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Kongkamol C, Chintrakul A, Horsiritham K, Kiranantawat N, Nirattisaikul S, Sungsiri J, Sathirapanya P, Sathirapanya C, Boonma K, Chowwanapoonpohn T, Nuiman P, Supunthuchaikul J, Chokthamangoon N, Chintana C, Suktaneekul T, Watcharanimit C. The predictors of voluntary participation in pulmonary tuberculosis screening program: a study in a suburban community of southern Thailand. Front Public Health 2024; 12:1360986. [PMID: 38660360 PMCID: PMC11040456 DOI: 10.3389/fpubh.2024.1360986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 03/14/2024] [Indexed: 04/26/2024] Open
Abstract
Background The health belief model (HBM), baseline health condition, and sociocultural factors impact the decision to participate in a tuberculosis screening program. Methods This cross-sectional and descriptive study was carried out among the "Kao Taew" community dwellers aged 18 years and above, who voluntarily underwent the provided pulmonary tuberculosis (PTB) screening by chest radiographs (CXRs). The level of individual HBM domain perception, attitudes toward PTB prevention, and regularity of PTB prevention practices by the participants were evaluated. The significantly associated or correlated factors such as demographic characteristics, individual HBM domain perception, and attitudes toward PTB prevention with the regularity of PTB prevention practices from the univariate analysis were further analyzed by multiple linear regression (p < 0.05) to determine the independent significant predictors of PTB prevention practices. Results Among 311 participants comprising 65% women, 57.9% aged ≥ 65 years and 67.2% had an underlying disease. The study participants had a high level of perception of HBM domains but a low level of perception of the barrier. In addition, a high level of attitudes toward PTB prevention and a high regularity of PTB prevention practices were found. A multiple linear regression analysis revealed that the perceived benefits of PTB screening [Beta = 0.20 (0.04, 0.36) p = 0.016] and acquiring underlying diseases [Beta = 1.06 (0.38, 1.73), p = 0.002] were significant predictors for PTB prevention practices, while belief in Islam was a reverse predictor [Beta = -0.84 (-1.47, -0.21), p = 0.010]. Conclusions The level of perception of the individual domain of HBM, health status, and religious belief significantly predicted voluntary participation in PTB screening programs. Careful consideration by integration of the relevant health psychology, physical, and sociocultural factors is crucial for planning a health screening program.
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Affiliation(s)
- Chanon Kongkamol
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
- Air Pollution and Health Effect Research Center, Prince of Songkla University, Songkhla, Thailand
| | - Apinya Chintrakul
- Health Sciences and Clinical Research, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Kanakorn Horsiritham
- Division of Digital Innovation and Data Analytics (DIDA), Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Nantaka Kiranantawat
- Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Sitang Nirattisaikul
- Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Jitpreedee Sungsiri
- Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Pornchai Sathirapanya
- Department of Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Chutarat Sathirapanya
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Koontidar Boonma
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Tuck Chowwanapoonpohn
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Paradon Nuiman
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Jekita Supunthuchaikul
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Nuttartham Chokthamangoon
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Chalanthon Chintana
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Trithep Suktaneekul
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Chananyu Watcharanimit
- Department of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
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Alenezi AM, Alshariyah MMH, Alanazi MN, Abdel-Salam DM, Al-Hazmi AH, Thirunavukkarasu A, Alhuwaydi AM, Alsabilah RH, Mohamed RA. Assessment of Psychosocial Correlates and Associated Factors of Colorectal Cancer Screening among Southwestern Saudi Population: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:2791. [PMID: 37893864 PMCID: PMC10606086 DOI: 10.3390/healthcare11202791] [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: 08/27/2023] [Revised: 10/09/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
Psychosocial correlates are one of the crucial determinants for the uptake of colorectal cancer (CRC) screening by the pre-eligible population. The present study aimed to identify the psychosocial correlates of colorectal cancer screening and determine their associated factors among the Saudi population in the Najran region, Saudi Arabia. Using a validated questionnaire, we assessed five constructs of psychosocial correlates of CRC screening among 790 participants aged 45 years and above. The five constructs were salience and coherence, cancer worries, perceived susceptibility, response efficacy, and social influence. Of the studied population, less than 50% agreed with most of the five constructs' statements, and 27.5% preferred to follow their family members' advice. Significantly higher mean scores (±SD) were identified for the male gender (7.38 ± 2.15, p = 0.027) and participants working in government sectors (7.60 ± 2.03, p = 0.027) in the cancer worries construct, while the mean (±SD) scores of perceived susceptibility were significantly higher among married participants (14.38 ± 4.10, p = 0.023) and smokers (14.95 ± 3.92, p = 0.041). Our survey results could help policymakers to implement focused health education programs for the pre-eligible population on the importance of the uptake of CRC screening. Furthermore, it is recommended to carry out exploratory mixed-method surveys in other regions of Saudi Arabia to understand the region's specific psychosocial correlates towards CRC screening.
