A Three-Factor Cancer-Related Mental Condition Model and Its Relationship With Cancer Information Use, Cancer Information Avoidance, and Screening Intention

Abstract

Cancer-related affect and cognition, such as cancer fear, cancer worry, and cancer risk perception, are important predictors of cancer prevention and communication behaviors. However, they have not been clearly conceptualized in cancer communication literature, and in particular, the role of affect (i.e., cancer fear) in cancer prevention and communication has not been fully investigated. The present study developed a 3-factor cancer-related mental condition model encompassing affective (cancer fear), cognitive (cancer risk perception), and affective-cognitive (cancer worry) conditions. Two studies were conducted. Study 1 developed the model with Sample 1 (U.S. undergraduates, N = 309), and subsequently validated the model with Sample 2 (Korean general population, ages 40 years or older, N = 1,130). Study 2, using Sample 2, tested the model's relationship with cancer information use, cancer information avoidance, and screening intention. While Sample 1 participants were asked about cancer in general, Sample 2 participants were asked specifically about stomach cancer. Thus, the model derived from the specific sample in a general context was confirmed via the general sample in a specific context. The results showed that both cancer worry and cancer risk perception are positively associated with cancer information use and screening intention, but they are negatively associated with cancer information avoidance. Cancer fear was positively associated with cancer information use, but it was also positively related to cancer information avoidance. Moreover, cancer fear was negatively associated with screening intention. Although the three components of the model are positively related to one another, they function differently in the cancer context.

Notes

¹Affect has been variously defined. In line with Clore and Ortony (1988), this study used affect as a general term that includes emotions, but contrary to cognition.

²Consistent with this expectation, all four items loaded on the same factor in the subsequent factor analysis (see the Results section).

³Korea launched its National Cancer Screening Program in 1999. Recipients of the Korean version of Medicaid and those in the lower 50% of the National Health Insurance premium are screened without charge, and those in the upper 50% of the premium can receive cancer screening for a 10% out-of-pocket expense (National Cancer Center, 2013). Thus, Korean health policy makes it relatively easy to get screened for cancer.