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Menéndez Rodríguez M, García-Morales N, Seoane Pillado T, Garau Ramírez J, Traver Salvador A, Hervás Jiménez Y, Pin Vieito N, Menéndez Rodríguez L, Cubiella J. Perceived barriers and benefits in the participation in faecal occult blood test colorectal cancer screening programme. GASTROENTEROLOGIA Y HEPATOLOGIA 2023; 46:185-194. [PMID: 35605825 DOI: 10.1016/j.gastrohep.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/11/2022] [Accepted: 05/05/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Colorectal cancer is the second cancer-related cause of death in the world. Tumour stage at diagnosis is the principal prognosis factor of survival. However, the participation in the programme is around 50%. The aim of the study was to identify the benefits and barriers perceived by the population when participating in a colorectal cancer screening programme with faecal occult blood test. METHODS We carried out a cases-controls study with 408 participants. We analyzed epidemiological and social variables associated with lifestyle and behavioural factors based in the Health Belief Model. We conducted a descriptive analysis, and identified variables associated to adherence by a logistic regression. RESULTS Variables independently associated with the participation in a colorectal cancer screening programme were age (OR 1.06; 95% CI: 1.01-1.11), having a stable partner (OR 1.96; 95% CI: 1.20-3.18), the level of education (OR 1.59; 95% CI: 1.02-2.47) and two of the barriers to participate in the faecal occult blood test screening: "you don't know how to do one" (OR=0.46; 95% CI: 0.23-0.93) and "it is not that important right now" (OR=0.43; 95% CI: 0.24-0.78). CONCLUSION The existing barriers for screening with faecal occult blood test are the best factor predicting. This is relevant when designing the intervention programmes, as they should focus on reducing perceived barriers to increase the participation in colorectal cancer screening, thereby reducing colorectal cancer mortality.
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Affiliation(s)
- Martín Menéndez Rodríguez
- Primary Health Center Salceda de Caselas, Gerencia de Gestión Integrada de Vigo, SERGAS, Vigo, Spain; Area of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Natalia García-Morales
- Digestive Service, Complexo Hospitalario Universitario de Vigo Sergas, Vigo, Spain; South Galicia Health Research Institute, Vigo, Spain
| | - Teresa Seoane Pillado
- Unit of Preventive Medicine and Public Health, Department of Health Sciences, University of A Coruña-INIBIC, A Coruña, Spain
| | - Jorge Garau Ramírez
- Primary Health Center Chile, Área Hospital Clínic-Malvarrosa, Valencia, Spain
| | | | | | - Noel Pin Vieito
- South Galicia Health Research Institute, Vigo, Spain; Digestive Service, Hospital Universitario de Ourense, Ourense, Spain
| | | | - Joaquín Cubiella
- South Galicia Health Research Institute, Vigo, Spain; Digestive Service, Hospital Universitario de Ourense, Ourense, Spain; Center for Biomedical Research Network for Liver and Digestive Diseases, Ourense, Spain
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Alrubaiy L, Al-Rubaye A, Alrudainy W, Al-Hawaz MH, Mahmoud RA, Saunders BP. Colonoscopy Colorectal Cancer Screening Programme in Southern Iraq: Challenges, Knowledge Gaps and Future Potential. J Pers Med 2023; 13:jpm13020173. [PMID: 36836407 PMCID: PMC9964669 DOI: 10.3390/jpm13020173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
Data on current colorectal cancer screening practices in Iraq are limited. This study aimed to better understand the current colorectal cancer screening practice and perceived barriers. The project also aimed to use UK expertise to introduce Bowel Cancer Screening Programme (BCSP) in Basra, Iraq. The study consisted of two parts: A pre-visit online survey of clinicians to test the project's feasibility. A public survey was conducted to understand and gauge the general knowledge and perceived barriers to having colorectal cancer screening. The second phase included a short visit to Basra and the delivery of a multidisciplinary meeting for bowel screening colonoscopists. Fifty healthcare providers completed the survey. Basra has no established bowel cancer screening programme, let alone the country. Opportunistic colonoscopy surveillance is done on an ad hoc base. A total of 350 individuals completed the public survey. The survey showed that more than 50% of participants were not familiar with the concept of a BCSP and less than 25% were aware of "red flag" symptoms of bowel cancer. The short visit to Basra included a roundtable discussion and delivered a training workshop for screening colonoscopists using UK training materials in conjunction with the Iraqi Medical Association. Feedback from the course was extremely positive. Several potential barriers were identified to participate in BCSP. The study highlighted potential barriers, including a lack of public awareness and insufficient training resources to be addressed in future screening programmes. The study has identified several potential areas for future collaboration to support the development of a BCSP centre in Basra.
