Demographic, social cognitive and social ecological predictors of intention and participation in screening for colorectal cancer

Abstract

BackgroundPrevious research points to differences between predictors of intention to screen for colorectal cancer (CRC) and screening behavior, and suggests social ecological factors may influence screening behavior. The aim of this study was to compare the social cognitive and social ecological predictors of intention to screen with predictors of participation.MethodsPeople aged 50 to 74 years recruited from the electoral roll completed a baseline survey (n = 376) and were subsequently invited to complete an immunochemical faecal occult blood test (iFOBT).ResultsMultivariate analyses revealed five predictors of intention to screen and two predictors of participation. Perceived barriers to CRC screening and perceived benefits of CRC screening were the only predictor of both outcomes. There was little support for social ecological factors, but measurement problems may have impacted this finding.ConclusionsThis study has confirmed that the predictors of intention to screen for CRC and screening behaviour, although overlapping, are not the same. Research should focus predominantly on those factors shown to predict participation. Perceptions about the barriers to screening and benefits of screening are key predictors of participation, and provide a focus for intervention programs.

Exploring the Validity of the Continuum of Resistance Model for Discriminating Early from Late and Non-uptake of Colorectal Cancer Screening: Implications for the Design of Invitation and Reminder Letters

“…Results that highlight any underlying differences in cognitions and attitudes between participants and non-participants are consistent with studies that identify differences in the variables that predict intention to screen versus action, suggesting the existence of underlying stages of readiness [e.g., 25,29]. Whilst the analysis did not specifically examine the strength of barriers associated with a particular decision stage, it could be surmised that those who perceived the barriers to be less significant were nearer the action phase and were earlier participants; certainly, a review of the relationship of the TTM to breast cancer screening behaviour found, that perceived barriers decreased as stage progressed from pre-contemplation to action [30]..…”

“…The final sample consisted of 376 eligible people who had supplied full survey data and were in the early stages of readiness to screen. The data collection process ensured that no-one was truly in the precontemplation stage of the TTM after baseline survey completion although our data indicated that, before survey completion, a significant proportion (n=215) had never contemplated CRC screening [25]. Of these participants, 196 completed the FOBT (52%) and 180 did not.…”

“…Full details of the factor analysis, factor loadings and items are reported elsewhere [25]. Given that the aim of the present analyses was to examine whether screening participants responded to the same factors (in line with the continuum of resistance model) or whether in fact different factors related to early, late or never participation, the barriers/benefits factor from the above-mentioned study [25] was split into two composite variables termed barriers and facilitators, respectively.…”

“…Given that the aim of the present analyses was to examine whether screening participants responded to the same factors (in line with the continuum of resistance model) or whether in fact different factors related to early, late or never participation, the barriers/benefits factor from the above-mentioned study [25] was split into two composite variables termed barriers and facilitators, respectively. The term facilitators replaced 'benefits' from the original paper [25] as the items representing this construct were not regarded as benefits but rather a positive attitude toward screening that enabled, or facilitated, uptake. These variables were calculated by averaging standardised scores across each of the items measuring these constructs.…”

“…This study was approved by ethics committees at the University of Adelaide and the Repatriation General Hospital and conducted in early 2006 as part of a study of predictors of intention and participation in CRC screening [25]. All individuals were mailed an advance notification letter and accompanying study information, followed by a Bowel Cancer Screening Questionnaire (BCSQ) two weeks later.…”