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Affiliation(s)
| | | | - Maryam Nazal Alanazi
- Department of Psychological Counseling, College of Sciences and Arts, Qurrayat Campus, Jouf University, Qurrayat 77425, Saudi Arabia;
| | - Doaa Mazen Abdel-Salam
- Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Assiut 71515, Egypt;
| | - Ahmad Homoud Al-Hazmi
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (A.H.A.-H.); (A.T.)
| | - Ashokkumar Thirunavukkarasu
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (A.H.A.-H.); (A.T.)
| | - Ahmed M. Alhuwaydi
- Department of Internal Medicine, Division of Psychiatry, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia;
| | | | - Rehab A. Mohamed
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt;
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Wang Z, Zhou C, Zhang L, Shen J, Mo M, He Y, Zheng Y. Predictors of cancer screening behavior of the working population in China based on the information-motivation-behavioral skills model. Front Public Health 2023; 11:1112172. [PMID: 37575100 PMCID: PMC10412821 DOI: 10.3389/fpubh.2023.1112172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 07/13/2023] [Indexed: 08/15/2023] Open
Abstract
Background The cancer screening rate in the working population is very low in China. Information-motivation-behavioral skills (IMB) model has been applied to elucidate screening behavior for various chronic diseases but has not been investigated in analyzing cancer screening behavior. This study aimed to examine factors influencing cancer screening behavior and their linkages based on the IMB model. Methods A cross-sectional study was conducted in Shanghai, China from August to October 2021. Data were obtained through an anonymous questionnaire. Predictive relationships between variables in the IMB model and cancer screening behavior were evaluated. Structural equation modeling (SEM) was constructed to demonstrate the utility of the IMB model. Results Among the 556 participants included in the analysis, 34.4% of participants had ever done a cancer screening. The construct validation analysis supported that the measure items included were acceptable. SEM found that knowledge of cancer warning signs and symptoms (β = 0.563, p < 0.001) and cancer screening behavioral skills (β = 0.264, p = 0.003) were related to participation in cancer screening, whereas cancer screening motivation was not directly influenced the participation in cancer screening (β = - 0.075, p = 0.372). Conclusion The cancer screening rate was found to be lower than expected in the working population. The IMB model could be used to make decisions in implementing behavioral interventions to participate in cancer screening among the Chinese working population. Enhancing the knowledge of cancer warning signs and symptoms and strengthening behavioral skills should be focused on to improve participation in cancer screening.