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Affiliation(s)
- Laith Alrubaiy
- Gastroenterology Department, Swansea University Medical School, Swansea SA8 2PP, UK
- Correspondence: ; Tel.: +44-7809670683
| | - Ali Al-Rubaye
- Medical Research Unit, Basra Health Directorate, Basra 289, Iraq
| | | | | | - Raja A. Mahmoud
- Public Health Department, Al-Zahraa Medical College, Basra 289, Iraq
| | - Brian P. Saunders
- Bowel Cancer Screening for North West London, St Mark’s Hospital, Watford Road, London HA1 3UJ, UK
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Karim MA, Talluri R, Chido-Amajuoyi OG, Shete S. Awareness of heated tobacco products among US Adults - Health information national trends survey, 2020. Subst Abus 2022; 43:1023-1034. [PMID: 35435808 PMCID: PMC9782695 DOI: 10.1080/08897077.2022.2060440] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Introduction: Heated Tobacco Products (HTP) have the potential to attain high uptake in the US. The current study estimated the prevalence of awareness, prevalence of use and the factors associated with awareness of HTP among US adults. Methods: This study included 3201 respondents from the Health Information National Trends Survey (HINTS) 5 Cycle 4 (2020). The prevalence of awareness of HTP and ever use of HTP among US adults were estimated. Multivariable logistic regression was conducted to identify the factors associated with awareness of HTP. Results: About 15% of the adult US population were aware of HTP, while 2.2% had ever used HTP. Age between 35 and 49 years (aOR, 1.9; 95% CI, 1.3-2.9; p-value = 0.003), male sex (aOR, 1.7; 95% CI, 1.0-2.7; p-value = 0.04), lower income ($0-$9,999) (aOR, 3.0; 95% CI, 1.3-6.9; p-value = 0.01), smoking on some days (aOR, 3.4; 95% CI, 1.2-9.4; p-value = 0.02) and moderately or extremely worrying about getting cancer (aOR, 1.7; 95% CI, 1.1-2.7; p-value = 0.03) were associated with higher odds of being aware of HTP; whereas, belief that there are so many cancer prevention recommendations, it's hard to know which ones to follow (aOR, 0.5; 95% CI, 0.3-0.8; p-value = 0.009) was associated with lower odds of being aware of HTP. Conclusions: A significant proportion of US adult population were aware of HTP in 2020. Given the recent high proliferation of e-cigarettes, potential health effects of the HTP products should be monitored by the regulators closely. Adequate surveillance and policy interventions are warranted in this regard.
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Affiliation(s)
- Mohammad A. Karim
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Rajesh Talluri
- Department of Data Science, University of Mississippi Medical Center, Jackson, Mississippi, United States of America,Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Onyema G. Chido-Amajuoyi
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Sanjay Shete
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America,Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America,Division of Cancer Prevention and Population Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
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Huang J, Choi P, Pang TWY, Chen X, Wang J, Ding H, Jin Y, Zheng ZJ, Wong MCS. Factors associated with participation in colorectal cancer screening: A population-based study of 7200 individuals. Eur J Cancer Care (Engl) 2020; 30:e13369. [PMID: 33205473 DOI: 10.1111/ecc.13369] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 06/22/2020] [Accepted: 10/14/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE This study aimed to evaluate how the knowledge and perception towards colorectal cancer (CRC) screening had been changed in a large population, and identified factors associated with its participation based on factors pertinent to the Health Belief Model (HBM). METHODS Data from 3600 screening participants and 3600 non-participants were collected through a telephone survey via simple random sampling of telephone numbers in a territory-wide directory from December 2016 to November 2018. Sociodemographic factors; the enabling factors of screening as well as the barriers of screening were collected. The changes in these factors were evaluated by Pearson's chi-square trend test. A logistic regression model was constructed to identify the association between the above factors and CRC screening participation. RESULTS The knowledge level (67.9% to 85.4%, p < 0.001), perceived severity of having CRC (37.7%-42.8%, p < 0.01), perceived benefits of screening (54.9%-72.1%, p < 0.001), and reductions in barriers (14.1%-5.1%, p < 0.001) of CRC screening significantly improved among the non-users. Subjects with older age (adjusted odds ratio (AOR): 2.01, p < 0.001), higher knowledge level of screening methods (AOR: 6.68, p < 0.001), greater perceived severity (AOR: 2.04, p < 0.001) and coverage of insurance (AOR: 1.22, p < 0.01) were more likely to participate. In contrast, more affluent subjects (AOR: 0.69, p < 0.001), female individuals (AOR: 0.63, p < 0.001), higher level of perceived psychological (AOR: 0.54, p < 0.001) and access barriers (AOR: 0.55, p < 0.001) were associated with poorer participation. CONCLUSION These findings demonstrated a substantial increase in the enabling factors of CRC screening, including knowledge, perceived severity and perceived benefits. The study also identified the target groups such as younger individuals, females and more affluent people among whom more intensive educational initiatives are needed to enhance their participation.
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Affiliation(s)
- Junjie Huang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Peter Choi
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Tiffany W Y Pang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiao Chen
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jingxuan Wang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hanyue Ding
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yinzi Jin
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Martin C S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China.,Department of Global Health, School of Public Health, Peking University, Beijing, China.,School of Public Health, The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Guidry JPD, Vraga EK, Laestadius LI, Miller CA, Occa A, Nan X, Ming HM, Qin Y, Fuemmeler BF, Carlyle KE. HPV Vaccine Searches on Pinterest: Before and After Pinterest's Actions to Moderate Content. Am J Public Health 2020; 110:S305-S311. [PMID: 33001720 DOI: 10.2105/ajph.2020.305827] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To compare how human papillomavirus (HPV) vaccination was portrayed on Pinterest before and after the platform acted to moderate vaccine-related search results to understand (1) what the information environment looked like previously and (2) whether Pinterest's policy decisions improved this environment in terms of sources and content.Methods. In this quantitative content analysis, we compared 2 samples of 500 HPV vaccine-focused Pinterest posts ("pins") collected before and after Pinterest's actions to provide more reliable vaccine-related information. Pins were based on search results and were analyzed using the Health Belief Model.Results. The majority of preaction search results leaned toward vaccine skepticism, specifically focused on perceived vaccine barriers. Few pins were published by public health-related Pinterest accounts. Postaction search results showed a significant shift to HPV vaccination benefits, and the number of pins by government or medical accounts increased. However, the proportion of pins in search results containing HPV content of any type was significantly lower.Conclusions. Pinterest's efforts to moderate vaccination discussions were largely successful. However, the ban also appeared to limit HPV vaccination search results overall, which may contribute to confusion or an information vacuum.
