Abstract:Background: Colorectal cancer is common, the presenting symptoms are non-specific, and the stage of disease at diagnosis is closely related to survival. Regular screening reduces morbidity and mortality from this disease. The Health Belief Model posits that individuals are more likely to engage in preventive health behavior. Aim: to evaluate the effectiveness of nurse-led intervention on adults' health beliefs and screening behaviors toward colorectal cancer. Design: A quasi experimental design. Setting: This … Show more
“…Two additional articles were selected from citations within these articles ( Figure 1 ). The final review included 13 articles: six were nonintervention studies [ 13 , 17–21 ] ( Table 1 ) and seven were intervention studies [ 10 , 22–27 ] ( Table 2 ). Figure 1.…”
Section: Resultsmentioning
confidence: 99%
“… Ref. [#], location and article type/study design Sample size, patient demographics Intervention Result and patient feedback Barriers Recommendations [ 24 ]; Nigeria; prospective review 422 (1 male:2.2 female); mean age, 62 yr; most participants had college-level education FIT (50 ng/ml) FIT complete, 375 (88.9%); FIT positive, 38 (10.1%); colonoscopy, 28.9% (11/38) FIT nonadherent: 11.1% (misplaced kit, traveled out of town, lost to follow-up); priority to manage index illness before CRC; discouraged by friends/family; limited capacity/acceptability of colonoscopy; unwilling to undergo invasive procedure when asymptomatic Make more FIT kits available, link screening option to generic family health programs, educate people on importance of evaluation after positive screening; need additional studies of barriers to uptake of screening colonoscopy [ 22 ]; Egypt; quasi-experimental design 60 (76.7% female); mean age, 68.1 yr (range: 60–83 yr); married, 56.7%; education: university, 60%; secondary, 33%; positive medical history, 96.7%; no tumor, 66.7% Nurse-led intervention on knowledge and perceptions regarding CRC among older adults Significant differences ( p < 0.001) before and after intervention: ‘good’ knowledge of CRC: before (61.7%), after (96.7%), and 4 weeks later (88.3%); good CRC screening practices before (3.3%) and after (63.3%); perceived confidence to perform CRC screening before (39.0%) and after (98.3%) Lack of interest from older adults in searching for information; seeking medical help when asymptomatic not a common practice nor a welcomed idea in this culture Design health-related educational leaflets/posters using simple familiar words about CRC prevention and screening procedures and make them available at clubs, at different health care settings, and via mass media and social media; Replicate the study with a larger sample from different geographical areas to achieve more generalised results [ 10 ]; Egypt; quasi-experimental design 140; mean age, 54.3 yr (study group) and 52.1 yr (controls) Nurse-led intervention on adults’ health beliefs and screening behaviors toward CRC Significant improvement of total awareness score in study group (9.39 ± 4.31) vs. controls (5.01 ± 2.93); Significant differences ( p < 0.001) in total mean health belief score pre- and postintervention Design effective nursing strategies to address barriers of CRC screening and improve CRC knowledge/awareness to achieve greater adherence …”
Section: Resultsmentioning
confidence: 99%
“…Alatise et al [ 22 ] found that less-educated participants were more likely to fail to complete FITs and that education level was positively associated with the rate of follow-up colonoscopy among patients with a positive FIT result. Interestingly, El Sayad et al [ 10 ] found an association between participants’ educational level and awareness, but not knowledge, about CRC. This finding was consistent with that in the study by Hafez [ 23 ], in which one-third of the participants had poor to fair knowledge about CRC despite having a university education.…”
Section: Resultsmentioning
confidence: 99%
“…By contrast, the incidence of CRC is increasing in countries in Africa, including Tunisia [ 6 ], Ghana [ 7 ] and Nigeria [ 8 ]. Moreover, CRC mortality in low- and middle-income countries is attributable to poor awareness of the manifestations of CRC, late diagnosis and the lack of screening tests [ 9 , 10 ]. However, some studies have recommended using scarce resources to combat communicable diseases rather than for CRC screening because of the perceived urgency of the former [ 11 ].…”
Background
Colorectal cancer (CRC) is the third most common cancer worldwide. The incidence of CRC is rising in low- and middle-income countries but decreasing in high-income countries due to the widespread use of surveillance colonoscopy. In Africa, the implementation of screening programs remains a challenge, even in countries, such as Ghana that have established CRC screening guidelines.
