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April 16, 2019

Todd Lucas: Taking on the 'ick' factor

April 17. 2019

Todd Lucas is an associate professor in the College of Human Medicine’s Division of Public Health in Flint and C.S. Mott Endowed Professor of Public Health. His research considers psychosocial causes of racial health disparities with a focus on stress and preventive health behavior pathways, such as cancer screening.

Every year in the United States, colorectal cancer claims more lives than traffic accidents. Just like the use of seat belts to save lives, appropriate screening for colorectal cancer can also prevent needless loss of life from cancer. Why do so many of us fail to “buckle up” by getting screened for colorectal cancer as recommended?

I am trained as a social and health psychologist. Much of my time is spent considering how and why people make many of the individual health behavior decisions that they do, including things like colorectal cancer screening.

I am especially attuned to how individual-level health behavior decisions can be both a cause and a consequence of health inequity, including African American communities of Flint and Detroit. While the economic drivers of health behavior and health disparities are undeniable, they are not the only root cause.

Did you know that roughly three-quarters of people who have not been screened for colorectal cancer have access to insurance that would pay this screening? This suggests that “intangible” factors like personality characteristics, social environments, perceptions of risk and benefit and emotion play a crucial role when it comes to cancer screening and other health behaviors.

Like many health psychologists, my program of research is geared towards developing intervention strategies that reduce health disparities by changing individual-level health behavior decisions. In other words, how can we better compel useful health behaviors, such as colorectal cancer screening?

We are recognizing the importance of “intangibles” highlights that psychological interventions, which address those antecedent factors like cognition and emotion, can be both a practical and effective solution when it comes to nudging health behavior.

Currently, my research team is considering how widely-used health communication strategies impact whether African American individuals decide to engage in colorectal cancer screening. We are looking at ways to improve communication for African American audiences. One pathway to improving screening rates is to consider how health communications can be crafted to avoid arousing medical mistrust and thoughts about racism, which drastically impedes openness to cancer screening among African Americans and other racial minorities.

Changing health behavior for the better often means understanding the choices that individuals are confronted with. Sometimes, this means further educating individuals and communities about their health behavior options. For example, there are now multiple widely available alternatives to colonoscopy, such as Fecal Immunochemical Testing (FIT) and stool DNA testing, which fully satisfy the requirements of recommended screening for colorectal cancer and can be done entirely from the comfort of your home.

Many of us are either unaware of or do not adequately consider these options — a virtual tragedy when it comes to colorectal cancer screening. The resistance to getting a colonoscopy that many individuals portray is due in part to the substantial “ick” factor that colonoscopy may present. This is the driving factor behind my program of research. For me, changing health behavior starts with educating ourselves and others about our health behavior landscapes and developing interventions to match their unique contours.