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Affiliation(s)
- Jeanine P D Guidry
- Jeanine P. D. Guidry is with the Robertson School of Media and Culture, Virginia Commonwealth University, Richmond. Emily K. Vraga is with the Hubbard School of Journalism and Mass Communication, University of Minnesota, Minneapolis. Carrie A. Miller, Hannah M. Ming, Bernard F. Fuemmeler, and Kellie E. Carlyle are with the Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond. Linnea I. Laestadius is with the Joseph J. Zilber School of Public Health, University of Wisconsin, Milwaukee. Aurora Occa is with the Department of Communication, University of Kentucky, Lexington. Xiaoli Nan and Yan Qin are with the Department of Communication, University of Maryland, College Park
| | - Emily K Vraga
- Jeanine P. D. Guidry is with the Robertson School of Media and Culture, Virginia Commonwealth University, Richmond. Emily K. Vraga is with the Hubbard School of Journalism and Mass Communication, University of Minnesota, Minneapolis. Carrie A. Miller, Hannah M. Ming, Bernard F. Fuemmeler, and Kellie E. Carlyle are with the Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond. Linnea I. Laestadius is with the Joseph J. Zilber School of Public Health, University of Wisconsin, Milwaukee. Aurora Occa is with the Department of Communication, University of Kentucky, Lexington. Xiaoli Nan and Yan Qin are with the Department of Communication, University of Maryland, College Park
| | - Linnea I Laestadius
- Jeanine P. D. Guidry is with the Robertson School of Media and Culture, Virginia Commonwealth University, Richmond. Emily K. Vraga is with the Hubbard School of Journalism and Mass Communication, University of Minnesota, Minneapolis. Carrie A. Miller, Hannah M. Ming, Bernard F. Fuemmeler, and Kellie E. Carlyle are with the Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond. Linnea I. Laestadius is with the Joseph J. Zilber School of Public Health, University of Wisconsin, Milwaukee. Aurora Occa is with the Department of Communication, University of Kentucky, Lexington. Xiaoli Nan and Yan Qin are with the Department of Communication, University of Maryland, College Park
| | - Carrie A Miller
- Jeanine P. D. Guidry is with the Robertson School of Media and Culture, Virginia Commonwealth University, Richmond. Emily K. Vraga is with the Hubbard School of Journalism and Mass Communication, University of Minnesota, Minneapolis. Carrie A. Miller, Hannah M. Ming, Bernard F. Fuemmeler, and Kellie E. Carlyle are with the Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond. Linnea I. Laestadius is with the Joseph J. Zilber School of Public Health, University of Wisconsin, Milwaukee. Aurora Occa is with the Department of Communication, University of Kentucky, Lexington. Xiaoli Nan and Yan Qin are with the Department of Communication, University of Maryland, College Park
| | - Aurora Occa
- Jeanine P. D. Guidry is with the Robertson School of Media and Culture, Virginia Commonwealth University, Richmond. Emily K. Vraga is with the Hubbard School of Journalism and Mass Communication, University of Minnesota, Minneapolis. Carrie A. Miller, Hannah M. Ming, Bernard F. Fuemmeler, and Kellie E. Carlyle are with the Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond. Linnea I. Laestadius is with the Joseph J. Zilber School of Public Health, University of Wisconsin, Milwaukee. Aurora Occa is with the Department of Communication, University of Kentucky, Lexington. Xiaoli Nan and Yan Qin are with the Department of Communication, University of Maryland, College Park
| | - Xiaoli Nan
- Jeanine P. D. Guidry is with the Robertson School of Media and Culture, Virginia Commonwealth University, Richmond. Emily K. Vraga is with the Hubbard School of Journalism and Mass Communication, University of Minnesota, Minneapolis. Carrie A. Miller, Hannah M. Ming, Bernard F. Fuemmeler, and Kellie E. Carlyle are with the Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond. Linnea I. Laestadius is with the Joseph J. Zilber School of Public Health, University of Wisconsin, Milwaukee. Aurora Occa is with the Department of Communication, University of Kentucky, Lexington. Xiaoli Nan and Yan Qin are with the Department of Communication, University of Maryland, College Park
| | - Hannah M Ming
- Jeanine P. D. Guidry is with the Robertson School of Media and Culture, Virginia Commonwealth University, Richmond. Emily K. Vraga is with the Hubbard School of Journalism and Mass Communication, University of Minnesota, Minneapolis. Carrie A. Miller, Hannah M. Ming, Bernard F. Fuemmeler, and Kellie E. Carlyle are with the Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond. Linnea I. Laestadius is with the Joseph J. Zilber School of Public Health, University of Wisconsin, Milwaukee. Aurora Occa is with the Department of Communication, University of Kentucky, Lexington. Xiaoli Nan and Yan Qin are with the Department of Communication, University of Maryland, College Park
| | - Yan Qin
- Jeanine P. D. Guidry is with the Robertson School of Media and Culture, Virginia Commonwealth University, Richmond. Emily K. Vraga is with the Hubbard School of Journalism and Mass Communication, University of Minnesota, Minneapolis. Carrie A. Miller, Hannah M. Ming, Bernard F. Fuemmeler, and Kellie E. Carlyle are with the Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond. Linnea I. Laestadius is with the Joseph J. Zilber School of Public Health, University of Wisconsin, Milwaukee. Aurora Occa is with the Department of Communication, University of Kentucky, Lexington. Xiaoli Nan and Yan Qin are with the Department of Communication, University of Maryland, College Park
| | - Bernard F Fuemmeler
- Jeanine P. D. Guidry is with the Robertson School of Media and Culture, Virginia Commonwealth University, Richmond. Emily K. Vraga is with the Hubbard School of Journalism and Mass Communication, University of Minnesota, Minneapolis. Carrie A. Miller, Hannah M. Ming, Bernard F. Fuemmeler, and Kellie E. Carlyle are with the Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond. Linnea I. Laestadius is with the Joseph J. Zilber School of Public Health, University of Wisconsin, Milwaukee. Aurora Occa is with the Department of Communication, University of Kentucky, Lexington. Xiaoli Nan and Yan Qin are with the Department of Communication, University of Maryland, College Park
| | - Kellie E Carlyle
- Jeanine P. D. Guidry is with the Robertson School of Media and Culture, Virginia Commonwealth University, Richmond. Emily K. Vraga is with the Hubbard School of Journalism and Mass Communication, University of Minnesota, Minneapolis. Carrie A. Miller, Hannah M. Ming, Bernard F. Fuemmeler, and Kellie E. Carlyle are with the Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond. Linnea I. Laestadius is with the Joseph J. Zilber School of Public Health, University of Wisconsin, Milwaukee. Aurora Occa is with the Department of Communication, University of Kentucky, Lexington. Xiaoli Nan and Yan Qin are with the Department of Communication, University of Maryland, College Park
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Abuadas FH, Abuadas MH. An Interventional Study to Improve Colorectal Cancer Screening Knowledge and Health Perceptions among Jordanians' Average Risk Population. Open Nurs J 2019. [DOI: 10.2174/1874434601913010237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Context:
Globally, Colorectal Cancer (CRC) is the second most commonly occurring cancer in women and the third most commonly occurring cancer in men.