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Affiliation(s)
- Zezhou Wang
- Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Changming Zhou
- Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Li Zhang
- Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Jie Shen
- Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Miao Mo
- Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yulian He
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Ying Zheng
- Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Shanghai Engineering Research Center of Artificial Intelligence Technology for Tumor Diseases, Shanghai, China
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Zhu Y, Zhao G, Ma W, Chen X, Chen X, Li D, Zhao S, Xiong S, Zheng M. Real-world application of a fast stool DNA test for colorectal cancer screening in primary screening positive population. Cancer Med 2023; 12:7689-7698. [PMID: 36468523 PMCID: PMC10134307 DOI: 10.1002/cam4.5521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Stool DNA test has been emerged as an effective noninvasive method for colorectal cancer (CRC) screening, but the real-world performance of stool DNA test in Chinese population has rarely been reported. METHODS A total of 36,527 subjects were recruited in Haining City from January 2021 to December 2021. Participants underwent primary screening by taking both two-samples fecal immunochemical tests (FITs) and high-risk factor questionnaire (HRFQ), and those who tested either positive by FITs or evaluated to be high risk by HRFQ were recommended to undertake subsequent stool DNA test and colonoscopy. RESULTS Of 36,527 participants, 34,778 (95%) completed both HRFQ and FITs, 9947 (29%) showed positive results during primary screening, and the colonoscopy compliance rate was 49%. Of primary screening positives, 8733 (88%) completed stool sample collections, and colonoscopy results from 4293 eligible participants were used for analyzing the performance of stool DNA test. The sensitivities for detecting CRC and advanced adenomas (AA) were 100% (95% CI: 60-100%) and 40% (95% CI: 34-46%), and the area under curve (AUC) was 0.961 (95% CI:0.954-0.967) and 0.625 (95% CI: 0.609-0.641), respectively. The specificity of stool DNA test was 84% (95% CI: 82-85%). The false-positive rate for stool DNA test is about 10% less than that of primary screening. CONCLUSION Stool DNA test is a cost-effective and promising alternative strategy for CRC screening in China.
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Affiliation(s)
- Yunfeng Zhu
- Haining Hospital of Traditional Chinese MedicineHaining Cancer Prevention and Treatment Research InstituteHainingZhejiangChina
| | - Guodong Zhao
- Zhejiang University Kunshan Biotechnology LaboratoryZhejiang University Kunshan Innovation InstituteKunshanJiangsuChina
- Suzhou VersaBio Technologies Co. Ltd.KunshanJiangsuChina
| | - Weihua Ma
- Haining Hospital of Traditional Chinese MedicineHaining Cancer Prevention and Treatment Research InstituteHainingZhejiangChina
| | - Xinmin Chen
- Haining Hospital of Traditional Chinese MedicineHaining Cancer Prevention and Treatment Research InstituteHainingZhejiangChina
| | - Xiaofei Chen
- Haining Hospital of Traditional Chinese MedicineHaining Cancer Prevention and Treatment Research InstituteHainingZhejiangChina
| | - Danning Li
- Suzhou VersaBio Technologies Co. Ltd.KunshanJiangsuChina
| | - Shuyan Zhao
- Suzhou VersaBio Technologies Co. Ltd.KunshanJiangsuChina
| | - Shangmin Xiong
- Zhejiang University Kunshan Biotechnology LaboratoryZhejiang University Kunshan Innovation InstituteKunshanJiangsuChina
- Suzhou VersaBio Technologies Co. Ltd.KunshanJiangsuChina
| | - Minxue Zheng
- Zhejiang University Kunshan Biotechnology LaboratoryZhejiang University Kunshan Innovation InstituteKunshanJiangsuChina
- Suzhou Institute of Biomedical Engineering and TechnologyChinese Academy of SciencesSuzhouJiangsuChina
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Liu J, Chen B, Yang M, Qian Y, Shen Q, Chen H, Dong Y, Wang L, Jiao J. A three-plasma miRNA panel predicts the risk of colorectal cancer: a community-based nested case‒control study. Sci Rep 2023; 13:4196. [PMID: 36918702 PMCID: PMC10014991 DOI: 10.1038/s41598-023-31449-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 03/11/2023] [Indexed: 03/16/2023] Open
Abstract
Circulating microRNAs (miRNAs) have been considered potential markers for the early detection of malignant colorectal cancer (CRC). We aimed to identify a group of miRNAs for the early detection of CRC and assess their predictive ability in a community-based population in China. A nested case‒control study consisting of 97 incident colorectal cancer cases and 103 frequency-matched healthy controls was conducted. The data were randomly assigned into a training set (60%) and a test set (40%). We selected and detected 10 kinds of miRNAs in plasma samples. Multivariate logistic regression analysis was used to identify miRNAs associated with colorectal cancer risk in the training set and test set. Then, we evaluated the predictive ability of the identified miRNAs by the receiver operating characteristic curve (ROC). In this study, three miRNAs (miRNA-29a, miRNA-125b, miRNA-145) were significantly associated with colorectal cancer risk in both the training set and test set. The sensitivity of the identified miRNAs ranged from 0.854 to 0.961. After adding the identified miRNAs, the AUC (area under the curve) value significantly increased from 0.61 to 0.71 compared with the basic model consisting of only basic demographic information. We identified a three-plasma miRNA signature that may serve as a novel non-invasive biomarker in early CRC detection and in predicting individual CRC risk in the generation population.
