Daniela Lemmo

Cancer screening programs constitute fundamental public health tools, contributing substantially to the reduction of cancer incidence, mortality, and disease severity through early diagnosis and ti...

Background: This study investigates clinical psychological factors associated with colorectal cancer (CRC) screening participation, with a specific focus on intention–behavior configurations within the intention–behavior gap framework. Objective: From a mind–body perspective, we examine how emotion regulation, health anxiety, body awareness, and narcissistic traits are associated with screening decisions and may inform future personalized strategies to support participation. Methods: A cross-sectional study was conducted with 224 adults (aged 50–81) completing an online survey assessing screening intention, behavior, and key psychological variables. Action-control profiles were created based on intention–behavior patterns, and differences were analyzed using Fisher’s exact tests and Kruskal–Wallis tests. Results: Most participants (58%) were classified as non-intenders (low intention, no screening). Successful intenders (high intention, yes behavior) showed higher cognitive reappraisal than all other profiles, with small-to-moderate effect sizes (r = 0.25–0.53). Unsuccessful intenders (high intention, no behavior) exhibited higher disease phobia (r = 0.28), suggesting anxiety-related barriers to behavioral translation. Non-intenders who nonetheless engaged in screening (low intention, yes behavior) showed higher hypochondriacal beliefs and narcissistic vulnerability (r = 0.51), possibly reflecting screening behavior driven by concerns about illness or bodily cues. Conclusion: Despite the cross-sectional design and convenience sampling that limit generalizability and prevent causal or temporal inferences, clinical psychological dimensions appear to be associated with CRC screening intention and participation. Our study attests to the importance of an integrative clinical approach that considers psychosomatic aspects, emotion regulation, health anxiety, and personality vulnerabilities to better understand ambivalence in screening behaviors. Preventive programs should address specific psychological barriers (e.g., health literacy) and foster self-care engagement. Future research should explore whether psychological factors, such as emotion regulation, health anxiety, and personality vulnerabilities, can guide the development of approaches aimed at reducing discrepancies between intention and self-reported screening behavior.

Background Despite their proven effectiveness in providing timely diagnoses and early treatments, participation in breast and cervical cancer screening remains low. Objective Given the variability of findings in the literature and the scarcity of studies that deepen understanding of emotion regulation strategies, conceptualized as a dispositional style of the individual, this study aims to examine the relationship between cancer fatalism and intention to participate in cancer screening by exploring the moderating role of emotion regulation strategies. Methods Two separate studies were conducted on large samples of Italian women: Study 1 focused on cervical screening (N = 1,493) and Study 2 on breast screening (N = 1,402). A double moderation model was then tested in both studies. Results Results for Study 1 (cervical) confirmed only a direct negative effect of fatalism on intention, with no significant moderation effects. In Study 2 (breast), however, the negative relationship between fatalism and intention was significantly buffered by cognitive reappraisal; the association was non-significant among women reporting high reappraisal. Conclusion These findings suggest that cognitive reappraisal acts as a protective buffer; however, this mechanism may be more evident in higher-salience contexts (e.g., among older women with more screening experience). Public health interventions should therefore consider promoting adaptive emotion regulation skills to improve screening uptake.

