Abstract A60: A paradox: Engaging in at-risk behavior may not correlate with perceived susceptibility to cancer or heart disease
Authors: Tobo Betelihem B. , Short Tonya , Osazuwa-Peters Nosayaba , Mohammed Kahee A. , Wirth Lorinette , Geneus Christian , Boakye Eric Adjei 
Published: May 2016

Abstract
Background: The Health Belief Model states that behavioral change is highly influenced by perceived susceptibility to disease. The literature shows that physical activity, nutrition, and smoking are top factors associated with heart disease and cancer. Some studies have examined factors that affect perceived susceptibility to heart disease and cancer; however, there are no studies directly comparing predictors of perceived susceptibility to cancer and heart disease.
Objective: The objective of this study was to examine shared and differing predictors of respondents' perceived susceptibility to cancer and heart disease.
Methods: Data from the Health Information National Trends Survey 4 Cycle 3 (November 2013) were analyzed for 2,508 survey participants aged 18 years and older. Binary logistic regression was used to examine behavioral and socio-demographic risk factors for heart disease and cancer to determine predictors' of perceived susceptibility to these diseases.
Results:
Behavioral predictors:
Smoking status (p = 0.4385), nutrition (p = 0.6387), and physical activity (p = 0.5889) were not significant predictors of perceived susceptibility to cancer. Similarly, smoking status (p = 0.3702), nutrition (p = 0.1583), and physical activity (p = 0.0979) were not significant predictors of perceived susceptibility to heart disease. Former and current smokers perceived low susceptibility to heart disease but high susceptibility to cancer compared to non-smokers. In addition, those who consumed less than 5 servings of fruits and vegetables weekly perceived high susceptibility to heart disease but low susceptibility to cancer, compared to respondents who consumed 5 or more servings of fruits and vegetables weekly. Moreover, those who exercised 1-4 times per week perceived high susceptibility to heart disease and cancer, compared to respondents who exercised 5-7 times per week. On the other hand, those who did not engage in any physical activity perceived low susceptibility to heart disease and cancer, compared to respondents who exercised 5-7 times per week. Yet, none of these findings were significant.
Sociodemographic predictors:
Health status (p = 0.0116) was a significant predictor of perceived risk for cancer, illustrating a dose response relationship. Compared to those who reported excellent/very good health, those who reported fair/poor health (OR: 2.0; 95% CI: 1.22, 3.45) and good health (OR: 1.5; 95% CI: 1.04, 2.13) perceived high susceptibility to cancer. Similarly, health status (p = 0.0007) was a significant predictor of perceived susceptibility to heart disease. Compared to those who reported excellent/very good health, those who reported fair/poor health (OR: 1.8; 95% CI: 1.13, 2.99) and good health (OR: 2.0; 95% CI: 1.37, 2.79) perceived high susceptibility to heart disease. Race (p = 0.0002) was a significant predictor of perceived susceptibility to cancer. Compared to White respondents, Non-Hispanic Blacks (95% CI: 0.28, 0.84), Hispanics (95% CI: 0.38, 0.90), and other races (95% CI: 0.19, 0.62) were 49%, 58%, and 34% less likely to perceive susceptibility to cancer, respectively. However, race was not statistically significant predictor of perceived risk for heart disease.
Conclusions: Despite evidence that indicates the significance of engaging in top protective factors against cancer and heart disease—not smoking, proper nutrition, and exercise—our findings show that respondents at higher risk were not significantly more likely to perceive high susceptibility to illness. Perceived susceptibility is a key component of reducing risk behaviors and increasing health promoting behaviors. These paradoxical results pose important implications for disease-specific interventions targeting health behaviors. Healthcare providers and program planners should consider these findings for optimal intervention planning and implementation.
Citation Format: Betelihem B. Tobo, Tonya Short, Nosayaba Osazuwa-Peters, Kahee A. Mohammed, Lorinette Wirth, Christian Geneus, Eric Adjei Boakye. A paradox: Engaging in at-risk behavior may not correlate with perceived susceptibility to cancer or heart disease. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr A60.