Aims:
This study was conducted to investigate the current levels of Jordanians' CRC knowledge and health perceptions; and to test the effects of a health education intervention on them.
Settings and Design:
A descriptive quasi-experimental design was used to recruit a convenience sample of 197 Jordanian adult participants from two governmental hospitals in Amman.
Methods and Material:
A rolling enrolment strategy was used to randomly assign participants into intervention (n=98) and control (n=99) groups. An education intervention included a 1-hour Power Point presentation about CRC.
Results:
The mean knowledge scores were (6.51±1.60) and (6.91± 1.83) for females and males, respectively. The mean of the knowledge level in the intervention group subsequent to the intervention was significantly higher than that for the control group. More than half of the study participants (53.8%) did not believe they were susceptible to CRC, while about one third (37.4%) of the participants believed that CRC is a severe disease. 42.2% of study participants believed there were barriers preventing them from participating in CRC screening. The most frequently perceived barrier among them was the cost of screening tests. The means of the perceived susceptibility and severity subscales of the intervention group was significantly higher than that of the control group.
Conclusion:
Correcting the knowledge gap and improper health perceptions toward CRC could play an important role in facilitating early detection as a primary prevention measure. Findings may enhance health strategies to better address the needs of the average-risk population.
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Sharifikia I, Rohani C, Estebsari F, Matbouei M, Salmani F, Hossein-Nejad A. Health Belief Model-based Intervention on Women's Knowledge and Perceived Beliefs about Warning Signs of Cancer. Asia Pac J Oncol Nurs 2019; 6:431-439. [PMID: 31572765 PMCID: PMC6696815 DOI: 10.4103/apjon.apjon_32_19] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objective: Early detection of cancers essentially depends on knowledge of the warning signs. This study, therefore, aimed at investigating the effect of Health Belief Model (HBM)-based educational intervention on the knowledge and perceived beliefs of women about the warning signs of cancer. Methods: This experimental study with intervention (n = 80) and control (n = 80) groups was performed at four urban health centers affiliated to the university. Data collection was done in two phases, before and one month after the educational intervention, using three instruments, a demographic-clinical information questionnaire, the awareness questionnaire on cancer warning signs, and the cancer warning signs-HBM questionnaire. Results: The results of the multivariate repeated-measures analyses of variance indicated that the hypothesis of this study was confirmed. It means that “women's knowledge and their perceived beliefs of cancer warning signs” improved after HBM-based educational intervention in the intervention group, compared to the controls over time. Thus, the “level of knowledge” and perceived beliefs of the women in the intervention group compared to the controls increased, in terms of perceived “sensitivity,” “severity,” “benefits,” “barriers,” “cue to action,” and “self-efficacy” over time (P < 0.001). Conclusions: It could be hoped that this intervention would be effective for improving the performance of women in health-promoting behaviors of cancer prevention. It is recommended that health-care providers plan for HBM-based educational interventions, based on educational needs of the target groups at different community levels.
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Affiliation(s)
- Iman Sharifikia
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Camelia Rohani
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Estebsari
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Matbouei
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Salmani
- Department of Epidemiology and Biostatistics, Faculty of Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Azam Hossein-Nejad
- Department of Nursing, School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran
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Gholampour Y, Jaderipour A, Khani Jeihooni A, Kashfi SM, Afzali Harsini P. The Effect of Educational Intervention Based on Health Belief Model and Social Support on the Rate of Participation of Individuals in Performing Fecal Occult Blood Test for Colorectal Cancer Screening. ASIAN PACIFIC JOURNAL OF CANCER PREVENTION : APJCP 2018; 19:2777-2787. [PMID: 30360606 PMCID: PMC6291048 DOI: 10.22034/apjcp.2018.19.10.2777] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background and Aim: Among the screening tests for colorectal cancer, fecal occult blood test (FOBT) is important in comparison other methods due to its ease of use and low cost.The aim of this study is to survey the effect of educational intervention based on health belief model and social support on the rate of participation of individuals in performing fecal occult blood test for colorectal cancer screening among men who referred to the health centers in FasaCity, Fars province, Iran. Materials and Methods: In this quasi-experimental study, 200 men (100 in experimental group and 100 in control group) in FasaCity, Fars province, Iranwere selected in 2017. A questionnaire consisting of demographic information, knowledge, HBM constructs (perceived susceptibility, severity, benefits, barriers, self- efficacy and cues to action) and social support was used to measure the rate of participation of individuals in performing Fecal Occult Blood Test for colorectal cancer screening before and three months after the intervention. Data were analyzed using SPSS22 viadescriptive and inferential statistics, paired t-test, Mann-Whitney, Chi-square, and independent t-test at a significance level of 0.5. Results: The mean age of the men was 63.18 ± 8.25 years in the experimental group and 65.11 ± 7.66 years in the control group. Three months after the intervention, the experimental group showed a significant increase in the knowledge, perceived susceptibility, perceived severity, perceived benefits, Self-efficacy, cues to action, social support and the level of referrals (participation) of subjects for FOBTcompared to the control group. Conclusion: This study showed the effectiveness of HBM constructs and social support in adoption of the level of participation of subjects for FOBTin men. Hence, these models can act as a framework for designing and implementing educational interventions for undergoing FOBT.
