Factors associated with the fecal occult blood testing for colorectal cancer screening based on health belief model structures in moderate risk individuals, Isfahan, 2011

Perceived barriers and benefits in the participation in faecal occult blood test colorectal cancer screening programme

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.

Colonoscopy Colorectal Cancer Screening Programme in Southern Iraq: Challenges, Knowledge Gaps and Future Potential

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.

Evaluation of health belief model-based educational intervention on colorectal cancer screening behavior at South Khorasan, Iran

BACKGROUND

Colorectal cancer is the most common cancer of the gastrointestinal tract. Health beliefs play an important role in the development of health behaviors. In this study, the effect of educational intervention based on Health Belief Model on colorectal cancer screening behavior was investigated.

MATERIALS AND METHODS

This study was performed as a randomized controlled intervention. The study population was 50-70-years old in Khosf city. Initially, 120 eligible populations were randomly divided into intervention and control groups (60 people in each group). The data collection tool was a standard colorectal cancer screening questionnaire that was completed before, immediately, and 3 months after the intervention. The intervention consisted of eight 60-min training sessions. The collected data were analyzed using SPSS19 software and statistical tests.

RESULTS

The mean age of the intervention and control groups was 63.53 ± 5.67 and 57.73 ± 5.77 years. In terms of mean scores of knowledge, perceived susceptibility, perceived severity, and perceived barriers were homogeneous before intervention. After the intervention, the mean score of the model constructs showed significant changes, which was statistically significant (P < 0.05). The rate of occult blood test in stool 3 months after training reached 90% in the intervention group and 15% in the control group.

CONCLUSIONS

The results of this study showed that by taking measures to reduce perceived barriers as well as increase knowledge, perceived susceptibility, severity, benefits and self-efficacy, the rate of participation in occult blood testing in feces can be significantly increased.

The effect of educational intervention based on theory of planned behavior on the improvement of colorectal cancer screening intention among average-risk individuals referring to Asadabad city clinics

BACKGROUND

Colorectal cancer (CRC) is the third most common cancer in men and the fourth most common cancer in women in Iran. Therefore, the aim of this study was to determine the effect of educational intervention based on the theory of planned behavior (TPB) on the improvement of CRC screening intention among average-risk individuals.

MATERIALS AND METHODS

This quasi-experimental study was performed on the 50-69-year-old individuals referred to Asadabad city clinics in 2020. The individuals were randomly assigned to multistage cluster sampling in each intervention and control group. The instrument used in this research was a researcher-made questionnaire based on TPB. Educational intervention was conducted for the intervention group, one of their family members, and staff of clinic under intervention. Finally, the data were entered into SPSS and analyzed utilizing descriptive and analytical statistics. Results were considered significantly <0.05.

RESULTS

There were no significant differences between two intervention and control groups in the preintervention phase in terms of the mean scores of attitude (P = 0.58), subjective norms (P = 0.59), and behavioral intention (P = 0.66). However, in the postintervention phase, these differences were significant. Furthermore, regarding the mean score of perceived behavioral control, there was a significant difference between the two groups in the preintervention phase (P < 0.02), while in the postintervention phase, this difference was not significant (P = 0.29).

CONCLUSION

Educational intervention based on the TPB has been effective in improving the CRC screening intention among average-risk individuals. Therefore, using the results of this research and developing appropriate educational programs at the community level can be increased the participation of community members in CRC screening programs.

Comparing relationship between spiritual well-being and death anxiety among women with breast and cervical cancers and women with gastric and colorectal cancers

BACKGROUND

Death anxiety is one of the most common problems among women with cancer, which can affect the useful treatment process. With regard to the superior role of spiritual well-being over other aspects of health, the present study is aimed to compare the relationship between spiritual well-being and death anxiety among women with breast and cervical cancers and women with gastric and colorectal cancers.

METHODOLOGY

This was a descriptive-correlational study. Research statistical population included Iranian women with cancer at major hospitals in Isfahan, Iran. 160 research samples were selected through convenience sampling method based on inclusion criteria using a demographic questionnaire, spiritual well-being scale (Paloutzian et al.) and death anxiety scale (Templer). Research data were analyzed through SPSS 22 using independent t-test, Pearson's correlation, and analysis of variance at significance level 0.05.

RESULTS

The study findings indicated a significant inverse relationship between death anxiety and spiritual well-being (at 0.05) in both groups. As a result, people with higher spiritual well-being would experience less anxiety about death. In addition, the relationship between death anxiety and spiritual well-being in women with gastric and colorectal cancers was stronger than those with breast and cervical cancers.

CONCLUSION

Spiritual well-being is of effective factors of death anxiety among women suffering from cancer. Spirituality and meeting spiritual needs are considered as nursing care priorities for these women. Furthermore, paying attention to the spirituality by nurses may shield against individual difficulties.