Introduction: In clinical settings, adapted physical activity (APA) is increasingly prescribed to older adults with chronic conditions, yet adherence remains low and motivational readiness varies widely at the time of prescription. While the Transtheoretical Model (TTM) describes stages of change for health behaviors, less is known about how motivational stage relates to broader psychological dimensions relevant to healthy aging, such as self-care behaviors, engagement in healthy aging promotion, and psychological distress. Methods: A cross-sectional study within the Age.it Project was conducted with 74 older adults (mean age ≈ 70.82 years) attending outpatient clinics at the University Hospital Federico II and prescribed APA. Motivational stage was assessed through the MAC2-R AF. Self-care behaviors were measured with the Self-Care Inventory; Engagement in healthy aging promotion with the EHAP-S; Psychological distress with the K10. Group differences across motivational stages were tested using Kruskal–Wallis analyses with Dunn–Bonferroni post-hoc comparisons and epsilon squared effect sizes. Results: Most participants were classified in Contemplation (59.5%), followed by Determination (23%) and Precontemplation (17.6%). No participants were in Action or Maintenance stages. Motivational stage was significantly associated with self-care monitoring, engagement, and distress, with large effects. Contemplation showed higher self-care monitoring and higher distress, alongside lower engagement. Engagement was higher in Precontemplation and Determination compared to Contemplation, whereas distress increased progressively from Precontemplation to Determination. Discussion: Findings suggest distinct, non-linear psychological configurations within the motivational stages at the time of APA prescription. Contemplation emerges as a vulnerable phase characterized by symptom surveillance and emotional burden without engagement in healthy aging promotion; Determination combines higher engagement with heightened distress; Precontemplation may reflect stable self-care routines and low distress but potential resistance to integrating exercise into self-care identity. Integrating motivational stage assessment with psychological–clinical indicators may support more personalized, motivated, and sustainable APA prescriptions for older adults.

Introduction: Digital Health Interventions (DHIs) are increasingly used to support self-care in chronic illness. The clinical utility of these technologies for health is well established, but there is limited understanding of psychological and emotional processes that sustain long-term engagement with these technologies. This qualitative study investigates how individuals with hypertension experience and attribute meaning to their engagement with digital self-monitoring tools. Methods: McCarron’s engagement model—specifically the “retain” phase—and Braun and Clarke’s reflexive thematic analysis were used to analyze 35 semi-structured interviews with adults who used ICT-enabled blood pressure monitors and smart scales. Results: In the retain phase, engagement in DHIs is characterized by 3 main themes: (1) Reassurance and Sense of Control Over Health Status through Digital Tools; (2) Engaged but Ambivalent and Anxious: The Emotional Cost of Monitoring; (3) Connected Through Data as Numbers Redefine the Therapeutic Dialog. Discussion: From the results we identified five psychological functions of engagement with digital monitoring tools, each showing both functional and non-functional or ambivalent expression. Engagement with DHIs cannot be reduced to simple observable behavior, but must be understood as a dynamic, iterative and situated process, supported by the regulatory functions in the context of self-care. Clinicians, psychologists, and designers are therefore called upon to recognize and value the psychological functions implicit in DHIs in order to promote truly sustainable, meaningful, and person-centered care practices and engagement.

Background: This study investigated the cross-sectional associations of personal and general views on aging, number of non-communicable diseases, and their interactions as cross-sectional predictors of vigorous physical activity. Methods: Participants were 1699 individuals aged 50 years and over (Mean age = 67.79) and living in the community in the UK; 70.8% were women. Participants completed measures assessing Awareness of Age-Related Gains and Losses (AARC-Gains; AARC-Losses; indicators of personal views on aging), Expectations Regarding Aging (ERA; indicator of general views on aging), vigorous physical activity in the last month, non-communicable disease status, and sociodemographic questions. Linear regression models were used. Results: After having adjusted for age, sex, education, marital status, and working status, higher AARC-Gains, lower AARC-Losses, more positive ERA, and fewer non-communicable diseases were cross-sectionally associated with greater likelihood of engagement with vigorous physical activity (Adjusted models Odds Ratio (OR) of 1.08; 0.86; and 1.06, respectively). The interactions of AARC-Gains and AARC-Losses with number of non-communicable diseases as cross-sectional predictors of likelihood of engagement with vigorous physical activity were not statistically significant. The interaction between ERA (i.e., General Views on Aging) and number of non-communicable diseases was a statistically significant cross-sectional predictor of likelihood of engagement with vigorous physical activity (OR = 0.99; p = 0.044). Conclusions: Having more positive and less negative views on aging may prompt vigorous physical activity engagement. Moreover, positive general views of aging may be particularly important for physical activity among those who have one or more non-communicable diseases. Although we cannot infer causality, promoting positive views on aging and decreasing negative views on aging could help fostering active aging, especially among those with physical health conditions.