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Affiliation(s)
- Yousef Gholampour
- Department of Internal Medicine, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran.
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The Effect of a Health Education Intervention on Jordanian Participants' Colorectal Cancer Knowledge, Health Perceptions, and Screening Practices. Cancer Nurs 2017; 41:226-237. [PMID: 28252461 DOI: 10.1097/ncc.0000000000000480] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Globally, colorectal cancer (CRC) is the second and third most commonly diagnosed cancer in women and men, respectively. OBJECTIVES The aim of this study is to test the effectiveness of a health education intervention on the current level of Jordanians' CRC knowledge, health perceptions, and screening practices. METHODS A convenience sampling method was used to recruit a sample of 197 average-risk Jordanian adults aged 50 to 75 years. The sample was collected from outpatient departments of Jordan University and Al-Basheer Hospitals in Amman. This study used quasi-experimental design, and a rolling enrollment method was implemented to randomly assign the participants into intervention and control groups. RESULTS Baseline results indicated that Jordanian average-risk participants were not well informed about CRC and screening recommendations. One-fourth perceived themselves to be susceptible to CRC. About one-third comprehended the seriousness of CRC, most recognized the benefits of CRC screening, and fewer than half believed there were barriers preventing them from participating in CRC screening. Four weeks after intervention implementation, there was a significantly higher level of knowledge, as well as increased susceptibility and severity perceptions, screening via fecal occult blood test, and intentions to undergo screening via colonoscopy or sigmoidoscopy. CONCLUSION The findings support the implementation of a health education intervention as an effective way to enhance levels of knowledge and promote positive health perceptions regarding CRC and screening recommendations. IMPLICATIONS FOR PRACTICE This study may provide Jordanian and other nurses with a theory-based educational intervention to improve the quality of nursing care and reduce costs.
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Hughes AG, Watanabe-Galloway S, Schnell P, Soliman AS. Rural-Urban Differences in Colorectal Cancer Screening Barriers in Nebraska. J Community Health 2016; 40:1065-74. [PMID: 25910484 DOI: 10.1007/s10900-015-0032-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Nebraska ranks 36th nationally in colorectal cancer screening. Despite recent increases in CRC screening rates, rural areas in Nebraska have consistently shown lower rates of CRC screening uptake, compared to urban areas. The objective of this study was to investigate reasons for lower CRC screening rates among Nebraska residents, especially among rural residents. We developed a questionnaire based on Health Belief Model (HBM) constructs to identify factors associated with the use of CRC screening. The questionnaire was mailed in 2014 to adults aged 50-75 years in an urban community in the east and a rural community in the west regions of the state. Multiple logistic regression models were created to assess the effects of HBM constructs, rural residence, and demographic factors on CRC screening use. Of the 1200 surveys mailed, 393 were returned (rural n = 200, urban n = 193). Rural respondents were more likely to perceive screening cost as a barrier. Rural residents were also more likely to report that CRC cannot be prevented and it would change their whole life. In multiple regression models, rural residence, perceived embarrassment, and perceived unpleasantness about screening were significantly associated with reduced odds of receiving colonoscopy. Older age (62 years and older), having a personal doctor, and perceived risk of getting CRC were significantly associated with increased odds of receiving colonoscopy. Interventions to increase uptake of colorectal cancer screening in rural residents should be tailored to acknowledge unique perceptions of screening methods and barriers to screening.
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Affiliation(s)
- Alejandro G Hughes
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, 984395 Nebraska Medical Center, Omaha, NE, 68198-4395, USA
| | - Shinobu Watanabe-Galloway
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, 984395 Nebraska Medical Center, Omaha, NE, 68198-4395, USA.
| | - Paulette Schnell
- Department of Community Health, Regional West Medical Center, 3700 Avenue B, Scottsbluff, NE, 69361, USA
| | - Amr S Soliman
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, 984395 Nebraska Medical Center, Omaha, NE, 68198-4395, USA
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Oberoi DV, Jiwa M, McManus A, Parsons R. Do Men Know Which Lower Bowel Symptoms Warrant Medical Attention? A Web-Based Video Vignette Survey of Men in Western Australia. Am J Mens Health 2016; 10:474-486. [DOI: 10.1177/1557988315574739] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The current study aims to explor how men would advise other men about seeking help for lower bowel symptoms and also to determine the factors that may influence help seeking. A purposive sample of Western Australian men aged 18 years and older was recruited for the study. Participants completed 8 of the 28 randomly assigned video vignettes (video clips) displaying men (older or younger) with various combinations of one or more lower bowel symptoms. Participants were asked if the person in the vignette should seek health advice. Subsequently, the participants answered a set of questions based on the Health Belief Model. A total of 408 participants (response rate = 51%) answered 3,264 vignettes. Participants younger than 50 years, participants who were not tertiary educated and those who had lower incomes, or those living in regional or remote areas were less likely to advise help seeking from general practitioner (GP). Participants who visited their general practitioner less frequently were also less likely to advisehelp seeking. There was a trend to consider unintentional weight loss and diarrhea as minor symptoms not necessitating medical attention compared with rectal bleeding. The findings suggest for a need to improve public awareness among men about the need to seek timely medical advice for lower bowel symptoms in primary care. The importance of early presentation of persistent lower bowel symptoms must be specifically targeted at men younger than 50 years, those with lower incomes, or residing in regional or remote areas.
