Many patient-level barriers to more effective post-fracture osteoporosis (OP) management are associated with patients’ perceptions of their bone health and the link between their fracture and OP. These barriers could be addressed by interventions which account for the role of patients’ perceptions, such as those based on theories of behaviour change. This thesis had two objectives: to review the literature and determine whether these theories have been integrated in post-fracture OP management and to examine patients’ awareness of the OP-fracture link. The results showed that theories of behaviour change have not been integrated into post-fracture interventions, that most patients do not perceive the OP-fracture link even after a baseline intervention and that two baseline factors predict who is less likely to make the OP-fracture link at follow up. Based on these findings, modifications to current OP interventions were proposed and guidance that could help create new, patient-centered interventions was provided.

Many patient-level barriers to more effective post-fracture osteoporosis (OP) management are associated with patients’ perceptions of their bone health and the link between their fracture and OP. These barriers could be addressed by interventions which account for the role of patients’ perceptions, such as those based on theories of behaviour change. This thesis had two objectives: to review the literature and determine whether these theories have been integrated in post-fracture OP management and to examine patients’ awareness of the OP-fracture link. The results showed that theories of behaviour change have not been integrated into post-fracture interventions, that most patients do not perceive the OP-fracture link even after a baseline intervention and that two baseline factors predict who is less likely to make the OP-fracture link at follow up. Based on these findings, modifications to current OP interventions were proposed and guidance that could help create new, patient-centered interventions was provided.

Prior research suggests that fear of cancer recurrence is very common among cancer survivors. This study examined the extent to which Protection Motivation Theory variables of threat appraisal and coping appraisal accounted for differences in fear of recurrence and performance of health behaviors in cancer patients who recently completed treatment. It was hypothesized that greater fear of recurrence would be related to a combination of high threat appraisal and low coping appraisal. Also, it was hypothesized that higher rates of health behaviors would be related to higher threat appraisals for cancer recurrence and higher coping appraisals for reducing risk of recurrence by improving diet or exercising. A sample of 155 early-stage breast cancer patients (mean age = 59 years) who completed surgery, chemotherapy, and/or radiotherapy between 6-24 months previously (mean = 12 months) completed measures of fear of recurrence, threat appraisal (perceived risk and severity of a potential cancer recurrence), fruit and vegetable intake in the past month, exercise for the past week, and coping appraisal (perceived response efficacy and self-efficacy to perform diet and exercise recommendations to reduce recurrence risk). Basic demographic and clinical information was also collected. The study findings supported the hypothesis that the combination of threat and coping appraisal beliefs explain which breast cancer survivors report higher fear of recurrence. However, the observed results did not support the hypothesized interaction between threat and coping appraisal for predicting either diet or exercise habits. Instead, coping appraisal alone predicted both fruit and vegetable consumption and exercise habits. Future research should focus on examining these relationships longitudinally and further assess coping appraisal and how it impacts fear of recurrence.

Prior research suggests that fear of cancer recurrence is very common among cancer survivors. This study examined the extent to which Protection Motivation Theory variables of threat appraisal and coping appraisal accounted for differences in fear of recurrence and performance of health behaviors in cancer patients who recently completed treatment. It was hypothesized that greater fear of recurrence would be related to a combination of high threat appraisal and low coping appraisal. Also, it was hypothesized that higher rates of health behaviors would be related to higher threat appraisals for cancer recurrence and higher coping appraisals for reducing risk of recurrence by improving diet or exercising. A sample of 155 early-stage breast cancer patients (mean age = 59 years) who completed surgery, chemotherapy, and/or radiotherapy between 6-24 months previously (mean = 12 months) completed measures of fear of recurrence, threat appraisal (perceived risk and severity of a potential cancer recurrence), fruit and vegetable intake in the past month, exercise for the past week, and coping appraisal (perceived response efficacy and self-efficacy to perform diet and exercise recommendations to reduce recurrence risk). Basic demographic and clinical information was also collected. The study findings supported the hypothesis that the combination of threat and coping appraisal beliefs explain which breast cancer survivors report higher fear of recurrence. However, the observed results did not support the hypothesized interaction between threat and coping appraisal for predicting either diet or exercise habits. Instead, coping appraisal alone predicted both fruit and vegetable consumption and exercise habits. Future research should focus on examining these relationships longitudinally and further assess coping appraisal and how it impacts fear of recurrence.

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