Perceived economic pressure and colorectal cancer-related perceptions among U.S. males (aged 45–75)

Kevin M. Korous; Uchenna C. Ogbonnaya; Mary A. De Vera; Ellen Brooks; Justin X. Moore; Charles R. Rogers

doi:10.1007/s10552-023-01713-y

Perceived economic pressure and colorectal cancer-related perceptions among U.S. males (aged 45–75)

Kevin M. Korous, Uchenna C. Ogbonnaya, Mary A. De Vera, Ellen Brooks, Justin X. Moore, Charles R. Rogers

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

Purpose: To examine whether a greater perception of economic pressure would be associated with more-negative attitudes, greater perceived barriers, and lower subjective norms regarding colorectal cancer (CRC) and CRC screening among males aged 45–75 years. Methods: We recruited 492 self-identified males aged 45–75 years living in the United States. We operationalized perceived economic pressure as a latent factor with three subscales: can’t make ends meet, unmet material needs, and financial cutbacks . Our dependent variables were attitudes toward CRC and CRC screening, perceived barriers to completing a CRC screening exam, and subjective norms regarding CRC screening (e.g., how others value CRC screening). We tested a hypothesized model using structural equation modeling with maximum-likelihood estimation, adjusting for covariates, and made post-hoc modifications to improve model fit. Results: Greater perceived economic pressure was associated with more-negative attitudes toward CRC and CRC screening (β = 0.47, 95% CI: 0.37,0.57) and with greater perceived barriers to CRC screening (β = 0.22, 95% CI: 0.11, 0.34), but was not significantly associated with subjective norms (β = 0.07, 95% CI: − 0.05, 0.19). Perceived economic pressure was an indirect pathway by which lower-income and younger age were associated with more-negative attitudes and greater perceived barriers. Conclusions: Our study is one of the first to show that, among males, perceived economic pressure is associated with two social-cognitive mechanisms (i.e., negative attitudes, greater perceived barriers) that are known to influence CRC screening intent and, ultimately, CRC screening completion. Future research on this topic should employ longitudinal study designs.

Original language	English
Pages (from-to)	737-747
Number of pages	11
Journal	Cancer Causes and Control
Volume	34
Issue number	9
DOIs	https://doi.org/10.1007/s10552-023-01713-y
State	Published - Sep 2023

Bibliographical note

Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Nature Switzerland AG.

Funding

This project was partly supported by the Health Studies Fund, Department of Family and Preventive Medicine, University of Utah; 5 For the Fight; Huntsman Cancer Institute; the V Foundation for Cancer Research; the Medical College of Wisconsin; and the National Cancer Institute (Grant K01CA234319), an entity of the National Institutes of Health (NIH). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH, 5 For the Fight, V Foundation for Cancer Research, Huntsman Cancer Institute, the Huntsman Cancer Foundation, the Medical College of Wisconsin, or the University of Utah. The authors report no other financial disclosures. The research team extends gratitude to the participants who made the study possible as well as to Eleanor Mayfield, ELS, for editorial assistance. The data reported in this study are available from the corresponding author upon reasonable request. This project was partly supported by the Health Studies Fund, Department of Family and Preventive Medicine, University of Utah; 5 For the Fight; Huntsman Cancer Institute; the V Foundation for Cancer Research; the Medical College of Wisconsin; and the National Cancer Institute (Grant K01CA234319), an entity of the National Institutes of Health (NIH). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH, 5 For the Fight, V Foundation for Cancer Research, Huntsman Cancer Institute, the Huntsman Cancer Foundation, the Medical College of Wisconsin, or the University of Utah. The authors report no other financial disclosures. The research team extends gratitude to the participants who made the study possible as well as to Eleanor Mayfield, ELS, for editorial assistance. The data reported in this study are available from the corresponding author upon reasonable request. This project was partly supported by the Health Studies Fund, Department of Family and Preventive Medicine, University of Utah; 5 For the Fight; Huntsman Cancer Institute; the V Foundation for Cancer Research; the Medical College of Wisconsin; and the National Cancer Institute (Grant K01CA234319), an entity of the National Institutes of Health (NIH). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH, 5 For the Fight, V Foundation for Cancer Research, Huntsman Cancer Institute, the Huntsman Cancer Foundation, the Medical College of Wisconsin, or the University of Utah. Department of Family and Preventive Medicine, University of Utah School of Medicine, 5 for the Fight, Huntsman Cancer Institute, V Foundation for Cancer Research,Medical College of Wisconsin, Division of Cancer Prevention, National Cancer Institute, K01CA234319.

Funders	Funder number
Department of Family and Preventive Medicine, University of Utah
Health Studies Fund
National Institutes of Health (NIH)
National Childhood Cancer Registry – National Cancer Institute	K01CA234319
V Foundation for Cancer Research
University of Utah
Medical College of Wisconsin
Huntsman Cancer Foundation
Huntsman Cancer Institute, University of Utah

Keywords

Early detection of cancer
Health behavior
Income
Men’s health
Socioeconomic factors

ASJC Scopus subject areas

Oncology
Cancer Research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s10552-023-01713-y

