Perceived ambiguity about cancer prevention recommendations: associations with cancer-related perceptions and behaviours in a US population survey

• Published in: Health expectations : an international journal of public participation in health care and health policy 2007-12, Vol.10 (4), p.321-336
• Main Authors: Han, Paul K. J., Moser, Richard P., Klein, William M. P.
• Format: Article
• Language: English
• Subjects: Abstinence; Adult; Aged; Ambiguity; Attitude to Health; Behavior modification; Behaviour; Breast cancer; Cancer; cancer prevention; Cancer screening; Colon cancer; Colonic Neoplasms - prevention & control; Colonoscopy; Cross-Sectional Studies; Decision making; Female; Health Behavior; health behaviours; Health care; Health information; Health risks; Humans; Information for Patients; Logistic Models; Lung cancer; Lung Neoplasms - etiology; Lung Neoplasms - prevention & control; Male; Medical screening; Middle Aged; Neoplasms - prevention & control; Neoplasms - psychology; Perceptions; Polls & surveys; Prevention; Prevention programs; Prostate cancer; recommendations; Reliability; Risk behavior; Risk behaviour; Risk Factors; Risk perception; Risk reduction; Risk taking; Sigmoidoscopy; Skin cancer; Skin Neoplasms - etiology; Skin Neoplasms - prevention & control; Smoking; Sun screens; Sunscreening Agents - administration & dosage; Surveys; Surveys and Questionnaires; Theorists; Uncertainty; United States; Womens health; Worry
• ISSN: 1369-6513; 1369-7625
• DOI: 10.1111/j.1369-7625.2007.00456.x

Background  Health information reaching the public today is often characterized by what decision theorists have termed ‘ambiguity’– i.e. uncertainty regarding the information’s reliability, credibility or adequacy. This is a critical problem, as growing research suggests that ambiguity has important effects–promoting pessimistic judgments about risks and potential outcomes of risk‐reducing behaviours, and lowering adoption of these behaviours. However, little is known about the public’s perceptions of ambiguity in the health information domain, the effects of these perceptions, and the factors that influence these effects. Objective  To examine associations between perceived ambiguity regarding cancer prevention recommendations and prevention‐related perceptions and behaviours, and to explore how these associations differ by cancer type. Study design and participants  Cross‐sectional analysis of data on 4070 adults participating in the 2005 US Health Information National Trends Survey. Main variables and outcome measures  We examined associations between perceived ambiguity about colon, skin and lung cancer prevention recommendations and two main outcome variables: (i) risk‐related cognitions (perceived cancer risk and preventability, cancer‐related worry) and (ii) risk‐modifying behaviours (colon cancer screening, sunscreen use and smoking abstinence). Results  Perceived ambiguity was inversely associated with perceptions of the preventability of all three cancers, and with cancer‐specific risk‐modifying behaviours including sigmoidoscopy–colonoscopy testing, sunscreen use and smoking abstinence. Relationships with cancer risk perceptions and worry varied across different cancer types. Conclusions  Perceived ambiguity about cancer prevention recommendations has significant and predictable associations with cancer prevention‐related cognitions and behaviours, and some associations differ by cancer type. These findings have implications for future research and communication efforts.