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Affiliation(s)
- Jia Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.,Department of Health Promotion & Chronic Non-Communicable Disease Control, Wuxi Center for Disease Control and Prevention (The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University), Wuxi, Jiangsu, China
| | - Binglin Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Man Yang
- Department of Health Promotion & Chronic Non-Communicable Disease Control, Wuxi Center for Disease Control and Prevention (The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University), Wuxi, Jiangsu, China
| | - Yun Qian
- Department of Health Promotion & Chronic Non-Communicable Disease Control, Wuxi Center for Disease Control and Prevention (The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University), Wuxi, Jiangsu, China
| | - Qian Shen
- Department of Health Promotion & Chronic Non-Communicable Disease Control, Wuxi Center for Disease Control and Prevention (The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University), Wuxi, Jiangsu, China
| | - Hai Chen
- Department of Health Promotion & Chronic Non-Communicable Disease Control, Wuxi Center for Disease Control and Prevention (The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University), Wuxi, Jiangsu, China
| | - Yunqiu Dong
- Department of Health Promotion & Chronic Non-Communicable Disease Control, Wuxi Center for Disease Control and Prevention (The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University), Wuxi, Jiangsu, China
| | - Lu Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China. .,Department of Health Promotion & Chronic Non-Communicable Disease Control, Wuxi Center for Disease Control and Prevention (The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University), Wuxi, Jiangsu, China.
| | - Jiandong Jiao
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China. .,Department of Health Promotion & Chronic Non-Communicable Disease Control, Wuxi Center for Disease Control and Prevention (The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University), Wuxi, Jiangsu, China.
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Jiang C, Liu L, Wang Y, Wu L, Zhang W, Wu X. Fatalism and metaphor in Confucianism: A qualitative study of barriers to genetic testing among first-degree relatives of hereditary cancer patients from China. Psychooncology 2023; 32:275-282. [PMID: 36380559 PMCID: PMC10099923 DOI: 10.1002/pon.6068] [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: 05/21/2022] [Revised: 09/01/2022] [Accepted: 09/26/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Despite the benefits, the rate of genetic testing among first-degree relatives (FDRs; parents, children, and siblings) remains low, and the barriers to undergoing testing among FDRs in China are not clear. We explored the reasons why FDRs refused genetic testing. METHODS Semi-structured face-to-face interviews were conducted with 22 patients and 27 FDRs. Participants were recruited at an urban tertiary hospital in Guangzhou, South China. We used qualitative content analysis to analyse the transcripts of audio recordings and identify major themes and subthemes. RESULTS Three major themes emerged related to FDRs' low rate of participation in genetic testing. First, there is cognitive distance from genetic testing/cancer and a lack of knowledge of preventive medicine that deepens the 'fatalistic' attitude towards cancer among FDRs, which leads to an enormous gap between their knowledge and understanding of genetic testing. Second, medical consultation is not valued in Confucianism, and the view of cancer as 'bad news' and the risk of cancer as a curse makes cancer a metaphor, which leads to exhausting arguments when persuading FDRs to undergo genetic testing. Third, physical distance from the hospital, loss of privacy, possible discrimination in many social activities and genetic testing as a source of stress and anxiety lead FDRs to fear the disruption of their daily lives. CONCLUSIONS There are many barriers to genetic testing among the FDRs of hereditary cancer patients originating from the national social and cultural context. Healthcare professionals should develop interventions rooted in culture and promote cancer risk communication between hereditary cancer patients and FDRs.
