Faculty Publications

As the number of cancer survivors increases, the assessment and intervention for smoking among survivors are increasingly important. This study examined the extent to which cancer survivors reported being asked and advised about smoking by health-care providers and their use of smoking cessation treatments during quit attempts. The data were drawn from the 2005 National Health Interview Survey, an annual health survey of US adults. The participants were 1,825 individuals who reported being diagnosed with cancer at least 1 year previously and provided data regarding their current smoking status. Participants completed items assessing demographics, health and health-care factors, and smoking-related variables. More than three-quarters of participants (81.0%) reported that their smoking status was known by a health-care provider. Among current smokers (17.6%) who visited a health-care provider in the past year, 72.2% reported being advised to quit smoking by a provider. Factors associated with a higher rate of receiving advice to quit included greater cigarette consumption (P=0.008), more medical comorbidities (P= 0.001), high psychological distress (P= 0.003), and lack of health-care insurance (P = 0.03). Among current smokers who tried to quit in the last year, 33.5% used pharmacotherapy cessation treatment and 3.8% used an evidence-based behavioral treatment. This study reveals considerable missed opportunities for health-care providers to advise cancer survivors about smoking and provide evidence-based interventions. Systematic efforts are needed to increase the provision of smoking cessation advice and use of cessation treatments among cancer survivors.

Reviews the book, Helping couples cope with women's cancers: An evidence-based approach for practitioners by Karen Kayser and Jennifer L. Scott (see record 2007-13775-000). This book is a guide that describes an approach to working with couples who are dealing with early stage breast or gynecological cancers. Overall, this book is a useful resource for clinicians working with women coping with breast or gynecological cancers. There are few couple-focused psychological interventions for cancer patients, and this book will serve as a helpful guide for clinicians working with this patient population. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Introduction: The diagnosis and subsequent treatment for early stage breast cancer is stressful for partners. Little is known about the role of cognitive and social processes predicting the longitudinal course of partners' psychosocial adaptation. This study evaluated the role of cognitive and social processing in partner psychological adaptation to early stage breast cancer, evaluating both main and moderator effect models. Moderating effects for meaning making, acceptance, and positive reappraisal on the predictive association of searching for meaning, emotional processing, and emotional expression on partner psychological distress were examined. Materials and methods: Partners of women diagnosed with early stage breast cancer were evaluated shortly after the ill partner's diagnosis (N = 253), 9 (N = 167), and 18 months (N = 149) later. Partners completed measures of emotional expression, emotional processing, acceptance, meaning making, and general and cancer-specific distress at all time points. Results: Lower satisfaction with partner support predicted greater global distress, and greater use of positive reappraisal was associated with greater distress. The predicted moderator effects for found meaning on the associations between the search for meaning and cancer-specific distress were found and similar moderating effects for positive reappraisal on the associations between emotional expression and global distress and for acceptance on the association between emotional processing and cancer-specific distress were found. Conclusions: Results indicate several cognitive-social processes directly predict partner distress. However, moderator effect models in which the effects of partners' processing depends upon whether these efforts result in changes in perceptions of the cancer experience may add to the understanding of partners' adaptation to cancer. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (journal abstract).

Although first-degree relatives of colorectal cancer (CRC) patients diagnosed at an early age are at increased risk for CRC, their compliance with colorectal cancer screening (CRCS) is not high. Relatively little is known about why these intermediate-risk family members do not comply with CRCS. Study aims were to identify subgroups of siblings of individuals diagnosed with CRC prior to age 61 who were not compliant with CRCS using cluster analysis and to identify demographical, medical and attitudinal correlates of cluster membership. A total of 421 siblings completed measures of pros, cons, processes of change, CRCS knowledge, physician and family CRCS support, CRC risk, severity, preventability, curability, closeness with the affected sibling, distress about the sibling's cancer and screening intentions. Three clusters characterized as 'Positive about Screening', 'Uncertain about Screening' and 'Negative about Screening' were identified. External validation revealed that those in the Positive about Screening cluster reported significantly stronger CRCS intentions than those who are Uncertain about Screening and Negative about Screening clusters. Results provide an empirical typology for understanding motivations for CRCS among at-risk family members and may lead to the development of more effective interventions to improve screening uptake. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (journal abstract).

