Lipkus Isaac M, Green Lasonya G, Marcus Alfred
Duke University Medical Center, Durham, North Carolina, USA.
J Health Commun. 2003 May-Jun;8(3):213-28. doi: 10.1080/10810730305684.
Affecting peoples' perceptions of the health threat of colorectal cancer (CRC), that is, the probability of the cancer's occurrence multiplied by the severity of the outcomes, has not been experimentally manipulated as a means to increase CRC screening intentions and behaviors. As an exploratory pilot study to inform a larger randomized trial on CRC screening, we used a four-group pre-post longitudinal design to test whether providing information about: 1) colorectal cancer risks (no/yes) and, 2) the severity of treatment and illness consequences (no/yes) affected CRC screening intentions (i.e., fecal occult blood test/sigmoidoscopy) and behaviors at a six-month follow-up. The sample consisted of 119 men and women aged 50 and older who were off schedule for having a fecal occult blood test (FOBT). Although perceptions of CRC risks were not affected by the experimental manipulations, perceived severity increased screening intentions for FOBT and lowered felt ambivalence towards FOBT. At the six-month follow-up, 31% participants had a FOBT. Participants who received severity information were significantly more likely to report having had a FOBT. These results suggest that: 1) more attention needs to be given to developing strategies to affect perception of CRC risk, and 2) increasing the perceived severity of CRC is an important construct to increase FOBT screening.
影响人们对结直肠癌（CRC）健康威胁的认知，即癌症发生概率乘以结果的严重程度，尚未作为一种增加CRC筛查意愿和行为的手段进行实验性操控。作为一项为更大规模的CRC筛查随机试验提供信息的探索性试点研究，我们采用了四组前后纵向设计，以测试提供以下信息是否会影响六个月随访时的CRC筛查意愿（即粪便潜血试验/乙状结肠镜检查）和行为：1）结直肠癌风险（无/有），以及2）治疗和疾病后果的严重程度（无/有）。样本包括119名年龄在50岁及以上且未按计划进行粪便潜血试验（FOBT）的男性和女性。尽管对CRC风险的认知不受实验操控的影响，但感知到的严重程度增加了FOBT的筛查意愿，并降低了对FOBT的矛盾心理。在六个月的随访中，31%的参与者进行了FOBT。收到严重程度信息的参与者报告进行FOBT的可能性显著更高。这些结果表明：1）需要更加关注制定影响CRC风险认知的策略，以及2）提高对CRC的感知严重程度是增加FOBT筛查的一个重要因素。
