Showing papers by "Stephen Sutton published in 2004"
TL;DR: Meta-analysis of controlled trials showed that genetic counseling for familial cancer is associated with improvement in knowledge but does not have an adverse effect on affective outcomes.
Abstract: Background: Identification of a genetic basis underlying certain types of cancer has led to an increase in demand for genetic counseling about individual risks of the disease. We conducted a systematic review of the literature to determine the quality and strength of evidence relating to psychological outcomes of genetic counseling for familial cancer. Methods: Six electronic databases were searched to identify controlled trials and prospective studies that examined the effect of genetic counseling on risk perception, knowledge, anxiety, cancer-specific worry, depression, and cancer surveillance. Twenty-one studies from 25 papers met inclusion criteria, including five controlled trials and 16 prospective studies. Analysis of each outcome was stratified by short-term (≤1 month) and long-term (≥3 months) follow-up. Trial evidence was assessed with standardized differences of the means at follow-up between intervention and comparison groups, and these data were pooled by use of random-effects meta-analysis. Results: Meta-analysis of controlled trials showed that genetic counseling improved knowledge of cancer genetics (pooled short-term difference = 0.70 U, 95% confidence interval [CI] = 0.15 to 1.26 U) but did not alter the level of perceived risk (pooled short-term difference = -0.10 U, 95% CI = -0.23 to 0.04 U). Prospective studies reported improvements in the accuracy of perceived risk. No effect was observed in controlled trials on general anxiety (pooled long-term effect = 0.05 U, 95% CI = -0.21 to 0.31 U) or cancer-specific worry (pooled long-term difference = -0.14 U, 95% CI = -0.35 to 0.06 U), although several prospective studies demonstrated short-term reductions in these outcomes. Few studies examined cancer surveillance behaviors, and no studies attempted to measure informed choice. Conclusions: Genetic counseling for familial cancer is associated with improvement in knowledge but does not have an adverse effect on affective outcomes. We urge further investigation of these findings through well-designed, well-reported, randomized controlled trials with suitable comparison groups and additional outcome measures.
164 citations
Book•
18 Nov 2004
TL;DR: This book discusses the role of emotion, self-regulation, and intervention in the development of healthy emotions in the context of health-related illness and its consequences.
Abstract: Editors' Preface - Stephen Sutton, Andrew Baum and Marie Johnston Context and Perspectives in Health Psychology - Edward P Sarafino Epidemiology of Health and Illness - Reiner Rugulies, Birgit Aust and S Leonard Syme A Socio-Psycho-Physiological Perspective Biological Mechanisms of Health and Disease - Brent N Henderson and Andrew Baum Determinants of Health-Related Behaviours - Stephen Sutton Theoretical and Methodological Issues Health-Related Cognitions - Keith J Petrie and James W Pennebaker Individual differences, Health and Illness - Richard J Contrada and Tanya M Goyal The Role of Emotional Traits and Generalized Expectancies Stress, Health and Illness - Andrew Steptoe and Susan Ayers Living with Chronic Illness - Howard Leventhal et al A Contextualized, Self-Regulation Approach Lifespan, Gender and Cross-Cultural Perspectives in Health Psychology - Simon Murphy and Paul Bennett Communicating about Health Threats and Treatments - Theresa M Marteau and John Weinman Applications in Health Psychology - Stan Maes and Sandra N Boersma How Effective are Interventions? Research Methods in Health Psychology - David P French, Lucy Yardley and Stephen Sutton Assessment and Measurement in Health Psychology - Marie Johnston et al Professional Issues in Health Psychology - Cynthia D Belar and Teresa McIntyre
137 citations
TL;DR: The results suggest that the SRM provides a useful framework to explore the psychological response to genetic risk and further research is required in this population to examine illness perceptions in more detail, validate quantitative measures of illness perceptions, and examine interactions between risk perception and theSRM constructs.
Abstract: Variation in the levels of distress in women at increased risk of breast cancer has been reported, yet there is limited understanding of the factors that are associated with heightened distress in this population. This study took a theoretical approach using Leventhal's Self Regulatory Model (SRM) to understand variation in distress levels. The study examined the associations between perceptions of breast cancer and distress in women at increased risk of breast cancer, and a comparison sample with no experience of the disease in their social environment. Questionnaire data from 117 women at increased risk of breast cancer and 100 comparison women were analysed. Women at increased risk of breast cancer showed comparable levels of general distress but significantly higher levels of cancer specific distress than the comparison group. There were few differences in illness perceptions between the samples, although a number of cognitive perceptions of breast cancer were related to both general and cancer specif...
90 citations
TL;DR: ProActive is the first efficacy trial of an intervention programme to promote physical activity in a defined high-risk group accessible through primary care, based on psychological theory and evidence.
Abstract: Background
Increasing prevalence of obesity and disorders associated with sedentary living constitute a major global public health problem. While previous evaluations of interventions to increase physical activity have involved communities or individuals with established disease, less attention has been given to interventions for individuals at risk of disease.
83 citations
TL;DR: In this paper, the extent to which anglers were willing to make substitution decisions when constrained, and identify explanatory variables for substitution decisions, was found to be negatively related to age, positively related to years of education, and was greater for males than females.
Abstract: The authors wanted to know the extent to which anglers were willing to make substitution decisions when constrained, and identify explanatory variables for substitution decisions. Anglers were asked if there were other outdoor recreation activities that would provide them with the same satisfaction and enjoyment they received from fishing. About 51% said yes. The most frequently identified substitutes were hunting and golf for males and camping and swimming for females. Logistic regression was used to determine the effects of hypothesized demographic and fishing participation variables on the binary yes/no response variable. Willingness to substitute was negatively related to age, positively related to years of education, and was greater for males than females. Willingness to substitute was negatively related to the importance placed on fishing and the importance placed on challenge-oriented experiences, and positively related to overall satisfaction with the activity. Odds ratio multipliers revealed that...
