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The primary aim of this research was the development of a typology of respondents based on their "control identity"– i.e., perceived sense of control over themselves, their environment, and aspects of their health, including perceived vulnerability to disease and perceived value of health promotion. Testicular cancer and testicular self examination (TSE) were selected as the disease focus, with the realization that, if successful, the typology could be applied across a variety of diseases. The constructs of "realistic vs. unrealistic control" and "internal vs. external locus of control" provided the theoretical foundation to initially define the control-identity types that were then verified through cluster/segmentation analyses. Testicular cancer rates are rising among 15-54 year old men with the majority of those cases affecting males under the age of 35. Regular screening techniques for the disease, most notably testicular self-examination, are rarely performed among surveyed males. If testicular cancer is caught in its early stages, the survival rate is approximately 95%; however, if diagnosed in later stages, survival rates drop below 50%. The lack of published psychosocial behavioral research in this area has contributed to a general misunderstanding by men of the disease and its preventative/screening measures. If continued, this lack of screening for testicular cancer can only lead to increasing incidence and mortality rates. This exploratory study developed a Control Identity Survey, a 41-item questionnaire soliciting information on perceived vulnerability, value of health promotion, health control beliefs, and intention to perform testicular self-examination (TSE). The survey was administered via in-person and internet data collection methods to 300 men between the ages of 18-35. A principal components factor analysis of the survey’s key control variables (realistic vs. unrealistic illusory control constructs and internal v. external locus of control) defined the underlying structure of the data. The resulting factors were then used to create indices for use in the cluster analysis process. From this cluster analysis, control-identity groups were identified and profiled. Given the control-identity types, perceptual mapping techniques were then applied to model how each type of respondent perceives their vulnerability to testicular cancer, the value of testicular self-examination, and overall health control beliefs. This study equated perceptions with an individuals’ ‘outcome expectancy’, or attitude. The findings confirmed the following: •The hypothesized four-group control-identity typology was verified among men based on the variables of health control beliefs, perceived vulnerability, and perceived value of health promotion. The groups were labeled: 1) Realistic Externals, 2) Realistic Internals, 3) Unrealistic Internals, 4) Unrealistic Externals. •Unrealistic Externals perceive the value of TSE to be significantly lower than other types. •Unrealistic Externals perceived their control over health outcomes to be lower than all other types. •Each control-identity type structures perceptions of health control beliefs, vulnerability, and the value of health promotion similarly in a 3-dimensional perceptual mapping space, but the location of “self” within the concept set differs by control-identity type. •Realistic Internals scored the highest among types on value of health promotion, but not significantly so compared to the other groups, with the exception of the Unrealistic Externals, who least value health promotion. •The two “Realistic” types (Internal & External) scored significantly higher on perceived Vulnerability than did the two "Unrealistic" types (Internal & External), with the "Internals" v. "Externals" not differing significantly. •Unrealistic Internals scored highest on perceived self-efficacy (I-Control), but not significantly higher than Realistic Internals, which appears consistent with the fact that "internals" have a higher sense of health-related self-efficacy than do "externals". •Implications for social marketing and for the development of future behavioral intervention strategies are suggested. The methods used in this research could have wide application across the cancer continuum from primary prevention and screening to treatment and end-of-life decisions. From this research, it is clear that men differ significantly in their “control identity”-- the extent to which they perceive themselves as having an internal v. external and/or realistic vs. unrealistic sense of control over their health. Consistently, the control-types differed on perceptions of their own vulnerability to disease, their perceived value of health promotion, and their individual health control beliefs. The resulting typology appears to have exceptional potential for future research across a variety of health related behaviors and diseases. As well, the typology holds promise as a cost-effective way to tailor evidence-based decision aids for each of the control-identities. Since there is little reported success in promoting sustainable TSE among males, it is suggested that building on the control-identity approach will aid testicular cancer and TSE researchers in developing more effective, tailored messages for their study designs. / Public Health

Health beliefs of 221 postmenopausal women were assessed to predict the Breast Cancer Screening Behaviors of breast self-examination (BSE) and utilization of mammography. Champion's (1991) revised Health Belief Model (HBM) instrument for BSE, which assesses the HBM constructs of Seriousness, Susceptibility, Benefits, Barriers, Confidence and Health Motivation, was utilized along with her Barriers and Benefits instrument for mammography usage. Ronis' and Harel's (1989) constructs of Severity-Late and Severity-Early were evaluated along with Cuing and demographic variables. These exogenous latent constructs were utilized in a LISREL path model to predict Breast Cancer Screening Behavior.