BACKGROUND: The incidence of all types of skin cancer has increased over the past 3 decades in the United States. Increased skin cancer risk is associated with exposure to ultraviolet radiation. This study examined the age-stratified prevalence and correlates of multiple skin cancer risk behaviors (infrequent use of sun-protective clothing, staying in the sun when outside on a sunny day, infrequent use of sunscreen, indoor tanning, and receiving a sunburn) among U.S. adults. METHODS: 28,235 adults participating in the 2005 National Health Interview Survey (NHIS) answered questions regarding sun-protection behaviors, indoor tanning in the past year, and sunburns in the past year. Examined correlates included geographic location, demographics, healthcare access, BMI, physical activity, smoking, alcohol use, melanoma family history, perceived cancer risk, skin sensitivity to the sun, and receipt of a total skin exam. RESULTS: The most commonly reported skin cancer risk behaviors were infrequent use of sun-protective clothing and infrequent use of sunscreen. The majority of individuals reported multiple skin cancer risk behaviors. Although significant correlates varied according to age, individuals reporting more risk behaviors were more likely younger, residing in the Midwest, male, non-Hispanic white, less-educated, smokers, risky drinkers, and had skin that was less sun-sensitive. CONCLUSIONS: The majority of the U.S. population engage in multiple skin cancer risk behaviors. A comprehensive approach to skin cancer prevention requires attention to multiple skin cancer risk behaviors that are common in the U.S. population.

The authors highlighted the importance of viewing cancer from a relationship perspective. This perspective not only considers the marital relationship as a resource that individual partners draw upon but also highlights the importance of focusing attention onto the relationship and engaging in communication behaviors aimed at sustaining and/or enhancing the relationship during stressful times. On the basis of existing conceptualizations, empiric research on couples and cancer, and the authors' perspective on the literature, they formulated the relationship intimacy model of couples' psychosocial adaptation to cancer as a first step toward building a framework for researchers and clinicians to inform their work in this area. The model proposes that patients and their partners engage in behaviors that either promote or undermine the level of closeness in their relationship and that the closeness of the marital relationship is an important determinant of patient and partner psychologic adaptation to cancer. Preliminary data from a couples' intimacy-enhancing intervention for breast cancer patients and their partners supported the model. Of the 25 couples who consented to participate in the intervention and completed the preintervention surveys, 15 couples completed all 5 sessions, and 12 couples completed the follow-up survey. The current results suggested that the intervention improved patient and partner perceptions of the closeness of their relationship and reduced their distress. The authors also discuss limitations of the relationship intimacy model as well as future directions for empiric and clinical research on couples' psychosocial adaptation to cancer. (PsycINFO Database Record (c) 2009 APA, all rights reserved) (journal abstract).

Objectives: The purpose of this study was to explore the association of meaning-making with psychological adjustment to bereavement among mothers of children who had undergone haematopoietic stem cell transplantation (HSCT). Design: A prospective research design was used. Regression analyses were conducted to determine the relations between pre-bereavement variables (distress, searching for meaning, and finding meaning) and distress post-bereavement. Methods: Thirty-five mothers of children who had undergone HSCT were interviewed at the time of their child's HSCT and 3 months post-bereavement. Results: Mothers who reported searching for meaning at HSCT reported greater post-bereavement distress, and mothers who reported finding meaning at HSCT reported less post-bereavement distress. Distress at HSCT and the number of days between the time of death and the post-bereavement time point were also found to be significant predictors of post-bereavement distress. Conclusions: This study provides partial support for the role of meaning in adjustment to loss. (PsycINFO Database Record (c) 2008 APA, all rights reserved) (journal abstract).

The authors highlighted the importance of viewing cancer from a relationship perspective. This perspective not only considers the marital relationship as a resource that individual partners draw upon but also highlights the importance of focusing attention onto the relationship and engaging in communication behaviors aimed at sustaining and/or enhancing the relationship during stressful times. On the basis of existing conceptualizations, empiric research on couples and cancer, and the authors' perspective on the literature, they formulated the relationship intimacy model of couples' psychosocial adaptation to cancer as a first step toward building a framework for researchers and clinicians to inform their work in this area. The model proposes that patients and their partners engage in behaviors that either promote or undermine the level of closeness in their relationship and that the closeness of the marital relationship is an important determinant of patient and partner !

(from the cover) Early stage breast cancer can be stressful and upsetting for both the woman dealing with the disease and her partner. This illness can also place a strain on a couple's relationship. However, couples who are able to provide effective support to one another are more likely to adapt well. Focusing on the couple as a unit can promote effective coping for both patients and their partners. This couples-focused group program aims to improve a couple's functioning as a "team" and provides a supportive environment for couples facing similar breast cancer-related issues. Over the course of six sessions, couples learn support and communication skills, as well as techniques to manage stress and enhance intimacy. Modeling by group leaders and other couples facilitates skill acquisition. With continued use, the skills learned in group can have long-term benefits for couples. I his guide, along with the corresponding workbook, provides all the information needed to implement this group program. It contains step-by-step instructions for running the group, as well as sample group leader dialogues, in-session activities, and homework assignments. The couple's workbook is designed to be shared by both partners as they work together through the program. By the end of the six weeks, couples will be better equipped as a team to cope with the stresses of cancer and the challenges that may lie ahead. (PsycINFO Database Record (c) 2009 APA, all rights reserved)