Objective
The purpose of this review was to identify the barriers and recommend strategies for implementing CRC screening in African countries.
Methods
A literature search using PubMed was conducted with the following search terms: colorectal neoplasm, early detection of cancer, mass screening, colonoscopy, faecal occult blood test, faecal immunochemical test (FIT) and Africa. After inclusion and exclusion criteria were applied, a total of 13 articles were reviewed.
Results
The most common barriers reported were limited endoscopic capacity, poor knowledge of CRC and CRC screening, health care factors, cultural factors and sociodemographic factors. Recommendations to increase the availability of CRC screening tests were to include the use of FITs, to provide more training for health care providers, and to expand educational programs for patients, physicians, and religious/community leaders.
Conclusion
The primary barrier to screening for CRC in Africa is the limited endoscopic capacity, specifically the lack of infrastructure and trained personnel, which requires systematic changes by governing bodies. In addition, health care professionals should be involved in educating patients about CRC and CRC screening. Further research is needed to clarify the factors related to subtypes of CRC and to explore the feasibility of using FITs in Africa.
“…Two additional articles were selected from citations within these articles ( Figure 1 ). The final review included 13 articles: six were nonintervention studies [ 13 , 17–21 ] ( Table 1 ) and seven were intervention studies [ 10 , 22–27 ] ( Table 2 ). Figure 1.…”
Section: Resultsmentioning
confidence: 99%
“… Ref. [#], location and article type/study design Sample size, patient demographics Intervention Result and patient feedback Barriers Recommendations [ 24 ]; Nigeria; prospective review 422 (1 male:2.2 female); mean age, 62 yr; most participants had college-level education FIT (50 ng/ml) FIT complete, 375 (88.9%); FIT positive, 38 (10.1%); colonoscopy, 28.9% (11/38) FIT nonadherent: 11.1% (misplaced kit, traveled out of town, lost to follow-up); priority to manage index illness before CRC; discouraged by friends/family; limited capacity/acceptability of colonoscopy; unwilling to undergo invasive procedure when asymptomatic Make more FIT kits available, link screening option to generic family health programs, educate people on importance of evaluation after positive screening; need additional studies of barriers to uptake of screening colonoscopy [ 22 ]; Egypt; quasi-experimental design 60 (76.7% female); mean age, 68.1 yr (range: 60–83 yr); married, 56.7%; education: university, 60%; secondary, 33%; positive medical history, 96.7%; no tumor, 66.7% Nurse-led intervention on knowledge and perceptions regarding CRC among older adults Significant differences ( p < 0.001) before and after intervention: ‘good’ knowledge of CRC: before (61.7%), after (96.7%), and 4 weeks later (88.3%); good CRC screening practices before (3.3%) and after (63.3%); perceived confidence to perform CRC screening before (39.0%) and after (98.3%) Lack of interest from older adults in searching for information; seeking medical help when asymptomatic not a common practice nor a welcomed idea in this culture Design health-related educational leaflets/posters using simple familiar words about CRC prevention and screening procedures and make them available at clubs, at different health care settings, and via mass media and social media; Replicate the study with a larger sample from different geographical areas to achieve more generalised results [ 10 ]; Egypt; quasi-experimental design 140; mean age, 54.3 yr (study group) and 52.1 yr (controls) Nurse-led intervention on adults’ health beliefs and screening behaviors toward CRC Significant improvement of total awareness score in study group (9.39 ± 4.31) vs. controls (5.01 ± 2.93); Significant differences ( p < 0.001) in total mean health belief score pre- and postintervention Design effective nursing strategies to address barriers of CRC screening and improve CRC knowledge/awareness to achieve greater adherence …”
Section: Resultsmentioning
confidence: 99%
“…Alatise et al [ 22 ] found that less-educated participants were more likely to fail to complete FITs and that education level was positively associated with the rate of follow-up colonoscopy among patients with a positive FIT result. Interestingly, El Sayad et al [ 10 ] found an association between participants’ educational level and awareness, but not knowledge, about CRC. This finding was consistent with that in the study by Hafez [ 23 ], in which one-third of the participants had poor to fair knowledge about CRC despite having a university education.…”
Section: Resultsmentioning
confidence: 99%
“…By contrast, the incidence of CRC is increasing in countries in Africa, including Tunisia [ 6 ], Ghana [ 7 ] and Nigeria [ 8 ]. Moreover, CRC mortality in low- and middle-income countries is attributable to poor awareness of the manifestations of CRC, late diagnosis and the lack of screening tests [ 9 , 10 ]. However, some studies have recommended using scarce resources to combat communicable diseases rather than for CRC screening because of the perceived urgency of the former [ 11 ].…”
Background
Colorectal cancer (CRC) is the third most common cancer worldwide. The incidence of CRC is rising in low- and middle-income countries but decreasing in high-income countries due to the widespread use of surveillance colonoscopy. In Africa, the implementation of screening programs remains a challenge, even in countries, such as Ghana that have established CRC screening guidelines.
