Question ID: Feb 4-6
Submitted by: February 4, 2011 Behavioral, Population, Epidemiology, and Prevention Provocative Questions workshop - Submitted to the website
March 27, 2011
Why don't more people alter behaviors known to increase the risk of cancers?
Background: A wealth of epidemiological research shows that certain modifiable behaviors are linked to increased cancer risk. These include tobacco use, UV exposure, sexual behaviors, obesity, and lack of cancer screening. However, despite this knowledge, many people struggle with, or are unable to modify, these behaviors. In addition to important external environmental factors, there are at least three classes of explanation that could influence the steps that should be taken to improve the likelihood of behavioral change: (1) the message itself is not designed optimally for impact; (2) the message is not effectively delivered; and (3) the interventions to facilitate behavior change are not optimal.
Feasibility: (1) Studies suggest that the nature of messages and how messages about cancer risk are conveyed greatly influences individual’s willingness to adopt behaviors that reduce cancer risk. Educational studies show that making students aware of negative academic stereotypes can acutely depress test performance, while more positive statements have the opposite effect. This approach could be applicable to oncology, if statements about health disparities might negatively influence a patient’s willingness to adopt cancer-preventing behaviors such as cancer screenings. (2) The means by which a message is delivered may also affect a patient’s behavior related to cancer risk, so changing the means and/or sources by which the message is delivered may improve the way a patient receives information about cancer risk. These modifications could include changes in the health system that delivers the message, changes in the role of traditional journalism, and changes in the way we use modern, internet-based communications. (3) Even with an effective message and mode of delivery, individuals may be unable to act on the message to alter their behavior. Advances in the field of neuroscience, coupled with technological advances in brain imaging, offer new opportunities to explore the neural mechanisms of decision-making and behavior change, and to develop novel interventions. For example, emerging evidence suggests it is plausible to enhance cognitive function through focused training in a manner that alters both the brain and the behavior.
Implications for success: Reductions in behavior that increase risk of cancer - whether attributable to one, two, or all three approaches - could have an enormous impact in the incidence of cancer. Cognitive training interventions could increase behavioral control among individuals struggling with cancer risk behaviors such as obesity and cigarette smoking. Studying the molecular and neural mechanisms that contribute to cancer-causing behaviors will provide a better understanding of how to change these behaviors and thus reduce cancer risk. How cancer risk is conveyed to patients, especially among minorities, is equally important. By changing the message, we might change the behavior. Lastly, by modifying how different systems communicate information about cancer, we can better understand how various factors influence patients, as well as the organizations and teams that deliver care.
Average Score: 5.0
 (2 evaluations)Provocativeness - 5.0
Novelty - 4.5
Public Health Significance - 5.0
Feasibility - 5.0
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