Rocio Garcia-Retamero

Background: Globally, human papillomavirus (HPV) vaccine uptake rates have declined within a wider context of vaccine hesitancy. Gender-neutral vaccine programmes are increasing and recommended for the prevention of cervical, anogenital, and oropharyngeal cancers affecting both women and men. To address the problem of suboptimal HPV uptake rates for boys and men, we aimed to understand young men’s communication needs for HPV messages in a cross-cultural analysis. Methods: Qualitative methods consisting of 14 focus group discussions were conducted with young men (18–26 years) about the HPV vaccine in three countries with varying HPV vaccine implementation policies at the time. A total of 55 participants were included from Scotland (n=14), Spain (n=25), single-gendered programmes, and the USA (n=16), gender-neutral programme. Analysis was informed by reflexive thematic analysis. Findings: Four themes were identified: (1) the ‘Girl vaccine’: primarily seen as a vaccine for girls, despite varying vaccine knowledge and awareness across contexts; (2) vaccine ambivalence: perceptions of men’s HPV risks were low and some vaccine worries were evident from US contexts; (3) altruism: a pervasive theme related to young men’s roles and responsibilities for HPV transmission within relationships; (4) trusted sources: messages from health care providers/authorities were persistently valued but direct opportunities were often absent. Conclusion: Public health messaging to increase HPV vaccination for young men should focus on direct appeal to young men’s health through specific and targeted HPV messages for cancer and sexual health benefits to increase the personal relevance of the vaccine. It should also focus on indirect appeal through incorporating messages about safe sex in relationships and for herd immunity. Healthcare providers and authorities are trusted sources of information and can influence men’s confidence for the HPV vaccine; opportunities for interactions should be optimised.

The human papillomavirus (HPV) vaccine has been shown to be an effective cancer-prevention vaccine against oncogenic types of the HPV virus implicated in cervical, anogenital, and oropharyngeal cancers. Since Covid-19, there are global suboptimal uptake rates for the HPV vaccine. In high-income countries, there are persistently lower uptake rates among boys/men and vulnerable groups despite many countries now offering the HPV vaccine to both girls and boys in gender-neutral vaccine campaigns. It is important to understand the nuances with vaccine hesitancy and qualitative research approaches can be valuable to understand rich, contextual understandings in public health communication among hard-to-reach groups. This commentary draws insights from previous literature and our own research including two studies submitted to this Special Edition on Vaccine Communication. We consider the cultural context, gender and specific hard-to-reach groups in Scotland including those with an intellectual disability, sexual minorities, and ethnically diverse groups to draw some insights. Such groups may experience taboos and stigma in various guises. It is important that public health communication in given contexts is gender-inclusive and can incorporate messages that reach vulnerable groups. Cancer prevention communication delivered by trusted healthcare providers and community leaders are important strategies to deliver trusted messages.

Background Individuals with cancer often experience stress throughout the cancer trajectory and have a high risk of experiencing depression.Objective The aim of this study was to examine the relationship between allostatic load (AL), a measure of cumulative stress-related physiologic dysregulation of different body systems, and symptoms of depression in cancer survivors.Methods Participants were 294 adult cancer survivors from the US National Health and Nutrition Examination Survey (NHANES 2007-2018). Allostatic load was measured using 14 indicators representing cardiometabolic risk, glucose metabolism, cardiopulmonary functioning, parasympathetic functioning, and inflammation. Depressive symptoms were measured with the Patient Health Questionnaire-9. The relationship between AL and depressive symptoms was investigated using multiple regression adjusted for diverse sociodemographic and diagnosis variables.Results Higher AL was associated with higher depressive symptom scores. The higher risk of depression was concentrated among those survivors in the highest AL quartile, with 21% (95% confidence interval, 11%-32%) of survivors presenting a high risk of depression compared with 8% to 11% of survivors in the lower quartiles. In exploratory analyses, the relationship between AL and depressive symptoms was only significant among survivors with a lower income. In contrast, in survivors in the highest income group, depressive symptoms were lower and unrelated to AL.Conclusion High AL is associated with more depressive symptoms among cancer survivors.Implications for Practice Nurses have an important role in identifying psychological distress in cancer patients and survivors. Further research is needed to investigate the usefulness of AL as a marker in the context of cancer follow-up care and screening for psychological distress.

We introduce a brief instrument specifically validated for measuring positive and negative feelings about risks—the Berlin Emotional Responses to Risk Instrument (BERRI). Based on seven studies involving diverse adults from three countries (n = 2120), the BERRI was found to robustly estimate anticipatory affective reactions derived from subjective evaluations of positive (i.e., assured, hopeful, and relieved) and negative emotions (i.e., anxious, afraid, and worried). The brief BERRI outperformed a 14-item assessment, uniquely tracking costs/benefits associated with cancer screening among men and women (Studies 1 and 2). Predictive validity was further documented in paradigmatic risky choice studies wherein options varied over probabilities and severities across six contexts (health, social, financial, technological, ethical, and environmental; Study 3). Studies 4–6, conducted during the Ebola epidemic and COVID-19 pandemic, indicated BERRI responses were sensitive to subtle effects caused by emotion-related framing manipulations presented in different cultures and languages (the United States, Spain, and Poland). Study 7 indicated BERRI responses remained stable for 2 weeks. Although the BERRI can provide an estimate of overall affect, choices were generally better explained by the unique influences of positive and negative affect. Overall, results suggest the novel, brief instrument can be an efficient tool for high-stakes research on decision making and risk communication.

