Effects of Promotional Materials on Attitudes and Fear towards Colorectal Cancer Screening among Chinese Older Adults: An Experimental Study

Abstract

Colorectal cancer (CRC) screening is a cost-effective prevention and control strategy. However, the promotion of CRC screening for older adults may be difficult because reading CRC prevention information may evoke embarrassment, fear, and anxiety towards the screening procedure and cancer diagnosis. This study aims to (1) examine the effects of three promotional materials for CRC screening on the attitudes toward CRC screening tests (screening interest, screening effectiveness, and trust in the screening results) and cancer fear, and (2) to explore the interaction effect of cancer fear with screening effectiveness and trust in the screening results on screening interest of the three screening tests (fecal occult blood test (FOBT), flexible sigmoidoscopy, and colonoscopy) among Chinese older adults. A total of 114 community-dwelling older adults were asked to look at the corresponding promotional materials (pamphlet, cartoon, and video) of one of the three study groups. The pamphlet and video represent convention strategies and the cartoon represents an innovative strategy. No significant difference was observed in the screening interest and cancer fear across groups. FOBT was the most preferred screening modality. The video group has a large proportion agreed screening effectiveness of flexible sigmoidoscopy than pamphlet and cartoon groups and trusted in the screening results for FOBT and flexible sigmoidoscopy than the pamphlet group. Logistic regression results showed that the effect of trust in the screening results on screening interest for colonoscopy was greater among participants with higher cancer fear than those with lower cancer fear level. In conclusion, the three promotional groups had produced similar results in their attitudes toward CRC screening and cancer fear. The use of cartoons may be a comparable approach with conventional methods in the promotion of CRC screening. Additional components that can arouse fear and boost response efficacy simultaneously might also be useful for the effective promotion of colonoscopy among Chinese older adults.

Cancer literacy differences of basic knowledge, prevention, early detection, treatment and recovery: a cross-sectional study of urban and rural residents in Northeast China

“…In rural areas, the majority of older people possess lower education levels, and their children frequently reside elsewhere, limiting their access to vital information. Additionally, people with lower incomes, grappling with greater financial demands, may have limited time to focus on additional information, resulting in reduced attention toward personal health concerns (18). In addition to demographic factors, limited health educational resources and delayed information dissemination hinder timely access to the latest cancer knowledge in rural areas.…”

“…In addition to demographic factors, limited health educational resources and delayed information dissemination hinder timely access to the latest cancer knowledge in rural areas. Moreover, the rural population tends to delayed treatment and misunderstanding due to fear, embarrassment and traditional beliefs ( 19 , 20 ). Notably, participates with a family history of cancer and experience with cancer screenings exhibited relatively higher health literacy, consistent with previous research ( 21 ).…”

Identifying the main barriers for participation in a population-based colorectal cancer screening programme in East Azerbaijan, Iran

“…Thus, some people prefer not to know at all if they have cancer, or at least be diagnosed later so that they can live more easily and without worries instead of dealing with cancer treatment and costs. Providing enough information about early diagnosis and screening programmes, curable early stages of CRCs and preventing deaths from CRCs were highlighted by PHC workers and health policy makers among the population [29][30][31].…”

“…Assisting and helping them patiently and calmly about their fears, embarrassment, worries and discomforts could easily encourage them to follow the screening programme. Furthermore, the way people are informed and invited, the cold and inappropriate attitude and the interest of co-investigators may lead to the failure of screening programmes [ 26 , 27 , 29 , 38 , 40 , 41 ].…”