Salimzadeh Hamideh, Eftekhar Hassan, Majdzadeh Reza, Montazeri Ali, Delavari Alireza
Digestive Diseases Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
J Behav Med. 2014 Oct;37(5):1019-29. doi: 10.1007/s10865-013-9533-6. Epub 2013 Sep 13.
Colorectal cancer is the third most commonly diagnosed cancer and the fourth leading cause of death in the world. There are few published studies that have used theory-based interventions designed to increase colorectal cancer screening in community lay health organizations. The present study was guided by the theoretical concepts of the preventive health model. Twelve health clubs of a municipal district in Tehran were randomized to two study groups with equal ratio. The control group received usual services throughout the study while the intervention group also received a theory-based educational program on colorectal cancer screening plus a reminder call. Screening behavior, the main outcome, was assessed 4 months after randomization. A total of 360 members aged 50 and older from 12 health clubs completed a baseline survey. Participants in the intervention group reported increased knowledge of colorectal cancer and screening tests at 4 months follow-up (p's < .001). Moreover, exposure to the theory-based intervention significantly improved self-efficacy, perceived susceptibility, efficacy of screening, social support, and intention to be screened for colorectal cancer, from baseline to 4 months follow-up (p's < .001). The screening rate for colorectal cancer was significantly higher in the intervention group compared to the control group (odds ratio = 15.93, 95% CI = 5.57, 45.53). Our theory-based intervention was found to have a significant effect on colorectal cancer screening use as measured by self-report. The findings could have implications for colorectal cancer screening program development and implementation in primary health care settings and through other community organizations.
结直肠癌是全球第三大常见诊断癌症和第四大死因。很少有已发表的研究使用基于理论的干预措施来增加社区非专业健康组织中的结直肠癌筛查。本研究以预防健康模型的理论概念为指导。德黑兰一个市区的12个健康俱乐部被随机等分为两个研究组。在整个研究过程中，对照组接受常规服务，而干预组还接受了基于理论的结直肠癌筛查教育计划以及提醒电话。在随机分组4个月后评估主要结果——筛查行为。来自12个健康俱乐部的总共360名50岁及以上的成员完成了基线调查。干预组的参与者在4个月随访时报告了结直肠癌和筛查测试知识的增加（p值 <.001）。此外，从基线到4个月随访，接受基于理论的干预显著提高了自我效能感、感知易感性、筛查效能、社会支持以及结直肠癌筛查意愿（p值 <.001）。与对照组相比，干预组的结直肠癌筛查率显著更高（优势比 = 15.93，95%置信区间 = 5.57，45.53）。我们发现，通过自我报告衡量，基于理论的干预对结直肠癌筛查的使用有显著影响。这些发现可能对初级卫生保健机构以及通过其他社区组织开展和实施结直肠癌筛查计划具有启示意义。
