Indirect effects of perceived cancer risk on health promoting behaviors as mediated by cancer worry among US women

Approximately one-third of women in the U.S. will develop cancer in their lifetime. Engaging in health promoting behaviors (e.g., healthy eating, physical activity) has an important role in cancer prevention. There is some evidence that perceived cancer risk influences engagement in health promoting behaviors; however, the mechanisms behind this relationship need further examination. The purpose of this study was to (a) examine the associations between perceived cancer risk (PCR) and cancer worry (CW), fruit and vegetable (F&V) consumption, and physical activity (PA), and (b) separately test the indirect effects of PCR on F&V consumption and on PA as mediated by CW. The study sample included 2,304 women (Mean Age=52.5,SD=7.2) from the first cycle of the 2012 Health Information National Trends Survey (HINTS). More than half of the sample self-identified as non-Hispanic White (63.5%) and had a household income of <$50,000/year (57.3%). Pearson's correlation coefficients were used to examine linear associations between variables of interest, and the Sobel test was used to assess mediation. PCR was positively associated with CW (r=0.42,p<.0001), and inversely associated with F&V consumption (r=-0.05,p=0.02) and PA (r=-0.05,p=0.03). Controlling for race/ethnicity, age, and income, the indirect effect of PCR on PA through CW was statistically significant (z[Sobel]=-3.2,SE=0.03,p<.01). CW did not mediate the indirect effect of PCR on F&V consumption. Results have implications for health messages and intervention strategies to increase health promoting behaviors and prevent cancer as CW mediates the indirect effect of PCR on PA but not F&V consumption.