Department of Behavioral Sciences, Ruppin Academic Center, Emeq Hefer.
Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa.
Am J Prev Med. 2014 Mar;46(3):273-80. doi: 10.1016/j.amepre.2013.11.008.
Early detection of colorectal cancer (CRC) using fecal occult blood test (FOBT) reduces mortality, yet screening adherence remains low.
Enhancing FOBT adherence in a field experiment, using Implementation Intentions (II) technique.
Participants were randomly assigned to a standard care group or to II experimental group.
SETTING/PARTICIPANTS: A test kit was mailed to 29,833 HMO-insured members in two waves in 2011.
eligible persons aged 50-74 who underwent the test the year before. A sample of 2200 participants was interviewed over the telephone for possible cognitive and background moderators.
Leaflet attached to the test kit containing an "if-then" condition and planning instructions of when, where, and how.
Test performance at 2 and 6 months following mailing of the test kit, retrieved from HMO's computerized database (2011-2012).
Adherence in the experimental group ranged 1.2%-6.6% higher than in the control group. Within 6 months of kits' mailing, test uptake for the two waves was 71.4% and 67.9% for experiment and control, respectively (χ(2)=40.58, p=0.0001). The difference remained significant after controlling for age, gender, marital status, and wave (OR=1.17, 95% CI=1.11, 1.23, p<0.0001). Test performance was related to cognitive and background variables. No interaction was found among cognitive or background variables and the intervention.
II technique is useful in increasing adherence to CRC screening, even in a mailed form rather than a face-to-face experimental situation. Mailed II is an inexpensive and effective method, applicable for public health.
通过粪便潜血试验（FOBT）早期发现结直肠癌（CRC）可降低死亡率，但筛查依从性仍然较低。
使用实施意向（II）技术在现场试验中提高 FOBT 依从性。
参与者被随机分配到标准护理组或 II 实验组。
设置/参与者：在 2011 年，分两批向 29833 名 HMO 保险成员邮寄了检测试剂盒。
前一年接受过检测且年龄在 50-74 岁的合格人员。对 2200 名参与者进行了电话访谈，以确定可能的认知和背景调节因素。
将包含“如果-那么”条件和何时、何地以及如何计划的说明的传单附在检测试剂盒上。
在邮寄检测试剂盒后 2 个月和 6 个月时的检测性能，从 HMO 的计算机化数据库中检索（2011-2012 年）。
实验组的依从率比对照组高 1.2%-6.6%。在试剂盒邮寄后的 6 个月内，两批的检测率分别为实验组和对照组的 71.4%和 67.9%（χ²=40.58，p=0.0001）。在控制年龄、性别、婚姻状况和波次后，差异仍然显著（OR=1.17，95%CI=1.11，1.23，p<0.0001）。检测性能与认知和背景变量相关。在认知或背景变量与干预之间未发现交互作用。
即使在邮寄而非面对面的实验情况下，II 技术也可有效提高 CRC 筛查的依从性。邮寄 II 是一种廉价且有效的方法，适用于公共卫生。
