Examining Associations between Mental Health Symptoms with Cancer Screening Behavior and the Moderating Role of Social Support in a Population-based Sample Open Access

Vereen, Rhyan Nicole (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/cn69m448n?locale=en


Background: Many demographics such as race/ethnicity and socioeconomic status have been found to be significant predictors of cancer screening behaviors, leading to the formation of screening assistance programs and targeted interventions. Despite decades of research and interventions, disparities in cancer mortality still remain. In order to further decrease the burden of cancer, it is necessary to continue identifying factors that play a role in cancer screening use.

Methods: Data from the Health Information National Trends Survey (HINTS) 4, Cycle 2 cross sectional survey were used for secondary analyses for this study. Binary logistic regression models were used to determine the association between psychological distress and cancer screening behavior adjusting for demographic, health related, self efficacy, and social support variables. Interaction between psychological distress and social support was also assessed. All analyses were weighted and run separately using two different domains: colorectal cancer screening-eligible and mammography- eligible.

Results: Among 1,735 participants in the colorectal cancer screening-eligible domain, 472 (28.7%) reported some amount of psychological distress. Out of 1,398 participants in the mammography-eligible domain, 451 (33.5%) reported some amount of psychological distress. Psychological distress was not significantly associated with colorectal cancer screening (Adjusted OR: 0.94, 95% CI: 0.55, 1.63) or mammography (Adjusted OR: 1.21, 95% CI: 0.75, 1.97). There was no moderation by emotional or informational support.

Conclusions: Psychological distress was not associated with cancer screening behavior within this nationally representative sample. However, based on previous significant findings within specific populations, it is possible that the association between mental health symptoms and cancer screening may only be present in particular groups of people. Future research should further stratify populations to identify subgroups where mental health symptoms may be an important determinant of cancer screening.

Impact: Identifying modifiable factors associated with cancer screening behavior can inform intervention strategies and efforts to increase screening and decrease the burden of cancer in the United States.

Table of Contents

Chapter I: Background and Literature Review 1

Chapter 2: Manuscript

Title, Authors, Abstract 11

Introduction 12

Methods 14

Results 20

Discussion 22


Table 1a. Characteristics of Colorectal Cancer Screening-Eligible Domain (Weighted) 26

Table 1b. Characteristics of Mammography-Eligible Domain (Weighted) 28

Table 2a. Binary Logistic Regression for the Association Between Psychological Distress and Colorectal Cancer Screening in an Age-Eligible Population Based Sample 30

Table 2b. Binary Logistic Regression for the Association Between Psychological Distress and Up to Date Mammography Use in a Gender and Age-Eligible Population Based Sample 32

Chapter III: Summary, Public Health Implications, Possible Future Directions 34

References 37

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