(from the cover) Early stage breast cancer can be stressful and upsetting for both the woman dealing with the disease and her partner. This illness can also place a strain on a couple's relationship. However, couples who are able to provide effective support to one another are more likely to adapt well. Focusing on the couple as a unit can promote effective coping for both patients and their partners. This couples-focused group program aims to improve a couple's functioning as a "team" and provides a supportive environment for couples facing similar breast cancer-related issues. Over the course of six sessions, couples learn support and communication skills, as well as techniques to manage stress and enhance intimacy. Modeling by group leaders and other couples facilitates skill acquisition. With continued use, the skills learned in group can have long-term benefits for couples. I his guide, along with the corresponding workbook, provides all the information needed to implement this group program. It contains step-by-step instructions for running the group, as well as sample group leader dialogues, in-session activities, and homework assignments. The couple's workbook is designed to be shared by both partners as they work together through the program. By the end of the six weeks, couples will be better equipped as a team to cope with the stresses of cancer and the challenges that may lie ahead. (PsycINFO Database Record (c) 2009 APA, all rights reserved)

The authors evaluated mechanisms of change for a coping and communication-enhancing intervention (CCI) and supportive counseling (SC). They proposed that the effects of CCI on depressive symptoms would be mediated by psychological processes targeted by CCI, namely increases in the following: positive reappraisal, acceptance, planful problem solving, attempts to understand emotional reactions to cancer, emotional expression, seeking of emotional and instrumental support, and self-esteem. The authors hypothesized that the effects of SC on depressive symptoms would be mediated by the processes encouraged by SC, in this case increases in the following: expression of emotions, attempts to understand emotional reactions to cancer, and self-esteem. Three hundred fifty-three women were randomized to a CCI, SC, or usual care control group and completed measures at preintervention and 3, 6, and 9 months later. The effects of CCI were fully mediated by positive reappraisal, problem solving, and self-esteem and partially mediated by emotional expression. The effects of SC were partially mediated by positive reappraisal. These findings provide support for hypothesized mediators for CCI. The authors were less able to identify mediators for SC. Future research might benefit from identifying SC mediators. (PsycINFO Database Record (c) 2008 APA, all rights reserved) (journal abstract).

Background: The incidence of all types of skin cancer has increased over the past 3 decades in the United States. Increased skin cancer risk is associated with exposure to ultraviolet radiation. This study examined the age-stratified prevalence and correlates of multiple skin cancer risk behaviors (infrequent use of sun-protective clothing, staying in the sun when outside on a sunny day, infrequent use of sunscreen, indoor tanning, and receiving a sunburn) among U.S. adults. Methods: 28,235 adults participating in the 2005 National Health Interview Survey (NHIS) answered questions regarding sun-protection behaviors, indoor tanning in the past year, and sunburns in the past year. Examined correlates included geographic location, demographics, healthcare access, BMI, physical activity, smoking, alcohol use, melanoma family history, perceived cancer risk, skin sensitivity to the sun, and receipt of a total skin exam. Results: The most commonly reported skin cancer risk behaviors were infrequent use of sun-protective clothing and infrequent use of sunscreen. The majority of individuals reported multiple skin cancer risk behaviors. Although significant correlates varied according to age, individuals reporting more risk behaviors were more likely younger, residing in the Midwest, male, non-Hispanic white, less-educated, smokers, risky drinkers, and had skin that was less sun-sensitive. Conclusions: The majority of the U.S. population engage in multiple skin cancer risk behaviors. A comprehensive approach to skin cancer prevention requires attention to multiple skin cancer risk behaviors that are common in the U.S. population.

For individuals meeting Bethesda criteria for hereditary nonpolyposis colorectal cancer syndrome, the microsatellite instability (MSI) test is recommended as a screening evaluation before proceeding to genetic testing. The MSI test is new to the medical setting, but will be increasingly used to screen patients at high risk for hereditary nonpolyposis colorectal cancer. The main goals of this study were to examine knowledge about and exposure to the MSI test among individuals considering the test, to evaluate perceived benefits and barriers to undergoing the MSI test, and to identify the demographic, medical, and psychosocial correlates of the perceived benefits and barriers to undergoing the test. One hundred and twenty-five patients completed a survey after being offered the test, but prior to making the decision whether to pursue MSI testing. Results indicated low levels of knowledge about and previous exposure to the MSI test. Participants held positive attitudes about!