Objective
The purpose of this review was to identify the barriers and recommend strategies for implementing CRC screening in African countries.
Methods
A literature search using PubMed was conducted with the following search terms: colorectal neoplasm, early detection of cancer, mass screening, colonoscopy, faecal occult blood test, faecal immunochemical test (FIT) and Africa. After inclusion and exclusion criteria were applied, a total of 13 articles were reviewed.
Results
The most common barriers reported were limited endoscopic capacity, poor knowledge of CRC and CRC screening, health care factors, cultural factors and sociodemographic factors. Recommendations to increase the availability of CRC screening tests were to include the use of FITs, to provide more training for health care providers, and to expand educational programs for patients, physicians, and religious/community leaders.
Conclusion
The primary barrier to screening for CRC in Africa is the limited endoscopic capacity, specifically the lack of infrastructure and trained personnel, which requires systematic changes by governing bodies. In addition, health care professionals should be involved in educating patients about CRC and CRC screening. Further research is needed to clarify the factors related to subtypes of CRC and to explore the feasibility of using FITs in Africa.
“…Literature is scarce regarding CRC screening interventions in Egypt. However, a recent nurse-led CRC educational intervention examined patients' perceptions of CRC, screening, and knowledge of CRC risks and health promoting behaviors (El Sayad et al, 2021;Mohsen et al, 2020). Post-intervention, participants reported more positive perceptions of CRC screening (Mohsen et al, 2020) and had significant increases in knowledge and positive behavior changes, such as reducing dietary fat and increasing fiber intake (El Sayad et al, 2021).…”
Section: Using Intervention Mapping To Develop a Theory-based Interve...mentioning
Background: Colorectal cancer (CRC) incidence and mortality rates are increasing in Egypt. Because no national screening guidelines exist, developing an effective evidence-based screening intervention could lower rates by early detection of pre-cancerous and cancerous lesions and polyps. This paper describes the development of a CRC screening intervention in Alexandria, Egypt using Intervention Mapping (IM). Materials and Methods: Between September 2019 and March 2020, the successive steps of the IM process were completed. Beginning with the needs assessment, we conducted a literature review, held focus groups with residents of Alexandria, and conducted interviews with local gastroenterologists and oncologists. Program objectives and target audience were determined before designing the program components and implementation plan. Using the PRECEDE-PROCEED theoretical model, predisposing, reinforcing, and enabling screening barriers were assessed. Finally, we developed a Standard Operating Procedures manual detailing aspects of the intervention and evaluation to serve as a model for an expanded screening program. Results: The needs assessment, e.g., literature review, seven focus groups (N=61 participants) and interviews (N=17 participants), indicated that barriers among residents included CRC knowledge deficits, fear/anxiety regarding testing, high cost, and lack of accessibility. Physicians believed CRC testing should only be performed for high risk individuals. Findings from each step of the process informed successive steps. Our final intervention consisted of training components for medical students (Health Champions) who would deliver the intervention to patients in primary care waiting rooms, providing short descriptions of CRC risks and screening, educational brochures, and distributing vouchers for no-cost guaiac fecal occult blood test kits. Health Champions would then follow up with the patients, providing results and referrals for no-cost colonoscopy testing for those with abnormal results. Conclusion: Utilizing the IM steps successfully led to development of a theory-based CRC screening intervention for Egypt. Next steps include the implementation of a feasibility pilot intervention.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
