Evaluation of mass media campaign of early cancer diagnosis, targeting older adults in Northern Ireland: a cross-sectional study.

BACKGROUND: Cancer Research UK ran a mass-media campaign for 6 weeks from Sept 1, 2022, to Sept 13, 2022, targeted to people aged 50 years and older and from a lower social-grade (C2DE) in Northern Ireland. The campaign was developed to target barriers to help-seeking for the target audience. With this evaluation, we aimed to compare reported barriers and self-reported help-seeking before and after the campaign to assess changes potentially related to the campaign. METHODS: We ran cross-sectional surveys that collected data from independent participants before the campaign (wave 1; n=1262; July 18-Aug 31, 2022) and after the campaign (wave 2; n=1250; Oct 3-Nov 3, 2022; N=2512). A recruitment agency recruited participants to be representative of Northern Ireland by age, gender, and social grade (Office for National Statistics, 2011; quota sampling). After wave 2, age range was 16-94 years (mean 51 years) and gender breakdown was 46% male (n=1152), 54% female (n=1356), and <1% other (n=3). Participants gave written informed consent, and the survey was administered using Computer Assisted Personal Interviewing (CAPI) at waves 1 and 2, and Computer Assisted Telephone Interviewing (CATI) at wave 1. Ethics approval was given by Queens University Belfast. Data were analysed in SPSS. FINDINGS: 78% of the targeted audience (354/451) reported remembering the TV campaign. Of people who reported no symptoms, more reported "nothing would put them off or delay seeking medical attention" at wave 2 (447 [41%] of 1084 participants) than at wave 1 (221 [24%] of 936 participants), and this difference was significant (t(939.796)=2·243, p=0·025; 95% CI 0·083 to 1·244). Participants who reported experiencing a symptom (wave 1 n=186; wave 2 103) were less likely to report that they did not seek help from their GP or doctor in wave 2 (n=63 [61%]) than in wave 1 (n=157 [85%]); however, this difference was not significant (t(214.167)=1·133, p=0·258, 95% CI -0·051 to 0·188). INTERPRETATION: Decreases in barriers reported "nothing putting them off seeking help" and decreases in not seeking help from a GP or doctor to help seeking for actual symptoms experienced suggests this campaign might have resulted in some positive shifts in self-reported help-seeking behaviours for actual symptoms. However, these findings should be interpreted in light of the limitations of this research. Although this was a large sample, additional consideration should be given to the use of independent samples (rather than repeated surveys with the same population), self-reported data, and different data collection methods. FUNDING: Community Foundation for Northern Ireland through the Department of Health Cancer Charities Fund.

Potential impact of health communications to raise awareness of the relative risk of age and cancer: a qualitative study.

BACKGROUND: The Cancer Research UK Cancer Awareness Measure Survey (2022) found older age as a risk factor for cancer to be low (around 2-4% across UK nations). However, 89 in 100 cancers are in those aged 50 years and older, and the majority of health-communications are targeted to these higher risk groups. This research aimed to understand the potential impact on health behaviours of communicating messages on relative increased risk of cancer with older age on participant's capability, motivation, and opportunity (COM-B model) in relation to positive early diagnosis health behaviours (body vigilance, intention to take part in cancer screening, preventative measures). METHODS: In this qualitative study, we conducted 60 min semi-structured paired-depth interviews of people aged 25-74 years from across the UK (20 pairs; n=40; age: mean 58·5 years, range 25-74; 19 [47%] men and 21 [53%] women; 27 [67%] White and 13 [33%] from Black or Asian minority ethnic groups). Participants were recruited via a recruitment agency and provided with an incentive of £60 for their time. To assess potential longer-term impact, participants filled a survey 2 weeks later on their views on the messages tested, and on self-reported actions taken as a result of the messages tested. The three different messages tested were rotated. Data were analysed using rapid thematic techniques, two moderators reviewed the data, and a framework analysis style assessed themes against capability, opportunity, and motivation (COM-B model). FINDINGS: Message 2 was the most preferred, as it was clear and easy to understand. Results suggested that including this messaging in health campaigns could encourage some positive early diagnosis heath behaviours. The post survey identified self-reported behaviour changes in nine (23%) of the 40 participants and sustained intentions in 29 (73%). Results overlayed with COM-B, identified messaging could support behaviour change by increasing awareness (psychological capability), providing a social cue (social opportunity), and encouraging emotions related to not wanting to get cancer or that they should be doing specific behaviours (reflective motivation). INTERPRETATION: Findings suggest communicating this message might have a positive effect on help-seeking behaviours in older adults (age ≥50 years). However, considerations include ensuring that the message is clear and understandable and that it doesn't induce fear. Although this study design allowed for more in-depth exploration, results are limited due to the small sample size. FUNDING: Cancer Research UK.

Endothelium-dependent and cyclooxygenase-dependent cutaneous vasodilatation is blunted in young men with hypertensive parents.

BACKGROUND: Across ethnicities, offspring of hypertensive parents (OH) have higher risk of hypertension than offspring of normotensive parents (ON). Sympathetic hyperactivity and reduced nitric oxide availability have been reported in normotensive OH; but the role of vasodilator cyclooxygenase (COX) products is unclear. METHODS: In 12 OH and 12 ON men (19-24 years old), each group comprising six white Europeans and six South Asians with resting ABP less than 129/89 mmHg, reactive hyperaemia and responses evoked by iontophoresis pulses of acetylcholine (ACh) were recorded in forearm skin by laser Doppler fluximetry before and after COX inhibition. RESULTS: Peak reactive hyperaemia was larger in ON than OH (71.0 ±â€Š7.8 vs. 43.4 ±â€Š8.3 perfusion units (perf.units); P < 0.05). It was attenuated by COX inhibition in ON (24.8 ±â€Š5.2 perf.units, P < 0.01), not OH (54.2 ±â€Š7.5 perf.units). Similarly, increases in perfusion evoked by ACh were greater in ON than OH (169.1 ±â€Š20.4 vs. 142.1 ±â€Š19.9 perf.units; P < 0.05) and attenuated by COX inhibition in ON (94.5 ±â€Š13.7; P < 0.05), not OH (132.6 ±â€Š16.1 perf.units). Considering ethnicities, ACh-evoked dilation, though not reactive hyperaemia was greater in Europeans than Asians (176.8 ±â€Š21.7 vs. 130.4 ±â€Š15.0; P < 0.01; 61.0 ±â€Š8.7 vs. 51.7 ±â€Š9.2 perf.units). However, within both Europeans and Asians, COX inhibition attenuated reactive hyperaemia and ACh-induced dilatation in ON only. CONCLUSION: Reactive hyperaemia and ACh-evoked dilatation in cutaneous circulation are blunted in young, normotensive OH relative to ON men irrespective of white European, or South Asian ethnicity and are attributable to impaired contribution of COX vasodilator products in OH. These features may provide early markers of endothelial dysfunction that contribute to hypertensive risk in OH men.