Search

OBJECTIVE: To present common language for defining adherence of infrequent yet repeated health behaviors. METHODS: We illustrate methodological and conceptual issues using human papillomavirus (HPV) vaccination and screening mammography study data as examples. RESULTS: Adherence rates of infrequent, repeated behaviors varied widely depending on how adherence was defined and measured. We advocate use of 3 standard definitions of adherence: initiation of behavior (initiation), adherence to most recent opportunity (on-schedule), and timely adherence across multiple opportunities (maintenance or completion). CONCLUSIONS: The proposed framework has cross-cutting implications for research and practice. Standardizing adherence metrics may facilitate comparisons across studies of health behaviors practiced at infrequent yet repeated intervals. [ABSTRACT FROM AUTHOR]

Background: We investigated whether a history of cervical abnormalities predicts responses to cervical cancer prevention for women and their daughters. Methods: In 2007, we interviewed 832 mothers of adolescent daughters from North Carolina counties with elevated rates of cervical cancer. We measured the association of experiences with cervical abnormalities and emotions, beliefs, attitudes, and behaviors related to cervical cancer and its prevention. Results: Anxiety about cervical cancer was higher among women who had cervical cancer, hysterectomies, and abnormal Pap test results (including false positives) than in women who had experienced none of these (each p < 0.05). Pap tests were perceived as being more effective at reducing the chance of developing cervical cancer by women with a history of cancer and women who reported hysterectomies relative to women with normal Pap results (each p < 0.05). Intentions to vaccinate their daughters against human papillomavirus (HPV) were highest among women who had cervical cancer, women who had hysterectomies, and women who were treated for precancerous lesions (each p < 0.05). Conclusions: Women with histories of cervical health abnormalities reported more favorable views of Pap testing and HPV vaccination than women who had received only normal Pap testing results. They also reported higher levels of anxiety about cervical cancer. [ABSTRACT FROM AUTHOR]

While human papillomavirus (HPV) infection is associated with genital warts, anal cancer, and oral cancer, limited research has examined what men think causes these diseases. We sought to examine knowledge and beliefs about HPV-related disease among gay and bisexual men, who are at high risk for HPV infection and HPV-related cancers, and compare them to heterosexual men. We conducted an online survey in January 2009 with a national sample of men aged 18-59 who self-identified as either gay or bisexual ( n = 312) or heterosexual ( n = 296). The response rate was 70%. Fewer than half of men knew that HPV can cause genital warts (41%), anal cancer (24%), and oral cancers (23%). However, gay and bisexual men typically knew more than heterosexual men about these topics. Overall, most men believed that sexual behavior causes genital warts (70%) and anal cancer (54%), and tobacco use causes oral cancer (89%). Perceived causal factors differed substantially among the three diseases, while differences by sexual orientation were fewer and smaller in magnitude. Many men were unaware that HPV infection can cause genital warts, oral cancer, and anal cancer. [ABSTRACT FROM AUTHOR]

BACKGROUND: Little research has examined how anchor numbers affect choice, despite several decades of research showing that judgments typically and robustly assimilate toward irrelevant anchors. METHODS: In one experiment, HIV-positive patients (N = 99) judged the chances that sexual partners would become infected with HIV after sex using a defective condom and then indicated their choices of remedial action. In a second experiment, Iowa physicians (N =191) rated the chances that hypothetical patients had a pulmonary embolism and then formulated a treatment plan. RESULTS: Irrelevant anchor numbers dramatically affected judgments by HIV-infected patients of the chances of HIV infection after a condom broke during sex (43% v. 64% in the low- and high-anchor conditions, respectively) and judgments by doctors of the chances of pulmonary embolism (23% v. 53%, respectively). Despite large anchoring effects in judgement, treatment choices did not differ between low-and high-anchor conditions. Accountability did not reduce the anchoring bias in the doctors' judgments. DISCUSSION: The practical implications of anchoring for risk judgments are potentially large, but the bias may be less relevant to treatment choices. The findings suggest that the theoretical underpinnings of the anchoring bias may be more complex than previously thought. Key words: anchoring bias; assimilation effect; contrast effect; risk perception. (Med Decis Making 2007; 27: 203-211). [ABSTRACT FROM AUTHOR]