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Affiliation(s)
| | - Moyez Jiwa
- Curtin University, Bentley, Western Australia, Australia
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Screening behaviors, health beliefs, and related factors of first-degree relatives of colorectal cancer patients with ongoing treatment in Turkey. Cancer Nurs 2016; 37:E51-60. [PMID: 24476673 DOI: 10.1097/ncc.0000000000000121] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Colorectal cancer (CRC) is one of the most common cancers. Family history is an important risk factor; first-degree relatives (FDRs) are most at risk. Studies are needed to determine the screening behavior of FDRs and factors affecting their health behaviors. OBJECTIVE The purpose of this study was to investigate the screening behaviors, health beliefs, and related factors of FDRs (parent, sibling, or child) of CRC patients undergoing treatment. METHODS A cross-sectional design was used with 400 FDRs of patients undergoing treatment at 2 hospitals in Turkey. Data were collected using the Colorectal Cancer Risk Questionnaire and the Turkish Colorectal Cancer Health Belief Model Scale. RESULTS A slight majority of the participants were male (51.3%), with a mean of age 37.7 years. The rate of having at least 1 colonoscopy in FDRs was 22.2%. First-degree relatives reported high perceived confidence-benefits scores on average (mean, 48.4 ± 5.2) and high perceived barrier scores on average (mean, 15.5 ± 3.8). Health motivation of FDRs was the strongest predictor of their having a colonoscopy (odds ratio, 7.50; 95% confidence interval, 3.40-16.5). CONCLUSIONS First-degree relatives have a low rate of having a colonoscopy but are more likely to have had this procedure if they have strong health motivation. IMPLICATIONS FOR PRACTICE Nurses working with CRC patients must develop strategies to increase FDRs' knowledge of, awareness of, and motivation for CRC screening tests. Risk counseling of FDRs during the treatment period might increase screening rates.
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Taheri-Kharameh Z, Noorizadeh F, Sangy S, Zamanian H, Shouri-Bidgoli AR, Oveisi H. Factors Associated with Adherence to Colorectal Cancer Screening among Moderate Risk Individuals in Iran. Asian Pac J Cancer Prev 2016; 16:8371-5. [DOI: 10.7314/apjcp.2015.16.18.8371] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Chai J, Shen X, Feng R, Cheng J, Chen Y, Zha Z, Jia S, Liang H, Zhao T, Sha R, Shi Y, Li K, Wang D. eCROPS-CA: a systematic approach toward effective and sustainable cancer prevention in rural China. BMC Cancer 2015; 15:233. [PMID: 25886568 PMCID: PMC4416351 DOI: 10.1186/s12885-015-1253-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 03/25/2015] [Indexed: 12/21/2022] Open
Abstract
Background Effective prevention against cancers depends heavily on sustained individual efforts practicing protective behaviors and avoiding risk factors in a complex sociocultural context, which requires continuous and personalized supports. Contemporary prevention relies primarily on strategies targeting general population with limited attention being paid to individualized approaches. This study tests a novel package called, in acronym of core intervention components, eCROPS-CA that leverages protective behaviors against over 80% leading cancers among high risk individuals via continuous and tailored counseling by village doctors. Methods/Design The study utilizes a quesi-RCT design involving 4320 high risk individuals selected, via rapid and detailed risk assessments, from about 72,000 farmers aged 35+ in 36 administrative villages randomized into equal intervention and delayed intervention arms. The intervention arm receives baseline and semiannual follow up evaluations plus eCROPS-CA for 5 years; while the control arm, only the baseline and follow-up evaluations for the first 5 years and eCROPS-CA starting from the 6th year if the intervention is proved effective. eCROPS-CA comprises electronic supports and supervision (e), counseling cancer prevention (C), recipe for objective behaviors (R), operational toolkit (O), performance-based incentives (P), and screening and assessment (S). Evaluation measures include: incidence and stage of the leading cancers, cancer-related knowledge, attitudes and practices; easy biophysical indicators (e.g., body mass index, blood pressure); intervention compliance, acceptance of the package. Discussion The prevention package incorporates key success factors in a synergetic way toward cost-effectiveness and long-term sustainability. It targets a set rather than any single cancer; choses village doctors as key solution to the widespread lack of professional manpower in implementing personalized and thus relatively sophisticated prevention; adopts real-time monitoring in reaching continuous improvement; utilizes smart web aids to enable prioritizing complex determinants of objective behaviors, linking counseling sessions happened at different time points and hence delivering highly coordinated prevention; uses 2-stage risk assessment models in identifying high risk individuals so as to focus on the most needed; applies standardized operation procedures in simplifying and smoothing behavior intervention yet ensuring delivery of essential steps and key elements. Trials registry ISRCTN33269053 Electronic supplementary material The online version of this article (doi:10.1186/s12885-015-1253-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jing Chai
- School of Health Service Management, Anhui Medical University, Hefei, Anhui, China.
| | - Xingrong Shen
- School of Health Service Management, Anhui Medical University, Hefei, Anhui, China.
| | - Rui Feng
- Department of Literature Review and Analysis, Library of Anhui Medical University, Hefei, Anhui, China.
| | - Jing Cheng
- School of Health Service Management, Anhui Medical University, Hefei, Anhui, China.
| | - Yeji Chen
- Anhui Center for Disease Control and Prevention, Hefei, Anhui, China.
| | - Zhengqiu Zha
- Anhui Center for Disease Control and Prevention, Hefei, Anhui, China.
| | - Shangchun Jia
- Anhui Center for Disease Control and Prevention, Hefei, Anhui, China.
| | - Han Liang
- School of Health Service Management, Anhui Medical University, Hefei, Anhui, China.
| | - Ting Zhao
- School of Health Service Management, Anhui Medical University, Hefei, Anhui, China.
| | - Rui Sha
- School of Health Service Management, Anhui Medical University, Hefei, Anhui, China.
| | - Yong Shi
- Luan Center for Disease Control and Prevention, Luan, Anhui, China.