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Affiliation(s)
- Chaonan Jiang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Li Liu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ye Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Liangzheng Wu
- The Cancer Center of Guangzhou Medical University, Guangzhou, China
| | - Wenxia Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xiaodan Wu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
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Berger C, Ben-Shalom U, Tarant Z, Longo J, DeDonno M. The Influence of the Health Belief Model on the Decision to Get the COVID-19 Vaccine: An International Survey Study of College Students. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231164229. [PMID: 37016560 PMCID: PMC10076239 DOI: 10.1177/00469580231164229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 04/06/2023]
Abstract
To better prepare for a potential future pandemic, it is important to investigate factors that influenced responses to the recent COVID-19 pandemic. The aim of the present study was to investigate factors that influenced the decision to get the COVID-19 vaccine. The COVID-19 pandemic has affected almost everyone throughout the world. Vaccines are a significant factor in managing a pandemic. As vaccines are developed, governments develop vaccine roll-out plans. Unfortunately, vaccine hesitancies can slow the implementation of any vaccine program. A question arises as to the factors that are associated with the decision to get vaccinated. The present study explored associations between vaccine hesitancy, and the Health Belief Model (HBM) in student samples from the Czech Republic, Israel, and the United States. From August, 2021 through December, 2021, an online survey was distributed in Czech, Hebrew, and English. A total of 447 participants completed the survey. A binomial logistic regression was conducted to ascertain the influence of perceived susceptibility, severity, benefits, and barriers on the likelihood that participants are vaccinated. Results revealed that the factors of perceived severity and perceived benefits explained 52.6% (Nagelkerke R2) of the variance in vaccination. An analysis of Variance (ANOVA) found significant differences between countries for the 4 HBM factors. Based on these findings, it is recommended that policymakers put forth added emphasis on the severity of a virus and the benefits associated with the vaccine. Further, since there appears to be variability between countries in perceptions of the virus, and associated vaccine, governments should consider factors within their own environment when developing a strategy to combat a pandemic. More specifically, government could explore their own strengths, weaknesses, opportunities, and threats as they develop a pandemic strategy. Additional practical and theoretical implications are discussed.
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Affiliation(s)
| | | | | | - Joy Longo
- Florida Atlantic University, Christine
E. Lynn College of Nursing, Boca Raton, FL, USA
| | - Michael DeDonno
- Florida Atlantic University, College of
Education, Boca Raton, FL, USA
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8
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Cenin D, Li P, Wang J, de Jonge L, Yan B, Tao S, Lansdorp-Vogelaar I. Optimising colorectal cancer screening in Shanghai, China: a modelling study. BMJ Open 2022; 12:e048156. [PMID: 35577474 PMCID: PMC9115025 DOI: 10.1136/bmjopen-2020-048156] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/31/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION To reduce the burden of colorectal cancer (CRC) in Shanghai, China, a CRC screening programme was commenced in 2013 inviting those aged 50-74 years to triennial screening with a faecal immunochemical test (FIT) and risk assessment. However, it is unknown whether this is the optimal screening strategy for this population. We aimed to determine the optimal CRC screening programme for Shanghai in terms of benefits, burden, harms and cost-effectiveness. METHODS Using Microsimulation Screening Analysis-Colon (MISCAN-Colon), we estimated the costs and effects of the current screening programme compared with a situation without screening. Subsequently, we estimated the benefits (life years gained (LYG)), burden (number of screening events, colonoscopies and false-positive tests), harms (number of colonoscopy complications) and costs (Renminb (¥)) of screening for 324 alternative screening strategies. We compared several different age ranges, screening modalities, intervals and FIT cut-off levels. An incremental cost-effectiveness analysis determined the optimal strategy assuming a willingness-to-pay of ¥193 931 per LYG. RESULTS Compared with no screening, the current screening programme reduced CRC incidence by 40% (19 cases per 1000 screened individuals) and CRC mortality by 67% (7 deaths). This strategy gained 32 additional life years, increased colonoscopy demand to 1434 per 1000 individuals and cost an additional ¥199 652. The optimal screening strategy was annual testing using a validated one-sample FIT, with a cut-off of 10 µg haemoglobin per gram from ages 45 to 80 years (incremental cost-effectiveness ratio, ¥62 107). This strategy increased LY by 0.18% and costs by 27%. Several alternative cost-effective strategies using a validated FIT offered comparable benefits to the current programme but lower burden and costs. CONCLUSIONS Although the current screening programme in Shanghai is effective at reducing CRC incidence and mortality, the programme could be optimised using a validated FIT. When implementing CRC screening, jurisdictions with limited health resources should use a validated test.