Current ACS guidelines recommend routine screening for cancer (ACS, 2002). Motivation to adhere to guidelines may be different for individuals with and without a family history of melanoma (Jonna, et al., 1998). Prior research examining the relationship between family history and skin cancer detection behaviors (Berwick et al., 1996; Friedman et al., 1993; Oliveria et al., 1999) have failed to utilize a theoretical framework to derive hypotheses. The purpose of the present study was to examine the utility of Protection Motivation Theory (PMT) in explaining intentions to engage in skin cancer screening (SCS) and skin self-examination (SSE). In addition, the present study explored whether PMT variables explained the relationship between having a family history of melanoma and SCS/SSE intentions. The research design was cross-sectional with 101 participants in the positive family history group and 80 participants in the negative family history group. Using a standardized, self-report measure, participants were assessed on demographic characteristics, melanoma risk factors, PMT variables, family history, and SCS/SSE behaviors and intentions. Statistical analyses included descriptive statistics, chi square for categorical variables, t-tests for continuous variables, correlational analyses, and multiple regression analyses. The majority of participants (N = 181) were Caucasian (97%) and female (59%). As expected, findings indicated that greater perceived vulnerability, self-efficacy, and response efficacy were associated with greater SCS intentions (p greater or less than .0001). Additionally, greater self-efficacy and response efficacy were associated with greater SSE intention (p greater or less than .01). Additionally, positive family history individuals reported greater perceived vulnerability, greater self-efficacy, and less perceived severity than negative family history individuals (p greater or less than .01). Individuals with a family history of melanoma also had greater SCS intentions and were more likely to have a healthcare provider who recommended SCS. Finally, perceived vulnerability and self-efficacy partially mediated the relationship between group status and SCS intentions. The present study confirms and extends prior research on psychological factors associated with SCS/SSE intentions and on individuals with a family history of melanoma. Clinical implications and future directions are discussed.

Little is known about breast health behaviors in Afro-Caribbean women (ACW) residing in the United States, as they are often included in the collective group of African American women (AAW). The objective of this study was to determine the influence of a spiritually-guided intervention on breast health self-care (BHSC) attitudes in ACW residing in southeastern Florida using a concurrent triangulation mixed methods design. One hundred and seventeen women were recruited from three local south Florida Caribbean churches. Inclusion criteria included: (a) self-identification as Afro-Caribbean, (b) female aged 30 years or older, (c) living in the United States for at least 1 year, (d) able to provide informed consent, (e) able to speak and read English at the 8th grade level, and (f) no previous history of breast cancer. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2015. / FAU Electronic Theses and Dissertations Collection

The main concern of this thesis are breast, cervical and testicular cancer with focus on their epidemiology, screening and prevention. The epidemiological situation in Czechia and selected member states of EU is described by using indicators of incidence and mortality. The first main goal of this thesis is to analyze breast and cervical cancer screening coverage as well as the coverage by regular gynecologist check ups by using data from VZP health insurance company. It has been found that the breast cancer screening coverage rates are influenced by age structure. Cervical cancer screening coverage and gynecologist check-up coverage grow from 2009 to 2017. The other main task was to find out about knowledge of self-examination of Czech young people by using the data from questionnaires from educational programme "Healthy balls". Health knowledge among these students was low. There were found some differences in health behaviour and health literacy between gender and age groups.

Made available in DSpace on 2015-07-22T20:50:38Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-06-30 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Introdução: No Brasil, o Instituto Nacional do Câncer (INCA) estima que haverá 14.120 novos casos de câncer bucal em 2010, sendo 10.330 em homens e 3.790 em mulheres. A maioria dos cânceres de boca infelizmente só é diagnosticada em fase tardia. O autoexame bucal, por representar uma estratégia simples e eficaz na identificação precoce das lesões cancerizáveis e do câncer bucal, deveria ser feito periodicamente, sobretudo por indivíduos do grupo de risco. Objetivo: Desenvolver e avaliar um website educacional no intuito de promover a prevenção e a identificação precoce das lesões cancerizáveis e do câncer bucal. Método: Foram desenvolvidos um website com conteúdo educacional sobre o câncer bucal, um questionário de conhecimento e um vídeo do autoexame bucal. A avaliação do website baseou-se em uma amostra n=100 dividida em dois grupos. O grupo G1 foi avaliado pré e pós navegação no website, e o grupo G2 não teve acesso ao conteúdo do website. Ambos os grupos executaram o autoexame bucal e registraram seus achados clínicos, que foram comparados com os achados clínicos dos dentistas. Resultados: O website desenvolvido foi intitulado “Website Educacional da Prevenção do Câncer Bucal”. A análise estatística mostrou que os grupos G1 e G2 eram homogêneos quanto ao conhecimento prévio sobre o câncer bucal. Entretanto, o G1 mostrou diferença significante (p<0,01) sobre o conhecimento pós navegação no website. Já a análise de concordância entre os grupos versus dentistas apresentou alta concordância para o G1 e fraca concordância para o G2. Conclusões: O website desenvolvido mostrou-se uma eficiente ferramenta educacional quanto ao ganho de conhecimento sobre o câncer bucal e propiciou eficaz reprodutibilidade do autoexame bucal. / Introduction: In Brazil, the National Cancer Institute (INCA) estimates there will be 14,120 new cases of oral cancer in 2010, with 10,330 men and 3,790 women. Unfortunately, most mouth cancers are only diagnosed in late stage. The oral self-examination represents a simple and effective strategy for early identification of precancerous lesions and oral cancer, and should be done periodically, especially for individuals in risk groups. Objective: To develop and evaluate an educational website aimed at promoting prevention and early detection of cancerous lesions and oral cancer. Method: A website with educational content on oral cancer, a survey of knowledge and a video of oral self-examination have been developed. The website evaluation was based on a sample n = 100, divided into two groups. Group 1(G1) was evaluated before and after browsing the website, and the group 2(G2) did not have access to the website content. Both groups performed the oral self-examination and recorded their clinical findings, which were compared with dentists clinical findings. Results: The developed website was named "Educational Website for Oral Cancer Prevention." Statistical analysis showed that G1 and G2 were homogeneous with respect to prior knowledge about oral cancer. However, G1 showed a significant difference (p <0.01) on knowledge after browsing the website. However, analyzing the agreement between the groups versus dentists, it was found high concordance for G1 and poor agreement for G2. Conclusions: The website proved to be an effective educational tool for gain of knowledge about oral cancer and provided effective reliability of oral self-examination. / TEDE / BV UNIFESP: Teses e dissertações

