latina’s cancer screening behavior: a systematic review of the literature. Behav Med. 2011;18(4):310–8. https://doi.org/10.1007/s12529-010-9119-4.
Cohen M. Cancer fatalism: attitudes toward screening and care. In: Carr BI, Steel J, eds. Psychological Aspects of Cancer. New York, NY, US: Springer; 2013: 83–100. https://doi.org/10.1007/978-1-4614-4866-2_6
Crosby RA, Collins T. Correlates of community-based colorectal cancer screening in a rural population: the role of fatalism. J Rural Health. 2017;33(4):402–5. https://doi.org/10.1111/jrh.12257.
Clarke N, Kearney PM, Gallagher P, McNamara D, O’Morain CA, Sharp L. Negative emotions and cancer fatalism are independently associated with uptake of faecal immunochemical test-based colorectal cancer screening: results from a population-based study. Prev Med. 2021;145: 106430. https://doi.org/10.1016/j.ypmed.2021.106430.
Cohen M, Rosenfeld M, Greenblatt-Kimron L. Development and validation of the Fatalistic Causal Attributions of Cancer Questionnaire: a three-phase study. Psychooncology. 2020. https://doi.org/10.1002/pon.5531.
Leventhal H, Meyer D, Nerenz D. The common-sense representations of illness and danger. In: Rachman S, editor. Contributions to medical psychology. Oxford, England: Pergamon; 1980. p. 7–30.
Israel Central Bureau of Statistics. Population of Israel on the eve of 2020 [Internet]. 2019 [cited 2021 Feb 26]. Available from: https://www.cbs.gov.il/en/mediarelease/Pages/2019/Population-of-Israel-on-the-Eve-of-2020.aspx.
Mayo RM, Ureda JR, Parker VG. Importance of fatalism in understanding mammography screening in rural elderly women. J Women Aging. 2001;13(1):57–72. https://doi.org/10.1300/j074v13n01_05.
Powe BD. Cancer fatalism among elderly Caucasians and African Americans. Oncology Nurs Forum. 1995;22(9):1355–9.
Champion VL. Instrument development for the health belief model constructs. Adv Nurs Sci. 1984;6(3):73–85. https://doi.org/10.1097/00012272-198404000-00011.
Coppock A. 10 things to know about multiple comparisons [Internet]. 2016 [cited 2021 Feb 26]. Available from: https://egap.org/resource/10-things-to-know-about-multiple-comparisons.
Goldblatt H, Cohen M, Azaiza A, Manassa R. Being within or being between? The cultural context of Arab women’s experience of coping with breast cancer in Israel. Psychooncology. 2013;22(4):869–75. https://doi.org/10.1002/pon.3078.
Baron-Epel O, Granot M, Badarna S, Avrami S. Perceptions of breast cancer among Arab Israeli women. Women Health. 2004;40(2):101–16. https://doi.org/10.1300/J013v40n02_07.
Leyva B, Allen JD, Tom LS, Ospino H, Torres MI, Abraido-Lanza AF. Religion, fatalism, and cancer control: a qualitative study among Hispanic Catholics. Am J Health Behav. 2014;38(6):839–49. https://doi.org/10.5993/AJHB.38.6.6.
Abraido-Lanza AF, Martins MC, Shelton RC, Flórez KR. Breast cancer screening among Dominican Latinas: a closer look at fatalism and other social and cultural factors. Health EducBehav. 2015;42(5):633–41. https://doi.org/10.1177/1090198115580975.
Cohen M, Azaiza F. Developing and testing an instrument for identifying culture-specific barriers to breast cancer screening in Israeli Arab women. Acta Oncol. 2008;47(8):1570–7. https://doi.org/10.1080/02841860802078069.
Freund A, Cohen M, Azaiza F. The doctor is just a messenger: beliefs of ultraorthodox Jewish women in regard to breast cancer and screening. J Religion Health. 2013;53(4):1075–90. https://doi.org/10.1007/s10943-013-9695-0.
Hughes AG, Watanabe-Galloway S, Schnell P, Soliman AS. Rural-urban differences in colorectal cancer screening barriers in Nebraska. J Community Health. 2015;40(6):1065–74. https://doi.org/10.1007/s10900-015-0032-2.
National Cancer Registry, Ministry of Health, Israeli State. Updated data on prevalence and death of cancer for 2018. https://www.health.gov.il/UnitsOffice/HD/ICDC/ICR/Pages/default.aspx
Cohen M, Azaiza F. Increasing breast examinations among Arab women using a tailored culture-based intervention. Behav Med. 2010;36(3):92–9. https://doi.org/10.1080/08964280903521313.
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Cohen, M., Rosenfeld, M. & Greenblatt-Kimron, L. Associations Between Cancer Fatalism, Causal Attributions, and Perceptions of Benefits and Barriers to Screening for Colorectal Cancer. Int.J. Behav. Med. 29, 357–366 (2022). https://doi.org/10.1007/s12529-021-10023-z
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DOI: https://doi.org/10.1007/s12529-021-10023-z