Cite this

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title = "Perceived economic pressure and colorectal cancer-related perceptions among U.S. males (aged 45–75)",

abstract = "Purpose: To examine whether a greater perception of economic pressure would be associated with more-negative attitudes, greater perceived barriers, and lower subjective norms regarding colorectal cancer (CRC) and CRC screening among males aged 45–75 years. Methods: We recruited 492 self-identified males aged 45–75 years living in the United States. We operationalized perceived economic pressure as a latent factor with three subscales: can{\textquoteright}t make ends meet, unmet material needs, and financial cutbacks . Our dependent variables were attitudes toward CRC and CRC screening, perceived barriers to completing a CRC screening exam, and subjective norms regarding CRC screening (e.g., how others value CRC screening). We tested a hypothesized model using structural equation modeling with maximum-likelihood estimation, adjusting for covariates, and made post-hoc modifications to improve model fit. Results: Greater perceived economic pressure was associated with more-negative attitudes toward CRC and CRC screening (β = 0.47, 95\% CI: 0.37,0.57) and with greater perceived barriers to CRC screening (β = 0.22, 95\% CI: 0.11, 0.34), but was not significantly associated with subjective norms (β = 0.07, 95\% CI: − 0.05, 0.19). Perceived economic pressure was an indirect pathway by which lower-income and younger age were associated with more-negative attitudes and greater perceived barriers. Conclusions: Our study is one of the first to show that, among males, perceived economic pressure is associated with two social-cognitive mechanisms (i.e., negative attitudes, greater perceived barriers) that are known to influence CRC screening intent and, ultimately, CRC screening completion. Future research on this topic should employ longitudinal study designs.",

keywords = "Early detection of cancer, Health behavior, Income, Men{\textquoteright}s health, Socioeconomic factors",

author = "Korous, \{Kevin M.\} and Ogbonnaya, \{Uchenna C.\} and \{De Vera\}, \{Mary A.\} and Ellen Brooks and Moore, \{Justin X.\} and Rogers, \{Charles R.\}",

note = "Publisher Copyright: {\textcopyright} 2023, The Author(s), under exclusive licence to Springer Nature Switzerland AG.",

year = "2023",

month = sep,

doi = "10.1007/s10552-023-01713-y",

language = "English",

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T1 - Perceived economic pressure and colorectal cancer-related perceptions among U.S. males (aged 45–75)

AU - Korous, Kevin M.

AU - Ogbonnaya, Uchenna C.

AU - De Vera, Mary A.

AU - Brooks, Ellen

AU - Moore, Justin X.

AU - Rogers, Charles R.

PY - 2023/9

Y1 - 2023/9

N2 - Purpose: To examine whether a greater perception of economic pressure would be associated with more-negative attitudes, greater perceived barriers, and lower subjective norms regarding colorectal cancer (CRC) and CRC screening among males aged 45–75 years. Methods: We recruited 492 self-identified males aged 45–75 years living in the United States. We operationalized perceived economic pressure as a latent factor with three subscales: can’t make ends meet, unmet material needs, and financial cutbacks . Our dependent variables were attitudes toward CRC and CRC screening, perceived barriers to completing a CRC screening exam, and subjective norms regarding CRC screening (e.g., how others value CRC screening). We tested a hypothesized model using structural equation modeling with maximum-likelihood estimation, adjusting for covariates, and made post-hoc modifications to improve model fit. Results: Greater perceived economic pressure was associated with more-negative attitudes toward CRC and CRC screening (β = 0.47, 95% CI: 0.37,0.57) and with greater perceived barriers to CRC screening (β = 0.22, 95% CI: 0.11, 0.34), but was not significantly associated with subjective norms (β = 0.07, 95% CI: − 0.05, 0.19). Perceived economic pressure was an indirect pathway by which lower-income and younger age were associated with more-negative attitudes and greater perceived barriers. Conclusions: Our study is one of the first to show that, among males, perceived economic pressure is associated with two social-cognitive mechanisms (i.e., negative attitudes, greater perceived barriers) that are known to influence CRC screening intent and, ultimately, CRC screening completion. Future research on this topic should employ longitudinal study designs.

AB - Purpose: To examine whether a greater perception of economic pressure would be associated with more-negative attitudes, greater perceived barriers, and lower subjective norms regarding colorectal cancer (CRC) and CRC screening among males aged 45–75 years. Methods: We recruited 492 self-identified males aged 45–75 years living in the United States. We operationalized perceived economic pressure as a latent factor with three subscales: can’t make ends meet, unmet material needs, and financial cutbacks . Our dependent variables were attitudes toward CRC and CRC screening, perceived barriers to completing a CRC screening exam, and subjective norms regarding CRC screening (e.g., how others value CRC screening). We tested a hypothesized model using structural equation modeling with maximum-likelihood estimation, adjusting for covariates, and made post-hoc modifications to improve model fit. Results: Greater perceived economic pressure was associated with more-negative attitudes toward CRC and CRC screening (β = 0.47, 95% CI: 0.37,0.57) and with greater perceived barriers to CRC screening (β = 0.22, 95% CI: 0.11, 0.34), but was not significantly associated with subjective norms (β = 0.07, 95% CI: − 0.05, 0.19). Perceived economic pressure was an indirect pathway by which lower-income and younger age were associated with more-negative attitudes and greater perceived barriers. Conclusions: Our study is one of the first to show that, among males, perceived economic pressure is associated with two social-cognitive mechanisms (i.e., negative attitudes, greater perceived barriers) that are known to influence CRC screening intent and, ultimately, CRC screening completion. Future research on this topic should employ longitudinal study designs.

KW - Early detection of cancer

KW - Health behavior

KW - Income

KW - Men’s health

KW - Socioeconomic factors

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Perceived economic pressure and colorectal cancer-related perceptions among U.S. males (aged 45–75)

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

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