We investigated what factors may foster or hinder physicians’ cancer screening risk literacy–specifically the ability to understand evidence regarding screening effectiveness and make evidence-based recommendations to patients. In an experiment, physicians in training (interns and residents) read statistical information about outcomes from screening for cancer, and had to decide whether to recommend it to a patient. We manipulated the effectiveness of the screening (effective vs. ineffective at reducing mortality) and the demand of the patient to get screened (demand vs. no demand). We assessed participants’ comprehension of the presented evidence and recommendation to the patient, as well as a-priori screening beliefs (e.g., that screening is always a good choice), numeracy, science literacy, knowledge of screening statistics, statistical education, and demographics. Stronger positive a-priori screening beliefs, lower knowledge of screening statistics, and lower numeracy were related to worse comprehension of the evidence. Physicians recommended against the ineffective screening but only if they showed good comprehension of the evidence. Physicians’ recommendations were further based on the perceived benefits from screening but not on perceived harms, nor the patient’s demands. The current study demonstrates that comprehension of cancer screening statistics and the ability to infer the potential benefits for patients are essential for evidence-based recommendations. However, strong beliefs in favor of screening fostered by promotion campaigns may influence how physicians evaluate evidence about specific screenings. Fostering physician numeracy skills could help counteract such biases and provide evidence-based recommendations to patients.

Autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are the most prevalent neurodevelopmental disorders. There is a growing body of literature investigating factors affecting quality of life in families (FQoL) with a child with these disorders. However, there are no studies that trace their knowledge anatomy. Thus, we conducted a scientometric analysis to describe this literature, detect certain variables that could be related to FQoL, and identify tendencies and open questions for future research. A literature search in the Web of Science, PubMed, and Scopus was run and identified 3281 publications published between 1975 and 2022. The results suggest an increase in the quantity of publications on FQoL in ASD and ADHD over the last few years (14% and 12%, respectively). For both research fields, the USA published the highest number of documents, showing that the production related to ADHD and FQoL is concentrated in just a few countries. Thematic analysis revealed several clusters, considering quality of life and children as core themes that are still setting trend lines. Moreover, it would be worthwhile to describe and analyze FQoL not only during the childhood of children with ASD and ADHD but also during their adolescence. Impact Although the relationship between family quality of life and neurodevelopmental disorders could be considered novel, there is a growing interest from an interdisciplinary perspective. Family quality of life should be monitored not only during the childhood of children with ASD and ADHD, but also during their adolescence and adulthood. The analysis of the family quality of life in first-degree relatives and its relationship with protective factors (e.g., resilience and social support) should be explored in future studies.

Many adult cancer patients present one or more physical comorbidities. Besides interfering with treatment and prognosis, physical comorbidities could also increase the already heightened psychological risk of cancer patients. To test this possibility, we investigated the relationship between physical comorbidities with depression symptoms in a sample of 2073 adult cancer survivors drawn from the nationally representative National Health and Nutrition Examination Survey (NHANES) (2007–2018) in the U.S. Based on information regarding 16 chronic conditions, the number of comorbidities diagnosed before and after the cancer diagnosis was calculated. The number of comorbidities present at the moment of cancer diagnosis was significantly related to depression risk in recent but not in long-term survivors. Recent survivors who suffered multimorbidity had 3.48 (95% CI 1.26–9.55) times the odds of reporting significant depressive symptoms up to 5 years after the cancer diagnosis. The effect of comorbidities was strongest among survivors of breast cancer. The comorbidities with strongest influence on depression risk were stroke, kidney disease, hypertension, obesity, asthma, and arthritis. Information about comorbidities is usually readily available and could be useful in streamlining depression screening or targeting prevention efforts in cancer patients and survivors. A multidimensional model of the interaction between cancer and other physical comorbidities on mental health is proposed.

The evolution of societal gender roles over time changes perceptions about the characteristics of men and women and how they behave. Previous studies on the dynamics of gender stereotypes have investigated people’s perceptions about men and women at specific time points (i.e., thinking in the past, present and future). However, studies comparing results of present perceptions of men and women measured at a lapse of time could clarify whether there have been real changes in gender stereotypes or just a desired perception for change. In the current research, we investigate whether perceptions about gender stereotypes evolve over time by comparing 453 Spanish participants’ perceptions of men and women over a 10-year period based on data collected at two time points: 2006 (n = 199) and 2016 (n = 254). In line with the conclusions of previous research, our results indicate that perceptions of gender stereotypes evolved over time from 2006 to 2016. Interestingly, over 10 years, men and women are perceived to be more similar on feminine characteristics but diverge on masculine characteristics. We discuss the dynamic of stereotypes in light of social constraints that may influence gender characteristics adscription.

Aims: Physical and psychiatric comorbidities are common in cancer patients and could impact their treatment and prognosis. However, the evidence base regarding the influence of comorbidities in the management and health service use of patients is still scant. In this research we investigated how physical comorbidities are related to the mental health and help‐seeking of cancer patients.Methods: Data were obtained from the representative National Health Survey of Spain (2017). Participants were respondents who reported a cancer diagnosis (n = 484). These were also matched with controls without cancer history (n = 484) based on age, gender, and region. Four alternative physical comorbidities indices were created based on information regarding 28 chronic conditions. Outcomes of interest were psychological distress and having consulted a mental healthcare professional in the year before the survey.Results: Thirty percent of cancer patients reported significant psychological distress but only 10% had consulted a professional. After adjusting for sociodemographic variables, among cancer patients each additional comorbidity was associated with 9% higher odds of reporting high psychological distress (odds ratio [OR] = 1.09, 95% confidence interval [CI]: 1.01–1.16) and 21% higher odds of having consulted a mental healthcare professional (OR = 1.21, 95% CI: 1.09–1.34). The effects of comorbidities depended on the type of index and were different in controls without cancer history.Conclusion: Physical comorbidities in cancer patients are associated with higher risk of psychological distress and higher demand for mental health services. We encourage further research on this issue as it could improve mental health screening and management in oncologic care.