Wenning Sun,1– 3,* Xingli Ma,1– 3,* Ao Zhang,1– 3 Yingjie Wang,1– 3 Boyang Fan,1– 3 Huifang Zhang,1– 3 Haining Yu,4 Haipeng Wang1– 3 

1Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, People’s Republic of China; 2NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, People’s Republic of China; 3Center for Health Management and Policy Research, Shandong University (Shandong Provincial Key New Think Tank), Jinan, 250012, People’s Republic of China; 4Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Haipeng Wang, Shandong University, 128# Wenhua Xi Road 44, Jinan, Shandong, 250012, People’s Republic of China, Email wanghaipeng@sdu.edu.cn Haining Yu, Shandong Cancer Hospital and Institute, 440# Jiyan Road, Jinan, Shandong, 250117, People’s Republic of China, Email yuhaining@sdfmu.edu.cn

Background: Secondary prevention plays a crucial role in reducing cancer-related deaths. Previous studies have indicated that cancer cognition and coping ability significantly influence behavioral intention towards secondary prevention. However, limited research has explored the relationship between the three, particularly among rural residents. Rural areas often face challenges like limited healthcare access and lower health literacy, impacting prevention intentions. This study aims to explore the path associations between cancer cognition, coping ability, and behavioral intention for cancer secondary prevention among rural residents.
Methods: A cross-sectional survey was conducted in Shandong Province, China, from August 10 to September 10, 2023. Using a multi-stage stratified random sampling method, 453 valid questionnaires were obtained. Univariate and bivariate analysis were conducted for preliminary assessment, and structural equation modeling (SEM) was used to examine the relationships among cancer cognition, coping ability, and secondary prevention intention.
Results: 22.3% of participants reported an intention to engage in secondary cancer prevention. Cancer cognition was positively associated with both prevention intention (β=0.06, p< 0.001) and coping ability (β=0.82, p< 0.001), while coping ability was also positively associated with prevention intention (β=0.64, p< 0.001). The SEM demonstrated a good model fit (GFI=0.841, CFI=0.916, IFI=0.916, TLI=0.906, RMSEA=0.056, SRMR =0.036, AGFI=0.812, PGFI=0.715).
Conclusion: Cancer cognition positively influences coping ability, which subsequently increases the intention to engage in secondary prevention among rural residents in Shandong Province. Tailored interventions to improve cancer cognition and coping ability are vital for enhancing prevention intention among rural residents.

Keywords: cancer cognition, coping ability, secondary prevention, rural residents, structural equation modeling