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Health Education Research Advance Access originally published online on August 4, 2009
Health Education Research 2009 24(5):897-908; doi:10.1093/her/cyp043
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© The Author 2009. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Identifying cluster subtypes for intentions to have colorectal cancer screening among non-compliant intermediate-risk siblings of individuals with colorectal cancer

Sharon L. Manne1,*, Elliot J. Coups1, Gary Winkel2, Arnold Markowitz3, Neal J. Meropol4, Samuel M. Lesko5, Paul B. Jacobsen6, Daniel Haller7, Lina Jandorf8 and Susan K. Peterson9

1 Fox Chase Cancer Center, Philadelphia, PA 19111, USA
2 Department of Environmental Psychology, City University of New York, New York, NY 10016, USA
3 Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA
4 Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA
5 Department of Epidemiology, Northeast Regional Cancer Institute, Scranton, PA 18510, USA
6 Department of Psychology, Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA
7 Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
8 Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY 10029, USA
9 Department of Behavioral Science, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA

* Correspondence to: S. L. Manne. Fox Chase Cancer Center, 510 Township Line Road, First Floor, Cheltenham, PA 19012, USA. E-mail: sharon.manne{at}fccc.edu

Although first-degree relatives of colorectal cancer (CRC) patients diagnosed at an early age are at increased risk for CRC, their compliance with colorectal cancer screening (CRCS) is not high. Relatively little is known about why these intermediate-risk family members do not comply with CRCS. Study aims were to identify subgroups of siblings of individuals diagnosed with CRC prior to age 61 who were not compliant with CRCS using cluster analysis and to identify demographical, medical and attitudinal correlates of cluster membership. A total of 421 siblings completed measures of pros, cons, processes of change, CRCS knowledge, physician and family CRCS support, CRC risk, severity, preventability, curability, closeness with the affected sibling, distress about the sibling's cancer and screening intentions. Three clusters characterized as ‘Positive about Screening’, ‘Uncertain about Screening’ and ‘Negative about Screening’ were identified. External validation revealed that those in the Positive about Screening cluster reported significantly stronger CRCS intentions than those who are Uncertain about Screening and Negative about Screening clusters. Results provide an empirical typology for understanding motivations for CRCS among at-risk family members and may lead to the development of more effective interventions to improve screening uptake.

Received on November 11, 2008; accepted on June 21, 2009


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