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objectives: Examine the 1) prevalence of worries among US mothers of infants; 2) association between worries and American Academy of Pediatrics recommended infant care practices (breastfeeding, supine sleep, roomsharing without bedsharing); 3) association of maternal and household characteristics with worries. Methods: We analyzed a nationally representative sample of 3165 mothers who were surveyed regarding safe sleep and breastfeeding when infants were 2 to 6 months of age in 2011-2014. We examined the prevalence of 8 maternal worries (housing, job, income, neighborhood, family relationships, health, baby's health, family member health). We used multi-variable logistic regression to examine associations of A) both overall number of worries and individual worries with each infant care practice; and B ) maternal and household characteristics with worries. results: Twenty-six percent of mothers reported 0 worries, 26% reported 1-2 worries, 23% reported 3-4 worries, and 25% reported 5-8 worries. Compared to those with 0 worries. mothers with 5-8 worries had increased odds of bedsharing (adjusted odds ratio = 1.60 [1.19-2.14J) and non-supine sleep (aOR = 1.37 [1.07-1.74]). Specific worries associated with increased odds of bedsharing included: housing (aOR = 1.39 [1.09-1.78]), income (aOR = 1.35 [1.09-1.67]), neighborhood (aOR = 1.37 [1.05-1.78]), family relationships (aOR = 1.43 [1.10-1.86]), and health of a family member (aOR = 1.24 [1.06-1.46]). Maternal worries were not associated with infant feeding practices. Conclusions: We found a high prevalence of worries regarding basic needs, family relationships, and health among US mothers. Greater total worries and several individual worries were associated with higher odds of bedsharing. The "cognitive load" of maternal worries may impact adherence to safe sleep practices and requires further investigation. [ABSTRACT FROM AUTHOR]

We discuss the implications of Seidenberg and colleagues' report confirming low levels of accurate awareness of the cancer harms associated with alcohol use, including wine, beer, and liquor consumption. The authors propose that academic and lay messaging describing consumption of wine and other forms of alcohol as reducing heart disease risk has created generalized beliefs about the health benefits of drinking alcohol. This "health halo" surrounding alcohol consumption leads the public to overgeneralize alcohol health benefits to other diseases, including cancer. We discuss the need to address high levels of perceived risk uncertainty to help the public distinguish between the impact of alcohol on heart disease versus cancer, and to overcome other barriers to including alcohol use reduction as a cancer prevention strategy. Given recent increases in U.S. population drinking rates, as well as morbidity and mortality associated with alcohol use, the time is right to marshal multilevel efforts to educate the public regarding the fact that alcohol is carcinogenic. If successful, these efforts will have multiple downstream benefits, including the ability of the lay public to use the most up-to-date scientific evidence to make informed decisions about whether, and how much, to engage in a risky behavior. [ABSTRACT FROM AUTHOR]

Background: Socioeconomic status (SES) disparities in colorectal cancer screening are persistent. Lower education and income are both associated with lower screening rates. Both cognitive (e.g., perceived barriers) and affective (e.g., disgust, fear) decision-making constructs are known determinants of colorectal cancer screening behavior. This study tests the hypotheses that SES may be related to decision-making constructs and that this SES-decision-making construct relation may contribute to explaining the SES-screening behavior disparity. Method: Surveys assessing perceived benefits and barriers to screening, self-efficacy, positive and negative affective associations with colonoscopy, fear of colonoscopy, colorectal cancer knowledge, past screening behavior, and demographics including education and income were completed by 2,015 African American participants ages 50 and older. Both univariable and multivariable relations of SES to decision-making constructs were examined, as were univariable and multivariable models of the indirect effect of SES on screening via decision-making constructs. Results: Socioeconomic status was related to both screening compliance and the decision-making constructs. Bootstrap modeling of the indirect effect showed that the total effect of the SES-screening behavior relation included an indirect effect via social cognitive decision-making constructs. Conclusion: These findings suggest that cognitive and affective decision-making constructs account for at least some of the SES disparities in colorectal cancer screening behavior. As such, more research is needed to explore the intra individual-level influences of disparities in colorectal cancer screening. In addition, work is needed to develop effective intervention approaches to address the relation of SES to decision-making constructs. [ABSTRACT FROM AUTHOR]

In 2016, the NCI provided supplemental funding to 15 NCI-designated cancer centers to enhance cancer centers' capacity to collect critical catchment-area data across behavioral and psychosocial domains [March 2019 issue of Cancer Epidemiology, Biomarkers & Prevention (CEBP)--CEBP Focus]. In response, we highlight opportunities for cancer risk perception research when collecting and utilizing catchment-area data given the remarkably high proportions of individuals who report they are at average cancer risk, high levels of cancer risk information avoidance, and extremely negative ("death") associations with cancer. First, we advocate for enhanced measurement specificity regarding whether some participants may be uncertain regarding their cancer risk. Second, we advocate for examination of whether the large proportion of people who rate their risk as average have common (demographic and attitudinal) characteristics, which may dictate specific and targeted cancer prevention and control intervention. Finally, we advocate for further examination of cancer risk information avoidance and negative cancer associations to clarify subgroups that may fail to engage with risk information. Given the ubiquity of risk uncertainty, information avoidance, and negative cancer associations, further research into these prevalent beliefs will enhance our ability to bring the latest information regarding cancer prevention and control to the general population of the United States. [ABSTRACT FROM AUTHOR]