72 citations
TL;DR: It is found that both personal and social comparison risk information have emotional and cognitive consequences and that the perceived clarity of the information may account for the different patterns of findings in the literature.
Abstract: Objectives: To examine the emotional and cognitive impact of personal and social comparison information about health risk. Methods: A total of 970 adults responded to vignettes describing risk presentation scenarios that varied in terms of having (a) a ‘real world’ analogue (cardiac event) versus no such analogue (a fictitious pancreatic disease) condition, (b) high versus low levels of personal risk, and (c) no comparison group information given, comparison group risk higher or lower than own risk. Results: For both the cardiac and pancreatic disease vignettes, respondents’ emotional responses and estimates of their own risk were influenced by both personal and social comparison risk information. The cardiac event vignettes produced larger effects than the pancreatic disease vignettes. Unfavourable social comparison information had no discernible impact, relative to not providing any social comparison information. Favourable social comparison information resulted in greater reassurance, less worry, and perceptions of lower susceptibility. Lower personal risk generally produced similar effects, relative to higher personal risk. Conclusions: In contrast to previous theory and research in this area, we found that both personal and (favourable) social comparison risk information have emotional and cognitive consequences. We hypothesize that the perceived clarity of the information may account for the different patterns of findings in the literature.
37 citations
TL;DR: Investigation of participants' anticipated emotional and behavioral reactions to genetic testing for colon cancer and whether gender or clinical risk influences these reactions found most people did not anticipate strong emotional reactions but thought it would change their lifestyle and would like continued clinical surveillance whatever the result.
Abstract: Genetic testing for cancer susceptibility (e.g. hereditary non-polyposis colorectal cancer) is available for some families with a history of colon cancer. Our aim was to investigate participants' anticipated emotional and behavioral reactions to genetic testing for colon cancer and whether gender or clinical risk influences these reactions. 437 asymptomatic participants with a colorectal cancer family history completed a questionnaire about anticipated emotions and actions, under different genetic testing scenarios. More women than men anticipated feeling worried, regretful, and angry if tested positive. People at lower-risk anticipated more surprise and disbelief than those at higher-risk. People anticipated feeling more guilt, regret and less relief if they were not tested than if they were. High-risk results were anticipated to increase depression and worry. Most people still wanted screening if at low risk, anticipated leading healthier lifestyles whatever the result, but would make more plans for the future if they were at high risk. Clinical implications are that as anticipated emotional effects of not being tested may be more severe than having a test, people choosing to forgo testing should feel able to reconsider their decision anytime. Most people did not anticipate strong emotional reactions but thought it would change their lifestyle and would like continued clinical surveillance whatever the result.
21 citations
TL;DR: For example, the authors found that scales with relatively few points (here a 9-point scale) yield sub-additive interactions and that these scales are not valid for perceptions of multiple risk factors.
Abstract: Some combinations of hazards yield disease rates greater than would be expected from the risk attributable to each hazard in isolation. However, perceptions are often more consistent with the combined risk being seen as less than the sum of the individual factors, raising concerns over the validity of some measures of risk perception. Here, 249 adults estimated the risk of cardiac events for four hypothetical men, described as having high or low levels of smoking and family history of heart disease. Three distinct measures were used. A 9-point scale produced a strong sub-additive interaction, a 101-point scale produced a weaker sub-additive interaction, and an unbounded scale produced no interaction. In this study, as in all previous research, scales with relatively few points (here a 9-point scale) yield sub-additive interactions. Given the consistency of results yielded by such scales, irrespective of context, it is concluded that these scales are not valid for perceptions of multiple risk factors. Copyright # 2004 John Wiley & Sons, Ltd.
15 citations
01 Jun 2004
TL;DR: A causal modelling approach to developing and evaluating theory-based interventions for randomised controlled trial evaluation provides a rational framework for development of theory- based health interventions, linked to implementation and outcome measures.
Abstract: Objectives: Few intervention studies using health-related self-regulation use theories to specify the behavioural determinants subsequently targeted by relevant behaviour change techniques, and to inform fidelity and outcome measures. The objective was to develop a causal modelling approach to developing and evaluating theory-based interventions for randomised controlled trial evaluation. Methods: Causal models link determinants of behaviour through physiological and biochemical variables to health outcomes. They specify techniques to change (determinants of) behaviour, and also measures for each level of the model. The approach was developed in two RCTs of interventions to prevent Type 2 diabetes in a high-risk group (ProActive, N=365, 30-50 years) and its consequences in people with newly diagnosed diabetes (ADDITION Plus, N=500, 40-69 years). Systematic reviews, consultations, and pilot studies informed the causal models. Results: Psychological theory and evidence informed selection of (a) behavioural determinants (intervention targets), which were derived from the Theory of Planned Behaviour and Leventhal's Self-regulation Model, (b) techniques, among others based on self-regulation principles (e.g., goal setting), and (c) psychological measures. Fidelity measures include training sessions, intervention protocols, and reliable coding frames to assess use of theory-based techniques among a random sample of participants. Epidemiological evidence informed choice of target groups, target behaviours and health outcomes, and associated measures (e.g., objectively assessed energy expenditure, modelled diabetes risk). The two studies will be used to illustrate the interrelationships between choice of theory and techniques, and measures of fidelity and outcomes. Conclusions: The causal modelling approach provides a rational framework for development of theory-based health interventions, linked to implementation and outcome measures. Challenges encountered included choice of criteria to guide theory selection, and the gap between theory and practicalities of intervention delivery.
1 citations