Recent developments in cancer research, molecular biology, and genetics provide promising new avenues for preventing and controlling cancer. Nevertheless, many lives are still lost unnecessarily every year to certain cancers that could have been prevented or controlled. The goal of our research is to make cancer prevention-control programs more effective by identifying the distinctive ways in which individuals make decisions, adjust to risk information, and carry out recommended screening, treatment, and follow-up regimens. Our efforts focus on the application of assessments and interventions that are specifically tailored to individual differences among patients. Toward this end, we have been conducting a series of interrelated projects to provide a systematic and comprehensive exploration of the psychosocial-biobehavioral links that underlie adaptive responses, across the spectrum of cancer risk and disease. The studies in our program are all conceptually derived from our integrative theory-based framework, the Cognitive-Social Health Information Processing (C-SHIP) model. This model addresses how different types of individuals process information about cancer threats and prevention-control options. The C-SHIP model recognizes that behavior is influenced by the individual's perceived vulnerability, self-efficacy expectations, health values and goals, emotions, and coping strategies, as well as by aspects of the cancer threat, such as its probability and curability. These factors need to be taken into account when designing assessments and interventions to facilitate complex decision-making, and to enhance long-term adherence and adjustment to medical recommendations and follow-up.
In particular, we have identified two main styles of processing cancer risk feedback. Conceptually, we distinguish between monitors, who look for and amplify threat-related cues, and blunters, who distract from such cues and minimize their impact. Our work identifies the ways in which monitors and blunters differ in how they cope with cancer risk and disease information, and in how they respond to psychosocial interventions designed to facilitate health protective decisions and behaviors. Towards this end, we have devised and validated the Monitor-Blunter Style Scale to distinguish between these patterns of response. This approach enables us to develop and evaluate the efficacy of tailored interventions, which are designed to help monitors versus blunters overcome the distinctive cognitive, emotional, and practical barriers that undermine this use of cancer prevention-control regimens.
We are currently exploring decision-making, adherence to recommended routine and innovative regimens, adjustment to cancer feedback, and biobehavioral linkages, from cancer risk through survivorship. The studies share a common focus on populations with a critical need for cancer prevention-control services, such as individuals with a family history of cancer, individuals from traditionally underserved groups, and individuals dealing with treatment and management regimens. Our ongoing work focuses on genetic and biomarker risk feedback (breast/ovarian, prostate, and lung cancer), biobehavioral factors, cervical cancer risk, tobacco control, cancer prevention and control outreach efforts, decision making and quality of life in high-risk groups and early stage disease, and survivorship concerns.