| | - Kaichun Li
- Luan Center for Disease Control and Prevention, Luan, Anhui, China.
| | - Debin Wang
- School of Health Service Management, Anhui Medical University, Hefei, Anhui, China. .,Collaboration Center for Cancer Control, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
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Zaharek-Girgasky MM, Wolf RL, Zybert P, Basch CH, Basch CE. Diet-Related Colorectal Cancer Prevention Beliefs and Dietary Intakes in an Urban Minority Population. J Community Health 2014; 40:680-5. [PMID: 25528326 DOI: 10.1007/s10900-014-9984-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In the United States, colorectal cancer (CRC) is the third leading cause of cancer-related death and third most commonly diagnosed cancer among adults. This study is the first to examine the relationship between diet-related beliefs for colorectal cancer prevention and dietary intake among an urban, predominantly Black population (n = 169). More than two-thirds reported diet-related CRC prevention beliefs. Those with diet-related CRC prevention beliefs had healthier intakes for dietary fiber (p = .005), fruit, vegetable, bean (p = .027), red meat (p = .032), vitamin C (p = .039), and cholesterol (p = .045). Most people may already have diet-related CRC prevention beliefs and having them is associated with a more healthful dietary intake.
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The Affordable Health Care Act annual wellness visits: the effectiveness of a nurse-run clinic in promoting adherence to mammogram and colonoscopy recommendations. J Nurs Adm 2014; 44:270-5. [PMID: 24759199 DOI: 10.1097/nna.0000000000000066] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The aim of this study was to determine the effectiveness of the nurse-run annual wellness visit (AWV) in improving adherence to cancer screening recommendations for colonoscopies and/or mammograms. BACKGROUND The Affordable Health Care Act provides Medicare beneficiaries access to AWVs. Nurse-run AWVs offer individualized education, reinforce health screening recommendations, and may enhance the patients' intent to complete the screenings. METHODS A nonexperimental comparative study was conducted using data collected from chart audits comparing patients who only attended the AWV, patients who attended the AWV linked with a physician visit, and patients who have not attended an AWV. RESULTS Patients who attended the AWV showed greater adherence to mammogram completion regardless of the link to the physician follow-up visit. Differences in adherence to colonoscopy recommendations were not significant, likely because of the low number of colonoscopies reported. CONCLUSIONS Nurse-run AWV clinics are associated with adherence to mammograms and show promise of increasing colonoscopy compliance.
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Wu TY, Wozny PJ, Raymond III DM. Promoting Colorectal Cancer Awareness in Undergraduate Community Health Nursing Education: A Community–Academic Collaboration. J Community Health Nurs 2013; 30:175-84. [PMID: 24219638 DOI: 10.1080/07370016.2013.838471] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Wong MCS, Hirai HW, Luk AKC, Lam TYT, Ching JYL, Griffiths SM, Chan FKL, Sung JJY. The knowledge of colorectal cancer symptoms and risk factors among 10,078 screening participants: are high risk individuals more knowledgeable? PLoS One 2013; 8:e60366. [PMID: 23573248 PMCID: PMC3616059 DOI: 10.1371/journal.pone.0060366] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 02/25/2013] [Indexed: 12/31/2022] Open
Abstract
Objectives We tested the a priori hypothesis that self-perceived and real presences of risks for colorectal cancer (CRC) are associated with better knowledge of the symptoms and risk factors for CRC, respectively. Methods One territory-wide invitation for free CRC screening between 2008 to 2012 recruited asymptomatic screening participants aged 50–70 years in Hong Kong. They completed survey items on self-perceived and real presences of risks for CRC (advanced age, male gender, positive family history and smoking) as predictors, and knowledge of CRC symptoms and risk factors as outcome measures, respectively. Their associations were evaluated by binary logistic regression analyses. Results From 10,078 eligible participants (average age 59 years), the mean knowledge scores for symptoms and risk factors were 3.23 and 4.06, respectively (both score range 0–9). Male gender (adjusted odds ratio [AOR] = 1.34, 95% C.I. 1.20–1.50, p<0.01), self-perception as not having any risks for CRC (AOR = 1.12, 95% C.I. 1.01–1.24, p = 0.033) or uncertainty about having risks (AOR = 1.94, 95% C.I. 1.55–2.43, p<0.001), smoking (AOR 1.38, 95% C.I. 1.11–1.72, p = 0.004), and the absence of family history (AOR 0.61 to 0.78 for those with positive family history, p<0.001) were associated with poorer knowledge scores (≤4) of CRC symptoms. These factors remained significant for knowledge of risk factors. Conclusions Male and smokers were more likely to have poorer knowledge but family history of CRC was associated with better knowledge. Since screening of these higher risk individuals could lead to greater yield of colorectal neoplasm, educational interventions targeted to male smokers were recommended.
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Affiliation(s)
- Martin C. S. Wong
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
- School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hoyee W. Hirai
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Arthur K. C. Luk
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Thomas Y. T. Lam
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jessica Y. L. Ching
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sian M. Griffiths
- School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Francis K. L. Chan
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Joseph J. Y. Sung
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
- * E-mail:
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Anderson RT, Camacho F, Iaconi AI, Tegeler CH, Balkrishnan R. Enhancing the Effectiveness of Community Stroke Risk Screening: A Randomized Controlled Trial. J Stroke Cerebrovasc Dis 2011; 20:330-5. [DOI: 10.1016/j.jstrokecerebrovasdis.2010.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2009] [Revised: 01/22/2010] [Accepted: 02/05/2010] [Indexed: 10/19/2022] Open
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Predictors of colorectal cancer knowledge and screening among church-attending African Americans and Whites in the Deep South. J Community Health 2009; 34:90-7. [PMID: 18941876 DOI: 10.1007/s10900-008-9128-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study examined colorectal cancer (CRC) knowledge and the relationship between knowledge, risk factors and screening behaviors among African Americans and Whites in the Deep South. One hundred and twenty three African Americans and Whites age-eligible for CRC screening were interviewed by telephone survey as part of a church-based CRC educational intervention. CRC knowledge was lower among those with less education, unemployed, Medicaid, Medicare, and less family income. Generally, participants who had more CRC knowledge were more likely to have engaged in screening behaviors. Participants who had a family history of CRC were more likely to have had a fecal occult blood test (OR = 2.55, 0.99-6.60) or barium enema (OR = 3.84, 1.44-10.24) than those without. Whites were more likely to have had a flexible sigmoidoscopy (OR = 4.17, 1.09-16.67), colonoscopy (OR = 7.14, 1.72-25) or barium enema (OR = 6.25, 1.67-25) than African Americans. Church-based CRC screening intervention programs should target African Americans, those with no family history of CRC, and those with less education.
