Health Education Research Advance Access originally published online on August 16, 2004
Health Education Research 2005 20(2):137-148; doi:10.1093/her/cyg110
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Health Education Research Vol.20 no.2, © Oxford University Press 2005; All rights reserved
Do benefits and barriers differ by stage of adoption for colorectal cancer screening?
1 School of Nursing, Indiana University, IN 46202, 2 College of Nursing, University of Utah, Salt Lake City, UT 84112, 3 School of Nursing, University of Indianapolis, IN 46227, 4 School of Medicine, Indiana University, IN 46202, USA and 5 Department of Surgery, Duke University Comprehensive Cancer Center, NC 27710, USA
6 Correspondence to: S. M. Rawl; E-mail: srawl{at}iupui.edu
In 2003, over 148 300 people were expected to be diagnosed and 56 000 to die from colorectal cancer (CRC). First-degree relatives (FDRs) of people with colon cancer have a two- to eight-fold increased risk for CRC. Despite evidence that screening is effective, adherence with screening recommendations in this at-risk population is low. This study's purposes were to (1) identify perceived benefits and barriers of fecal occult blood testing (FOBT), sigmoidoscopy and colonoscopy, and (2) compare demographic characteristics and perceived benefits and barriers by stage of adoption for CRC screening. Participating FDRs (n = 257) completed a 40-min structured telephone interview. Despite high rates of agreement with the benefits of screening, most FDRs were not contemplating being screened. Of those 50 and older, most were in precontemplation for FOBT, sigmoidoscopy and colonoscopy. Older age was related to stage for FOBT and sigmoidoscopy, but not colonoscopy. Lack of provider recommendation also was related to stage. Consistent with theoretical predictions, precontemplators had (1) higher rates of endorsement of specific barriers to screening and (2) lower rates of endorsement of benefits than contemplators or actors. For morbidity and mortality reduction, participation in routine, periodic screening is imperative. These findings can guide development of screening-promoting interventions.
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