Korean J Adult Nurs.  2023 Aug;35(3):225-233. 10.7475/kjan.2023.35.3.225.

Mediating Effect of Perceived Threat in the Relationship between Cue to Action and Secondary Cancer Preventive Behaviors among Breast and Colorectal Cancer Survivors: A Cross-Sectional Study

• Baek SY
• Choi JY

• KMID: 2545836
• DOI: http://doi.org/10.7475/kjan.2023.35.3.225

Abstract

Purpose
Cancer survivors face a high risk of developing secondary cancers; thus, they should consider their primary cancer experiences as signals to adopt secondary cancer-preventive behaviors. This study examined the mediating effect of perceived threat in the relationship between cue to action and such behaviors and identified the gender effect as a moderator in breast and colorectal cancer survivors.
Methods
A total of 505 cancer survivors (253 with breast cancer and 252 with colorectal cancer) participated in this study. These participants were involved in cancer-related physical activities at the outpatient oncology clinic of a tertiary teaching hospital in Korea. Participants completed structured, self-administered questionnaires, and a PROCESS macro was utilized to analyze the mediating effect of perceived threat.
Results
Cue to action positively affected perceived threat (B=0.38, p <.001). Additionally, both cue to action (B=0.20, p=.047) and perceived threat (B=1.28, p<.001) positively influenced secondary cancer-preventive behaviors. In the relationship between cue to action and these behaviors, perceived threat explained 30.0% of the variance. Gender was supported as a moderator in the relationship between cue to action and perceived threat. A bootstrap analysis confirmed the mediating effect of perceived threat.
Conclusion
Perceived threat can help cancer survivors understand the risk and seriousness of secondary cancer, thereby strengthening the relationship between cue to action and secondary cancer-preventive behaviors. Healthcare providers should provide accurate information as a cue to cancer survivors, enabling them to recognize the risk of secondary cancer.

Keyword

Cancer survivors; Cues; Health belief model; Risk reduction behavior