The Augmented Cognitive Mediation Model: Examining Antecedents of Factual and Structural Breast Cancer Knowledge Among Singaporean Women

Abstract

As knowledge acquisition is an important component of health communication research, this study examines factors associated with Singaporean women’s breast cancer knowledge using an augmented cognitive mediation model. We conducted a nationally representative study that surveyed 802 women between the ages of 30 and 70 using random-digit dialing. The results supported the augmented cognitive mediation model, which proposes the inclusion of risk perception as a motivator of health information seeking and structural knowledge as an additional knowledge dimension. There was adequate support for the hypothesized paths in the model. Risk perception was positively associated with attention to newspaper, television, Internet, and interpersonal communication. Attention to the three media channels was associated with interpersonal communication, but only newspaper and television attention were associated with elaboration. Interpersonal communication was positively associated with structural knowledge, whereas elaboration was associated with both factual and structural knowledge. Differential indirect effects between media attention and knowledge dimensions via interpersonal communication and elaboration were found. Theoretical and practical implications are discussed.

Funding

This project was funded by Nanyang Technological University (Grant No. M4080259).

Notes

¹ Although the ethnic composition of the sample was comparable to the national census conducted in 2010, the proportion of married women in our sample (83.4%) was higher than the national average of 57.7%, and the median monthly household income (S$3,001–S$4,001) was lower than the national average of S$6,342 (Department of Statistics Singapore, 2010, 2014). The deviation from the national census could have been due to our sampling strategy, in which we only surveyed women 30 to 70 years old. Despite this, the deviation should not pose a significant problem to the interpretation of the results, as the effects of demographic variables were controlled for in the model.

² Ordinary level refers to the Singapore-Cambridge General Certificate of Education Ordinary Level Examination that is taken annually by Singaporean students ages 16 to 17 years old. It is equivalent to a high school diploma in the United States.

³ The covariances among error terms of latent endogenous factors are not shown to reflect a parsimonious graphical presentation of the augmented CMM. An examination of the covariances between media attention factors, interpersonal communication and elaboration, as well as knowledge factors showed that there were no major multicollinearity issues: attention to newspaper and television (Φ = .43, p < .001), attention to newspaper and the Internet (Φ = .26, p < .001), attention to television and the Internet (Φ = .29, p < .001), interpersonal communication and elaboration (Φ = .33, p < .001), factual and structural knowledge (Φ = .26, p < .001).

Additional information

Funding

This project was funded by Nanyang Technological University (Grant No. M4080259).