Objectives: This study integrated the framework of the behavioral affective associations model with dual process theories to investigate whether feelings about condoms operate at both implicit and explicit levels to influence condom use. We then tested whether 2 factors related to the perceived controllability of condom use (perceived behavioral control and past experience losing control in the heat of the moment) moderated the reliance on implicit versus explicit affect. Method: Sexually active young adults (N = 54) completed measures of implicit and explicit affect surrounding condoms, perceived behavioral control, and whether they attributed their prior unprotected sex to getting lost in the heat of the moment. They then completed 30 daily reports of their sexual activity and condom use. Multiple moderation analysis using generalized estimating equation (GEE) models tested the relative influence of implicit and explicit affect on condom use at varying levels of perceived controllability. Results: Both perceived behavioral control and past unprotected sex because of getting lost in the heat of the moment moderated the effects of both implicit and explicit affect on behavior, ps < .05. Only implicit affect predicted condom use among participants who had gotten lost in the heat of the moment and who had low perceived behavioral control. Only explicit affect predicted condom use among participants without a history of getting lost in the heat of the moment and who had high perceived behavioral control. Conclusion: Feelings about condoms predicted condom use at either an implicit or explicit level, depending on perceived controllability, suggesting this is an important moderator of whether implicit processes drive condom use. [ABSTRACT FROM AUTHOR]

Objective: Given the well-documented efficacy of condoms as a means of preventing pregnancy and sexually transmitted infection transmission, the low rates of condom use among young adults necessitates a deeper understanding of the factors that influence condom use decision making. The central purpose of the current study was to examine how experimentally manipulated affective associations with condoms influence subsequent behavior in a condom selection task, thereby providing support for a causal relation of affective associations to behavior in this health domain. Method: Following a baseline assessment of cognitively based beliefs and affective associations, participants' {N = 171) affective associations with condoms were experimentally manipulated with an evaluative conditioning (EC) procedure. Images of condoms were paired repeatedly with positive or neutral affective stimuli. The key outcome measure was a behavioral choice task in which participants selected condoms upon completion of the experiment. Results: Participants in the positive condition reported more positive affective associations post-EC compared with those in the neutral condition, 3 = 0.33, p = .025, 95% Cl (0.041, 0.63). For participants who regularly used condoms at baseline, those in the positive condition also selected significantly more condoms, RR = 1.39, p = .015, 95% Cl (1.07, 1.83). This condition effect on behavior was partially mediated by the change in affective associations. There was no effect of condition on condom selection among participants who rarely used condoms at baseline. Conclusion: The current study extends our theoretical understanding of the affect-behavior relation in the realm of condom use, and provides preliminary support for interventions that target affective associations with condoms. [ABSTRACT FROM AUTHOR]

Objective: Health behaviors, including smoking and fruit and vegetable consumption, are both associated with psychological distress and vary by race/ethnicity. The relation of global psychological distress to behavior also varies by race/ethnicity, but the specific negative affective states responsible for this effect are not known. This study examined how the relation of feelings of depression and anxiety to health behaviors differs by race/ethnicity. Method: Secondary data analysis of the HINTS nationally representative population survey was conducted. Survey participants reported their current symptoms of depression and anxiety, as well as smoking status and fruit and vegetable consumption. Survey weighted linear and logistic regression analyses were used to assess whether race/ethnicity moderated the relation of symptoms of depression and anxiety to smoking and fruit and vegetable consumption. Results: For symptoms of depression, but not anxiety, there was a significant interaction between race/ethnicity and psychological distress in predicting both smoking status and fruit and vegetable consumption. Greater depressive symptoms were related to a greater likelihood of smoking and lower fruit and vegetable consumption for White, but not Black respondents. For Hispanic respondents, depressive symptoms were associated with a greater likelihood of currently smoking, but were not associated with fruit and vegetable consumption. Conclusion: The association between depressive symptoms and both smoking and fruit and vegetable consumption differs as a function of race/ethnicity. These findings have implications for understanding the extent to which negative affective states influence health behaviors across different racial/ethnic groups, and for developing interventions that effectively target smoking and fruit and vegetable consumption among different racial/ethnic subgroups. [ABSTRACT FROM AUTHOR]

The article discusses a study that explored racial or ethnic differences in perceived cancer risk. The determinants of these differences in a nationally representative sample of whites, blacks, Hispanics and Asians in the U.S. are identified. The study found that nonwhites have lower perceptions of cancer risk that whites. It also suggested that some of the racial or ethnic variability in perceived risk may be due to experiences with behavioral risk factors and differences in awareness of one's family history of cancer.

In this article, the author who is a member of ASPO's Behavioral Oncology Interest Group, discusses the importance of wide involvement in screening cancer prevention and early recognition. He says that the science of decision making is the key to understanding and increasing screening observance and suggests research instructions for the subject progress.

Individuals have affective associations with health behaviors. In other domains such associations have been shown to influence behavior, but affective associations with health behaviors are not included in current health decision-making models. The authors examined whether affective associations with exercise predicted individuals' activity behavior and, if so, how they interfaced with other decision-making constructs to influence behavior. Adult participants (N = 433) reported their current physical activity behavior and affective associations with physical activity. Health belief model and theory of planned behavior constructs were also assessed. More positive affective associations with activity significantly predicted greater activity behavior. Moreover, the influence of the health belief model and theory of planned behavior constructs on activity behavior was mediated through affective associations. Affective associations were shown to play a central role in individuals' activity behavior, both as a mediator of the effects of cognitively based decision-making factors and as an independent predictor of activity behavior. The results suggest the need to include affective influences on behavior in formal models of health decision making and, potentially, to explore affectively based intervention routes to change behaviors. [ABSTRACT FROM AUTHOR]