Leung Doris Y P, Chen Joanne M T, Lou Vivian W Q, Wong Eliza M L, Chan Aileen W K, So Winnie K W, Chan Carmen W H
The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
School of Health Sciences, Caritas Institute of Higher Education, Hong Kong, China.
Int J Environ Res Public Health. 2017 Jul 13;14(7):769. doi: 10.3390/ijerph14070769.
Colorectal cancer (CRC) screening is a cost-effective prevention and control strategy. However, the promotion of CRC screening for older adults may be difficult because reading CRC prevention information may evoke embarrassment, fear, and anxiety towards the screening procedure and cancer diagnosis. This study aims to (1) examine the effects of three promotional materials for CRC screening on the attitudes toward CRC screening tests (screening interest, screening effectiveness, and trust in the screening results) and cancer fear, and (2) to explore the interaction effect of cancer fear with screening effectiveness and trust in the screening results on screening interest of the three screening tests (fecal occult blood test (FOBT), flexible sigmoidoscopy, and colonoscopy) among Chinese older adults. A total of 114 community-dwelling older adults were asked to look at the corresponding promotional materials (pamphlet, cartoon, and video) of one of the three study groups. The pamphlet and video represent convention strategies and the cartoon represents an innovative strategy. No significant difference was observed in the screening interest and cancer fear across groups. FOBT was the most preferred screening modality. The video group has a large proportion agreed screening effectiveness of flexible sigmoidoscopy than pamphlet and cartoon groups and trusted in the screening results for FOBT and flexible sigmoidoscopy than the pamphlet group. Logistic regression results showed that the effect of trust in the screening results on screening interest for colonoscopy was greater among participants with higher cancer fear than those with lower cancer fear level. In conclusion, the three promotional groups had produced similar results in their attitudes toward CRC screening and cancer fear. The use of cartoons may be a comparable approach with conventional methods in the promotion of CRC screening. Additional components that can arouse fear and boost response efficacy simultaneously might also be useful for the effective promotion of colonoscopy among Chinese older adults.
结直肠癌（CRC）筛查是一种具有成本效益的防控策略。然而，对老年人推广CRC筛查可能会有困难，因为阅读CRC预防信息可能会引发对筛查程序和癌症诊断的尴尬、恐惧和焦虑。本研究旨在：（1）检验三种CRC筛查宣传材料对CRC筛查态度（筛查兴趣、筛查有效性和对筛查结果的信任度）及癌症恐惧的影响；（2）探讨在中国老年人中，癌症恐惧与筛查有效性及对筛查结果的信任度对三种筛查测试（粪便潜血试验（FOBT）、乙状结肠镜检查和结肠镜检查）的筛查兴趣的交互作用。共有114名社区居住的老年人被要求观看三个研究组之一的相应宣传材料（小册子、卡通片和视频）。小册子和视频代表传统策略，卡通片代表创新策略。各小组在筛查兴趣和癌症恐惧方面未观察到显著差异。FOBT是最受欢迎的筛查方式。视频组中同意乙状结肠镜检查筛查有效性的比例高于小册子组和卡通片组，且对FOBT和乙状结肠镜检查筛查结果的信任度高于小册子组。逻辑回归结果显示，与癌症恐惧程度较低的参与者相比，癌症恐惧程度较高的参与者中，对筛查结果的信任度对结肠镜检查筛查兴趣的影响更大。总之，三个宣传组在对CRC筛查的态度和癌症恐惧方面产生了相似的结果。在推广CRC筛查方面，使用卡通片可能是一种与传统方法相当的途径。同时能引发恐惧并提高反应效能的其他因素，可能也有助于在中国老年人中有效推广结肠镜检查。