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Sung JJY, Choi SYP, Chan FKL, Ching JYL, Lau JTF, Griffiths S. Obstacles to colorectal cancer screening in Chinese: a study based on the health belief model. Am J Gastroenterol 2008; 103:974-81. [PMID: 18047545 DOI: 10.1111/j.1572-0241.2007.01649.x] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Colorectal cancer (CRC) has emerged as the second most common cancer in Asia. This study uses the Health Belief Model (HBM) to examine the factors associated with the uptake of CRC testing. METHODS A population-based telephone survey in which 1,004 randomly selected Chinese residents of Hong Kong aged between 30 and 65 yr were interviewed in 2006. Instruments were developed to measure the variables pertinent to the HBM, including perceived susceptibility, severity, benefit, barriers, and cues to action. The relationships of these predictors with CRC testing were examined using bivariate and multiple logistic regression analyses. RESULTS Ten percent of the respondents had undertaken a CRC screening test. In the multiple logistic regression analyses, knowledge factors that were positively associated with CRC testing included knowledge of CRC symptoms (adjusted odds ratio [aOR] 3.33, 95% confidence interval [CI] 1.21-9.11) and knowledge of CRC risk factors (aOR 2.61, 95% CI 1.16-5.88). Five of the variables pertaining to the HBM were significant correlates of CRC testing-perceived severity of CRC (aOR 0.28, 95% CI 0.13-0.65), perceived health and psychological barriers to CRC testing (aOR 0.42, 95% CI 0.21-0.84, 95% CI 0.21-0.85), perceived access barriers to CRC testing (aOR 0.22, 95% CI 0.05-0.85), physician's recommendation (indicator of cues to action) (aOR 23.50, 95% CI 10.66-51.80), and having health insurance (indicator of cues to action) (aOR 2.06, 95% CI 1.01-4.19). CONCLUSIONS CRC testing compliance among this Asian population is low. Knowledge of CRC symptoms and risk factors are low. Perceived health, psychological, and access barriers to CRC testing are high. The physician's recommendation and having health insurance coverage significantly increase testing, but physicians mainly recommend patients with a family history of CRC for testing, and only around one-third of the population has health insurance.
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Affiliation(s)
- Joseph J Y Sung
- School of Public Health, Faculty of Medicine of the Chinese University of Hong Kong, Shatin, NT, Hong Kong
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Waterman AD, Browne T, Waterman BM, Gladstone EH, Hostetter T. Attitudes and behaviors of African Americans regarding early detection of kidney disease. Am J Kidney Dis 2008; 51:554-62. [PMID: 18371531 DOI: 10.1053/j.ajkd.2007.12.020] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2007] [Accepted: 12/12/2007] [Indexed: 11/11/2022]
Abstract
BACKGROUND Chronic kidney disease (CKD) is an African American public health crisis. To inform interventions, the National Kidney Disease Education Program surveyed African Americans about their attitudes and behaviors regarding early detection of kidney disease and screening. STUDY DESIGN Cross-sectional study. SETTING & PARTICIPANTS 2,017 African Americans from 7 states (Georgia, Maryland, Ohio, Mississippi, Louisiana, Missouri, and Tennessee) selected by using a random-digit dialing telephone survey (response rate, 42.4%). PREDICTORS Demographic, risk, knowledge, and behavior variables. OUTCOMES & MEASUREMENTS Perception of CKD as a top health concern, perceived risk of getting kidney disease, and accurate knowledge about CKD and its prevention. RESULTS Only 23.5% of African Americans were screened for kidney disease in the last year. Although almost half (43.7%) of African Americans had a CKD risk factor, only 2.8% reported that CKD was a top health concern. Almost half knew the correct definition of kidney disease (48.6%), but few knew a test to diagnose CKD (23.7%) or that African Americans were at greater risk of developing CKD (18.1%). African Americans who had diabetes (odds ratio [OR], 3.22; 95% confidence interval [CI], 2.17 to 4.76), hypertension (OR, 1.78; 95% CI, 1.28 to 2.44), at least a bachelor's degree (OR, 1.77; 95% CI, 1.17 to 2.66), who had spoken with a medical professional (OR, 1.85; 95% CI, 1.19 to 2.85) or their family (OR, 1.61; 95% CI, 1.11 to 2.38) about kidney disease, who knew that a family history of kidney disease is a risk factor (OR, 2.32; 95% CI, 1.08 to 5.0), and who had been tested for CKD in the last year (OR, 1.45; 95% CI, 1.03 to 2.0) were more likely to correctly perceive themselves at increased risk. LIMITATIONS Respondents were primarily African American women from urban areas. CONCLUSIONS Most African Americans have poor knowledge about CKD, do not perceive it as an important health problem, and are not getting screened. To increase early detection of kidney disease through screenings, educational efforts linking kidney disease prevention to other diseases that are health priorities for African Americans are necessary.
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Affiliation(s)
- Amy D Waterman
- Internal Medicine, Washington University School of Medicine, St Louis, MO 63110, USA.
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