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Affiliation(s)
- Dayna Cenin
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Centre for Health Services Research, School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Pei Li
- The Center for Disease Prevention and Control Huangpu Shanghai, Shanghai, China
| | - Jie Wang
- Department of Public Health, Fudan University, Shanghai, China
| | - Lucie de Jonge
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Bei Yan
- Xi'an International Medical Center Hospital, Xi'an, China
- Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Sha Tao
- Department of Public Health, Fudan University, Shanghai, China
| | - Iris Lansdorp-Vogelaar
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands
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Perceived Susceptibility and Severity of COVID-19 on Prevention Practices, Early in the Pandemic in the State of Florida. J Community Health 2022; 47:627-634. [PMID: 35451692 PMCID: PMC9024286 DOI: 10.1007/s10900-022-01090-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2022] [Indexed: 11/24/2022]
Abstract
Early in the pandemic and prior to the development of the COVID-19 vaccine, prevention measures were promoted to help inhibit the spread of the virus. To optimize adherence to prevention practices, it’s important to understand factors that may influence adherence. A study was conducted in the month of April, 2020, to explore the influence of perceptions of COVID-19 on prevention practices. The sample included members of a public social-media group focused on providing updates and information on COVID-19. A total of 719 individuals completed an online survey that assessed various aspects of COVID-19 which included experience, perceptions, and prevention practices. The perceptions of COVID-19 included perceived susceptibility of contracting the virus, and perceived potential severity if contracted COVID-19. To assess prevention practices, the survey included a 10-item prevention practices questionnaire that included items such as wearing a mask, and social distancing. Results revealed that perceived susceptibility of contracting COVID-19, and potential severity of COVID-19 were significant in predicting prevention practices. Further, results suggest that perceived potential severity predicts a greater proportion of the variance in prevention practices than susceptibility of contracting COVID-19. In addition, a moderation analysis revealed no interaction between perceived susceptibility and severity, which provides evidence that the variables do not influence one another. Theoretical and practical implications are discussed.
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Screening Intention Prediction of Colorectal Cancer among Urban Chinese Based on the Protection Motivation Theory. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074203. [PMID: 35409885 PMCID: PMC8998218 DOI: 10.3390/ijerph19074203] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/30/2022] [Accepted: 03/30/2022] [Indexed: 02/04/2023]
Abstract
Colorectal cancer poses a serious threat worldwide. Although early screening has been proved to be the most effective way to prevent and control colorectal cancer, the current situation of colorectal cancer screening remains not optimistic. The aim of this article is to apply the protection motivation theory (PMT) to examine the influencing factors on screening intention of colorectal cancer (CRC). This cross-sectional survey was launched in five communities in Wuhan, China. All the eligible urban Chinese were recruited and interviewed using paper-and-pencil questionnaires. The intention of colorectal cancer screening (CRCS) was measured using six PMT subconstructs, including perceived risk, perceived severity, fear arousal, response efficacy, response cost, and self-efficacy. Data on sociodemographic variables and knowledge of CRC were also collected. The structural equation modeling (SEM) method was used for data analysis. Among all the 569 respondents, 83.66% expressed willingness to participate in CRCS. Data of the research fit the proposed SEM model well (Chi-square/df = 2.04, GFI = 0.93, AGFI = 0.91, CFI = 0.91, IFI = 0.91, RMSEA = 0.04). Two subconstructs of PMT (response efficacy and self-efficacy) and CRC knowledge were directly and positively associated with screening intention. Age, social status, medical history, physical activity, and CRC knowledge were indirectly related to the screening intention through at least one of the two PMT subconstructs (response efficacy and self-efficacy). The findings of this study suggest the significance of enhancing response efficacy and self-efficacy in motivating urban Chinese adults to participate in CRC screening. Knowledge of CRC is significantly associated with screening intention. This study can provide useful information for the formulation and improvement of colorectal cancer screening strategies and plans.
