Basch Corey H, Basch Charles E, Wolf Randi L, Zybert Particia
Department of Public Health, William Paterson University, Wayne, NJ 07470, USA.
Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY 10027, USA.
Int J Prev Med. 2015 Mar 3;6:20. doi: 10.4103/2008-7802.152496. eCollection 2015.
Colonoscopy is the preferred screening method for colorectal cancer (CRC). This study aimed to identify factors motivating a beneficial health behavior, that is, the decision to complete a colonoscopy.
We surveyed 91 primarily urban minority health care workers who were ineligible for a large randomized controlled trial due to self-reported asymptomatic colonoscopy screening. Participants were asked an open-ended question about what made them get screened. Responses were classified as external or internal motivations.
The most commonly reported external motivation was a primary care physician's recommendation (n = 60, 65.9%). Other external motivations were familiarity with CRC or polyps through family or work (n = 16, 17.6%) and pressure from relatives or friends (n = 8, 8.8%). Seventeen respondents were deemed self-motivated; these individuals were more likely have income over $50K/year (P < 0.05) and to be US born (P = 0.05); they were more likely to mention being age-appropriate for screening (P < 0.05); knew more people who had colonoscopies (P < 0.001); they were less likely to believe that most of the age-appropriate population in New York City has been screened (P < 0.01) and less likely to be deterred from colonoscopy by work schedule (P < 0.001) or by having to take a powerful laxative (P < 0.001).
A primary care physician's recommendation may be the most prevalent motivating factor in patients' decisions to receive a colonoscopy, but a subgroup seeks CRC screening on their own. Analysis of the motivations of individuals who have sought colonoscopy screening may offer useful insights into motivating those who have not.
结肠镜检查是结直肠癌（CRC）的首选筛查方法。本研究旨在确定促使有益健康行为（即决定完成结肠镜检查）的因素。
我们对91名主要为城市少数族裔的医护人员进行了调查，这些人员因自我报告无症状结肠镜筛查而不符合一项大型随机对照试验的条件。参与者被问及一个开放式问题，即是什么促使他们接受筛查。回答被分为外部动机或内部动机。
最常报告的外部动机是初级保健医生的建议（n = 60，65.9%）。其他外部动机包括通过家庭或工作对CRC或息肉的了解（n = 16，17.6%）以及亲戚或朋友的压力（n = 8，8.8%）。17名受访者被认为是自我激励的；这些个体更有可能年收入超过5万美元（P < 0.05）且出生于美国（P = 0.05）；他们更有可能提到年龄适合筛查（P < 0.05）；认识更多做过结肠镜检查的人（P < 0.001）；他们不太可能认为纽约市大多数适合年龄的人群已经接受过筛查（P < 0.01），并且不太可能因工作安排（P < 0.001）或必须服用强力泻药（P < 0.001）而放弃结肠镜检查。
初级保健医生的建议可能是患者决定接受结肠镜检查最普遍的激励因素，但有一个亚组会自行寻求CRC筛查。对寻求结肠镜检查筛查的个体动机进行分析可能会为激励未进行筛查的个体提供有用的见解。
