Abstract
Background: Understanding multiple components of risk perceptions is important because perceived risk predicts engagement in prevention behaviors. Purpose: To examine how multiple components of risk perceptions (perceived magnitude of and worry about risk, prioritization of the management of one's risk) changed following genetic counseling with or without test reporting, and to examine which of these components prospectively predicted improvements in sun-protection behavior 1 year later. Methods: A prospective, nonrandomized study design was used. Participants were 114 unaffected members of melanoma-prone families who (i) underwent genetic testing for a CDKN2A/p16 mutation (n = 69) or (ii) were at comparably elevated risk based on family history and underwent genetic counseling but not testing (no-test controls, n = 45). Participants reported risk perception components and sun-protection behavior at baseline, immediately following counseling, and 1 month and 1 year after counseling. Results: Factor analysis indicated three risk components. Carriers reported increased perceived magnitude and priority of risk, but not cancer worry. No-test controls showed no changes in any risk perception. Among noncarriers, priority of risk remained high at all assessments, whereas magnitude of risk and cancer worry decreased. Of the three risk components, greater priority of risk uniquely predicted improved self-reported sun protection 1 year post-counseling. Conclusions: Priority of risk (i) seems to be a component of risk perceptions distinguishable from magnitude of risk and cancer worry, (ii) may be an important predictor of daily prevention behavior, and (iii) remained elevated 1 year following genetic counseling only for participants who received a positive melanoma genetic test result.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 24-40 |
| Number of pages | 17 |
| Journal | Annals of Behavioral Medicine |
| Volume | 55 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2021 |
Funding
This research was supported by the National Cancer Institute of the National Institutes of Health (R01 CA158322). Support was also received from the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant 8UL1TR000105 (formerly UL1RR025764). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. This research was also supported by the Huntsman Cancer Foundation (HCF), the Tom C. Mathews, Jr. Familial Melanoma Research Clinic endowment, the Pedigree and Population Resource of Huntsman Cancer Institute, and the Utah Population Database. This study also utilized the Utah Cancer Registry, which is funded by contract N01-PC-35141 from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program, with additional support from the Utah State Department of Health and the University of Utah. The authors acknowledge the use of the Genetic Counseling and Health Measurement and Survey Methods core facilities supported by the National Institutes of Health through National Cancer Institute Cancer Center Support Grant 5P30CA420-14 awarded to Huntsman Cancer Institute and additional support from the HCF. Partial salary support was also provided by Knight Cancer Institute and Oregon Health & Science University (S. A. Leachman, P. Cassidy). The authors additionally acknowledge the generous participation of all study participants who made this project possible. We thank also Dexter Thomas, Emily Scott, Taylor Haskell, Sandie Edwards, Roger Edwards, Rebecca Stoffel, Christopher Moss, Dixie Thompson, Lisa Reynolds, Tami Calder, Michelle Allred, Melissa Shepherd, Teresa Stone, Jason Hawkes, Julia Curtis, Matt Haskell, Janice Mathews, Jonathan Butner, Paul Tanner, Tracy Petrie, and Pascal Deboeck for their contributions to the conduct or analysis of the study.
Keywords
- Genetic counseling
- Genetic testing
- Melanoma
- Perceived risk
- Priority of risk
- Sun protection
ASJC Scopus subject areas
- General Medicine