The health belief model and colorectal cancer screening in the general population: A systematic review

Colorectal cancer screening saves lives and is cost-effective. It allows early detection of the pathology, and enables earlier medical intervention. Despite clinical practice guidelines promoting screening for average risk individuals, uptake remains suboptimal in many populations. Few studies have examined how sociobehavioural factors influence screening uptake in the context of behaviour change theories such as the health belief model. This systematic review therefore examines how the health belief model’s constructs are associated with colorectal cancer screening.

Four databases were systematically searched from inception to September 2019. Quantitative observational studies that used the health belief model to examine colorectal screening history, intention or behaviour were included.

A total of 30 studies met the criteria for review; all were of cross-sectional design. Perceived susceptibility, benefits and cues to action were directly associated with screening history or intention. Perceived barriers inversely associated with screening history or intention. The studies included also found other modifying factors including sociodemographic and cultural norms. Self-report of screening history, intention or behaviour, convenience sampling and lack of temporality among factors were common limitations across studies.

The health belief model’s associations with colorectal cancer screening uptake was consistent with preventive health behaviours in general. Future studies should examine how theory-based behavioural interventions can be tailored to account for the influence of socioecological factors.

Predictors of Colorectal Cancer Screening Participation in Southern Khorasan (Iran)

PURPOSE

Colorectal cancer is one of the most important common malignancies; therefore, timely screening for colorectal cancer can lead to early diagnosis and long survival for patients. The purpose of this study was to investigate the related factors in fecal occult blood test for screening of colorectal cancer based on health belief model constructs in high-risk population in east of Iran.

METHODS

This cross-sectional study was performed on 475 people over 40 years old in Birjand (East of Iran) who were selected by multi-stage sampling. A valid and reliable questionnaire was used for data collection. Data were analyzed using logistic regression test in the SPSS software version 19s.

RESULTS

In this study, 480 subjects were included in the final analysis, 331 (69%) were male, and the rest of them were female. Mean age of the participants was 55.12 with the standard deviation of 10.04. Of those studied population, 8.3% performed screening tests for early detection of colorectal cancer, and 15% intended to do so. There was a significant relationship between gastrointestinal disease history and perceived self-efficacy and test performance. In addition, significant relationship was observed between perceived self-efficacy in male participants and intention to do test (p < 0.05).

CONCLUSION

Perceived self-efficacy was the most salient predictor of the probability of undergoing fecal occult blood testing as well as the history of the test. Promoting perceived self-efficacy is very important in the process of promoting colorectal cancer screening behaviors. Therefore, it is recommended that when designing educational interventions, consideration should be given to enhancing the perceived self-efficacy of at-risk individuals to overcome the barriers for performing fecal occult blood testing.

Effectiveness of a health belief model intervention using a lay health advisor strategy on mouth self-examination and cancer screening in remote aboriginal communities: A randomized controlled trial

OBJECTIVE

Oral cancers caused by chewing betel nuts have a poor prognosis. Using a lay health advisor (LHA) can increase access to health care among underprivileged populations. This study evaluated a health belief model (HBM) intervention using LHAs for oral cancer screening (OCS) and mouth self-examination (MSE) in remote aboriginal communities.

METHODS

The participants were randomly assigned to intervention (IG; n = 171) and control groups (CG; n = 176). In the IG, participants received a three-chapter one-on-one teaching course from LHAs, whereas those in the CG received only a leaflet.

RESULTS

The IG participants were 2.04 times more likely to conduct a monthly MSE than those in the CG (95% confidence interval: 1.31-3.17) and showed significantly higher self-efficacy levels toward OSC and MSE (β = 0.53 and 0.44, effect size = 0.33 and 0.25, respectively) and a lower barrier level for OSC (β = -1.81, effect size = -0.24).

CONCLUSION

The LHA intervention had a significantly positive effect on MSE, strengthening self-efficacy and reducing barriers to OCS among aboriginal populations.

PRACTICE IMPLICATIONS

The effectiveness of the clinical treatment of underprivileged group can be improved through early diagnosis, which can be achieved using LHAs to reduce barriers to OSC.

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

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.

Cancer Screening Awareness and Practice in a Middle Income Country; A Systematic Review from Iran

