Method Revised

The HPLP-II is a 52-item scale developed by Walker and Hill-Polerecky (1996) to assess self-initiated health promoting behaviors individuals engage in to improve their overall well-being. The scale consists of six subscales measuring the components of health-promoting behaviors from the HPM. The subscales include health responsibility, spiritual growth, interpersonal relationships, nutrition, physical activity, and stress management. The health responsibility (HR) subscale has nine items. Some of the items in this subscale include, “Report any unusual signs or symptoms to a physician or other health professional” and “Read or watch TV programs about improving health.” The spiritual growth (SG) dimension also has nine items. Sample items in this subscale include, “Feel I am growing and changing in positive ways” and “Believe that my life has purpose.” Interpersonal relationship (IR) has nine items such as “Discuss my problems and concerns with people close to me” and “Praise other people easily for their achievements.” The nutrition (N) subscale has nine items and sample items in this subscale include “Choose a diet low in fat, saturated fat, and cholesterol” and “Limit use of sugars and food containing sugar (sweets).” The physical activity (PA) subscale has eight items. Examples are, “Follow a planned exercise program” and “Exercise vigorously for 20 or more minutes at least three times a week (such as brisk walking, bicycling, aerobic dancing, using a stair climber).” Finally, the stress management (SM) subscale has eight items including, “Get enough sleep” and “Take some time for relaxation each day.”

The responses will be given on a 4-point Likert scale of 1 (never), 2 (sometimes), 3 (often), and 4 (routinely). An overall health-promoting lifestyle score will be obtained by calculating the mean of the responses to all 52 items. The overall instrument has high internal consistency with a Cronbach’s alpha of .94 (Walker and Hill-Polerecky, 1996) and .91 (Alzarhani et al., 2019). Internal consistency for subscales ranged from .79 to .87 (Walker and Hill-Polerecky, 1996).

Champion’s Health Belief Model Questionnaire (CHBMQ)

The revised Champion’s Health Belief Model Questionnaire (CHBMQ) by Champion (1993) is a 57-item scale that measures the HBM psychological variables associated with breast cancer, breast self-examination (BSE), and the use of mammograms. The HBM psychological variables are perceived severity and susceptibility to breast cancer, the benefits and barriers of BSE and mammography. For this study, susceptibility is the variable of interest.

Perceived Susceptibility to Cancer and Depression. Comment by Wendy Kyei: Level 4 Heading

The researcher will use the CHBMQ Perceived Susceptibility Subscale to measure perceived susceptibility to cancer and depression. The researcher modified the subscale that was originally measuring susceptibility to breast cancer to measure susceptibility to cancer and susceptibility to depression (S. Moynihan, personal communication, April 12, 2023).

The subscale has five items with responses on a five-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Some of the questions include “It is likely that I will get cancer,” and “My chances of getting depression in the next few years is great.” Scores on the five items are summed and range from five to 25, with higher scores indicating higher perceived susceptibility to either cancer or depression. The reported internal consistency/reliability or Cronbach alpha for the susceptibility subscale was .93 (Champion, 1993).

Design & Procedures Comment by Wendy Kyei: Level 2 Heading

The current investigation will be a cross-sectional study. The researcher will seek approval from the Northwestern State University Human Subjects Internal Review Board (IRB) committee before data collection. After approval, the researcher will request permission from undergraduate professors to advertise the study to students at Northwestern State University of Louisiana (NSU) for bonus or course credit. The researcher will provide a brief description with a link to the study for instructors and ask them to advertise the survey on Moodle (a learning platform) to recruit participants.

Self-reported data will be collected using Survey Monkey. Firstly, the students will access the Informed Consent form. The form will require participants to electronically consent that they want to participate in the study. The consent form will include the purpose and procedures of the study and assurance of participants’ privacy and confidentiality. Participants who consent to the study will be directed to complete the measures. Those interested in receiving a summary of the study will also be asked to provide their email address. Before exiting the study, participants will be directed to a debriefing form. Only the members of the research team (principal investigator and supervisor) will have access to the data to download and enter information for analysis.

Proposed Analysis

The independent variables for this study are perceived susceptibility to cancer and perceived susceptibility to depression and family history of depression and cancer. The dependent variable is overall health-promoting behavior (physical activity, nutrition, self-management, spiritual growth, health responsibility, and interpersonal relationships). The data will be analyzed using SPSS Version 23. Statistical analyses for the current study include correlations and independent t-tests.

First, descriptive statistics will be calculated on demographics and each variable to characterize the sample. The planned analyses include a correlation and an independent t-test analysis. The correlation (Pearson Product Moment correlation) will be computed to test the first hypothesis which states that perceived susceptibility to cancer and perceived susceptibility to depression will significantly and positively correlate with overall health-promoting behaviors.

Two separate independent t-test will be computed to test hypothesis two and determine whether individuals with a family history of cancer and depression will report significantly higher perceived susceptibility to the respective illness than those with no family history.