Graduation Year


Document Type




Degree Granting Department


Major Professor

Paul B. Jacobsen, Ph.D.

Committee Member

Thomas H. Brandon, Ph.D.

Committee Member

Jamie L. Goldenberg, Ph.D.


breast cancer, diet, physical activity, survivorship, behavior change theories


Prior research suggests that fear of cancer recurrence is very common among cancer survivors. This study examined the extent to which Protection Motivation Theory variables of threat appraisal and coping appraisal accounted for differences in fear of recurrence and performance of health behaviors in cancer patients who recently completed treatment. It was hypothesized that greater fear of recurrence would be related to a combination of high threat appraisal and low coping appraisal. Also, it was hypothesized that higher rates of health behaviors would be related to higher threat appraisals for cancer recurrence and higher coping appraisals for reducing risk of recurrence by improving diet or exercising. A sample of 155 early-stage breast cancer patients (mean age = 59 years) who completed surgery, chemotherapy, and/or radiotherapy between 6-24 months previously (mean = 12 months) completed measures of fear of recurrence, threat appraisal (perceived risk and severity of a potential cancer recurrence), fruit and vegetable intake in the past month, exercise for the past week, and coping appraisal (perceived response efficacy and self-efficacy to perform diet and exercise recommendations to reduce recurrence risk). Basic demographic and clinical information was also collected. The study findings supported the hypothesis that the

combination of threat and coping appraisal beliefs explain which breast cancer survivors report higher fear of recurrence. However, the observed results did not support the hypothesized interaction between threat and coping appraisal for predicting either diet or exercise habits. Instead, coping appraisal alone predicted both fruit and vegetable consumption and exercise habits. Future research should focus on examining these relationships longitudinally and further assess coping appraisal and how it impacts fear of recurrence.