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Objetivos: comparar os achados do auto-exame das mamas com o seu exame clÃnico no rastreamento de anormalidades mamÃrias. Verificar a freqÃÃncia dos conhecimentos e prÃticas relacionadas com o auto-exame das mamas. Estimar a sensibilidade e especificidade do auto-exame das mamas em relaÃÃo ao seu exame clÃnico. Averiguar se a sensibilidade à influenciada pelas variÃveis antropomÃtricas e sociodemogrÃficas ou pelos conhecimentos e prÃticas do auto-exame. Metodologia: estudo transversal de validaÃÃo de teste diagnÃstico, envolvendo 505 funcionÃrias de um hospital universitÃrio. Foi aplicado um questionÃrio sobre conhecimentos e prÃticas relacionadas com o auto-exame das mamas e ministrada instruÃÃo sobre o auto-exame a todas as participantes que posteriormente realizaram o auto-exame e foram submetidas a exame clÃnico por Ãnico examinador. Os intervalos de confianÃa de 95% foram calculados pelo mÃtodo de aproximaÃÃo pela distribuiÃÃo normal. ProporÃÃes foram comparadas por meio do teste do qui-quadrado e foram consideradas significativamente diferentes (teste bicaudado) quando a probabilidade de estas serem semelhantes foi menor ou igual a 0,05. Resultados: 94,06% tinham recebido informaÃÃo sobre o auto-exame, 29,90% pelo mÃdico. 32,28% realizavam o auto-exame mensalmente, 55,95% apÃs a menstruaÃÃo e o procedimento mais realizado era a palpaÃÃo durante o banho. A sensibilidade para qualquer achado foi de 37,21 % com IC 95% de 32,77%-41,82%. A sensibilidade, excluindo-se a assimetria, foi de 44,85% com IC 95% de 39,59-50,26%. A sensibilidade exclusiva para nÃdulo e espessamento (massa) foi de 52,07% com IC 95% de 43, 17%-60,87%. A especificidade para qualquer achado foi de 71,64% com IC 95% de 60,00%Â81,44%. A especificidade, excluindo-se a assimetria, foi de 80,57% com IC 95% de 74,20%-85,93%. A especificidade exclusiva para massa foi de 90,10% com IC 95% de 86,81 %-92,79%. A sensibilidade nÃo mostrou diferenÃa estatisticamente significativa quando estratificada por mama, conhecimentos e prÃticas relacionadas ao exame feito pela prÃpria e variÃveis antropomÃtricas e sociodemogrÃficas. ConclusÃo: o auto-exame à bastante conhecido por essa populaÃÃo, apresenta em relaÃÃo ao exame clÃnico uma baixa sensibilidade e especificidade, que se eleva quando analisadas exclusivamente as massas, aproximando-se da sensibilidade e especificidade da mamografia em mulheres abaixo dos 40 anos de idade

Breast cancer is the second leading cause of cancer death in women in the United States. Several factors have been identified that interfere with women's breast cancer screening practices, including lack of knowledge and confidence in the breast self-examination (BSE) technique, and lack of information provided by health care provider. One of the reasons nurses do not teach breast cancer detection could be the little emphasis given to breast cancer examination in nursing schools. The BSE is a measure of significant value in detecting cancer of the breast. However, less than half of the women in the United States are participating in breast cancer screening. The purpose of this quantitative study was to investigate the relationship between the freshman and senior nursing students' breast cancer knowledge (BCK) and breast self-examination technique confidence (BSE_TC). An online survey was administered to measure the students' BCK and their BSE_TC. The social cognitive theory guided this study. A sample 100 nursing students (54 senior and 46 freshman) were included for hypothesis testing. The study results indicate that senior nursing students had higher mean scores on the BCK and BSE_TC, as would be expected. However, senior nursing students' BCK_BSE_TC scores were also very low. This is a concern for the future of breast cancer detection. This study provides data showing breast cancer screening concepts are unclear to freshman students, and remain unclear with senior students. Nursing educational curricula in breast cancer screening should be revised to affect improvements in nurses' role in advising and educating patients.

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