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Cohen M, Rosenfeld M, Greenblatt-Kimron L. Associations Between Cancer Fatalism, Causal Attributions, and Perceptions of Benefits and Barriers to Screening for Colorectal Cancer. Int J Behav Med 2021; 29:357-366. [PMID: 34523072 DOI: 10.1007/s12529-021-10023-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The aim of the study was to assess the associations between cancer causal attributions (divine providence, chance or luck, environmental or genetic factors, weak personal resilience), cancer fatalistic beliefs (cancer occurrence and outcome beliefs), and benefits of and barriers to screening for early detection of colorectal cancer. METHODS It was a cross-sectional study of 252 individuals (46% men and 54% women) aged 50-75. Participants completed measures of cancer causal attributions, Powe's cancer fatalism questionnaire, and the benefits and barriers to colorectal cancer screening subscales of the health belief model. The study model was assessed using path analysis and mediation tests. RESULTS Participants expressed moderate levels of occurrence and outcome of fatalistic beliefs, moderate levels of causal attributions, a high level of perception of the benefits of screening, and a moderate level of barriers to screening. The path model showed good fit measures (χ2 = 17.38, df = 14, p = .24; χ2/df = 1.24; NFI = .98; TLI = .99; CFI = .99; RMSEA = .03, 90% CI = .01, .07). Outcome fatalism mediated the relationship between each causal attribution and perceived barriers, whereas occurrence fatalism mediated only the relationship between the causal attribution of divine providence and the perceived benefits of screening. CONCLUSIONS The results add to our understanding of the effects of causal attributions and fatalistic beliefs on perceptions of benefits and barriers to screening; hence, these factors should be the focus of change to reduce barriers to screening for early detection of cancer.
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Affiliation(s)
- Miri Cohen
- School of Social Work, University of Haifa, Haifa, Israel.
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Zhang X, Zhang Y, Chen J, Zhang M, Gong N. Psychological distance: a qualitative study of screening barriers among first-degree relatives of colorectal cancer patients. BMC Public Health 2021; 21:716. [PMID: 33849506 PMCID: PMC8045384 DOI: 10.1186/s12889-021-10786-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 04/07/2021] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND Colorectal cancer screening can reduce the incidence and mortality through early detection. First-degree relatives (FDRs) of patients with colorectal cancer are at high risk for colorectal cancer and therefore require colonoscopy. However, despite the high risk, screening adherence among FDRs remains low and the barriers to undergoing screening among FDRs in China are not clear. We explored the reasons why FDRs refused screening. METHODS In this qualitative study, 28 semistructured, in-depth interviews were conducted face-to-face. Participants were recruited at two hospitals (an urban tertiary hospital and a community health center) in Guangzhou, South China. We used qualitative content analysis to analyze transcripts based on audio recordings and identify major themes and subthemes. RESULTS Three major themes emerged related to FDRs' low screening participation. First, the emotional distance between FDRs and medicine was pulled away by uncomfortable feelings approaching hospitals and misunderstanding of cancer. Second, they confirmed their health state and minimized cancer risk if they had no signs in routine health examination, no symptoms and maintained a healthy, happy life. Third, they considered screening far from their daily life from the perspective of spatial distance and priority. Therefore, screening was not necessary in their view. CONCLUSIONS Healthcare professionals should narrow psychological distance between people and screening when promoting screening technology.
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Affiliation(s)
- Xueying Zhang
- School of Nursing, Sun Yat-sen University, No. 74 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, China
| | - Yiheng Zhang
- School of Nursing, Sun Yat-sen University, No. 74 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, China
| | - Jingyu Chen
- School of Nursing, Sun Yat-sen University, No. 74 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, China
| | - Meifen Zhang
- School of Nursing, Sun Yat-sen University, No. 74 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, China.
| | - Ni Gong
- School of Nursing, Jinan University, No.601 West Huangpu Avenue, Guangzhou, 510632, Guangdong, China.
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