Objective: Ageing population and noticeable changes in lifestyle in developing countries like Iran caused an increase in cancer incidence. This requires organized cancer prevention and screening programs in population level, but most importantly community should be aware of these programs and willing to use them. This study explored existing evidence on public awareness and practice, as well as, adherence to cancer screening in Iranian population. Methods: Major English databases including Web of Science, PubMed, Scopus, and domestic Persian databases i.e., SID, Magiran, and Barakat search engines were searched. All publications with focus on Iranian public awareness about cancer prevention, screening, and early detection programs which were published until August 2015, were explored in this systematic review. For this purpose, we used sensitive Persian phrases/key terms and English keywords which were extracted from medical subject headings (MeSH). Taking PRISMA guidelines into considerations eligible documents, were evaluated and abstracted by two separate reviewers. Results: We found 72 articles relevant to this topic. Screening tests were known to, or being utilized by only a limited number of Iranians. Most Iranian women relied on physical examination particularly self-examination, instead of taking mammogram, as the most standard test to find breast tumors. Less than half of the average-risk adult populations were familiar with colorectal cancer risk factors and its screening tests, and only very limited number of studies reported taking at least one time colonoscopy or FOBT, at most 5.0% and 15.0%, respectively. Around half of women were familiar with cervical cancer and Pap-smear test with less than 45% having completed at least one lifetime test. The lack of health insurance coverage was a barrier to participate in screening tests. Furthermore some people would not select to be screened only because they do not know how or where they can receive these services. Conclusion: Low awareness and suboptimal use of screening tests in Iran calls for effective programs to enhance intention and compliance to screening, improving the patient-physician communication, identifying barriers for screening and providing tailored public awareness and screening programs.

Investigating Factors Associated with FOBT Screening for Colorectal Cancer Based on the Components of Health Belief Model and Social Support

Introduction:

This study aimed to investigate the factors associated with FOBT screening for colorectal cancer based on the components of Health Belief Model and social support in Fasa City, Fars Province, Iran.

Materials and Methods:

This was a cross-sectional study carried out on 240 subjects in people of Fasa city who had 50 years old and above. The subjects in this study were assigned to two groups of 120 patients. The first group included people over 50 years, who referred to the diagnostic laboratories for doing FOBT, but the second group included people aged 50 years and above who did not refer to a laboratory for doing FOBT and were assessed by questionnaires at home. Data were collected through a questionnaire based on health belief model and perceived social support.

Results:

The referring group included 61.3 percent women and 38.7 percent men, with a mean age of 65.24 ± 8.01. The non-referring group included 59.7 percent women and 40.3 percent men, with a mean age of 64.21 ±7.53 (p=0.24). In the referring group, 64.2 percent had undergone FOBT in the past year, while in the non-referring group only 12.72percent had done so (p=0.001). The results showed that the referring group obtained higher scores on awareness about CRC and ways to prevent it, and on HBM Model constructs, and social support compared to the non-referring group (p<0.001). In addition, the referring group reported significantly lower Perceived Barriers compared to the non-referring group (p<0.001).

Conclusion:

The results showed significant differences between the two groups in terms of HBM components and perceived social support for doing FOBT. Therefore, theory-based educational interventions can be used to increase individuals’ Perceived Severity, Perceived Susceptibility, and Perceived Benefits and reduce their Perceived Barriers in order to empower and encourage people to perform FOBT.

Does colorectal cancer risk perception predict screening behavior? A systematic review and meta-analysis

Although health behavior theories postulate that risk perception should motivate colorectal cancer (CRC) screening, this relationship is unclear. This meta-analysis aims to examine the relationship between CRC risk perception and screening behavior, while considering potential moderators and study quality. A search of six databases yielded 58 studies (63 effect sizes) that quantitatively assessed the relationship between CRC risk perception and screening behavior. Most included effect sizes (75 %) reported a positive association between CRC risk perception and screening behavior. A random effects meta-analysis yielded an overall effect size of z = 0.13 (95 % CI 0.10-0.16), which was heterogeneous (I (2) = 99 %, τ(2) = 0.01). Effect sizes from high-quality studies were significantly lower than those from lower quality studies (z = 0.02 vs. 0.16). We found a small, positive relationship between CRC risk perception and reported screening behavior, with important identified heterogeneity across moderators. Future studies should focus on high quality study design.

The effect of education on the improvement of fruits and vegetables consumption aiming to preventing colorectal cancer

AIM

This study was performed to determine the effect of health education on the improvement of intake of fruits and vegetables aiming at preventing colorectal cancer among high school girls in the city of Shahr-e-kord.

BACKGROUND

Colorectal cancer is one of the most important and most common cancers and the second leading cause of cancer death worldwide. Every year, nearly one million new cases of colorectal cancer are recognized around the world and nearly half of them lose their lives due to the disease.

PATIENTS AND METHODS

130 students were randomly divided to two groups, which experimental (65) and controls (65) were chosen from the city of Shahr-e-kord for this experimental study. The instruments for data collecting were self-made questionnaire health belief model based and food frequency questionnaire. The HBM FFQ questionnaires were completed before, immediately and two months after education by participants. After pre-test, 5 educational session classes in experimental group were performed. Finally, data collected and analyzed by SPSS16 computer software (T- test, T-Paired, repeated measure ANOVA).

RESULTS

Findings of the study showed that before the intervention there was no significant differences between the scores of different structures of HBM model in two groups (P > 0.05), after the intervention there was significant differences between experimental and control groups in the levels of knowledge, structures of HBM model and performance for preventing colorectal cancer (p < 0.001).

CONCLUSION

Performing educational programs based on health belief model increases the knowledge and improves the attitudes and practices of students regarding prevention of the colorectal cancer.