Long Novia Niannian, Lau Michele Petrova Xin Ling, Lee Ainsley Ryan Yan Bin, Yam Natalie Elizabeth, Koh Nicholas Ye Kai, Ho Cyrus Su Hui
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Front Med (Lausanne). 2022 Apr 26;9:889124. doi: 10.3389/fmed.2022.889124. eCollection 2022.
Colorectal cancer screening when done early can significantly reduce mortality. However, screening compliance is still lower than expected even in countries with established screening programs. Motivational interviewing is an approach that has been explored to promote behavioral change including screening compliance. This review synthesizes the efficacy of motivational interviewing in promoting uptake of colorectal screening modalities and is the only review so far that examines motivational interviewing for colorectal cancer screening alone.
A systematic review and meta-analysis was conducted to examine the effects of motivational interviewing for colorectal cancer screening. PubMed, EMBASE, CENTRAL, PsycINFO, and CINAHL were searched to identify eligible studies from inception to June 2021 and selection criteria was defined. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. The DerSimonian and Laird random effects model was used in the statistical analysis for studies included in the meta-analysis.
Fourteen studies from 14 randomized-controlled trials with a low to moderate risk of bias were analyzed. 8 studies in the systematic review showed that motivational interviewing is superior to a control group. Meta-analysis was conducted on 11 studies and showed that motivational interviewing is statistically significant in increasing colorectal cancer screening rates in both intention-to-treat and per-protocol analysis. Timing of data collection of colorectal cancer screening rates did not make a significant difference to the efficacy of motivational interviewing. Studies that offered and accepted a mixture of colorectal screening modalities such as colonoscopy and fecal immunochemical tests were significantly more likely to have favorable colorectal screening outcomes. Heterogeneity in intervention was noted between studies, specifically differences in the training of interventionists, intervention delivery and comparator components.
Motivational interviewing is a tailored intervention demonstrating mixed evidence in improving colorectal cancer screening attendance amongst individuals. More research is needed to rigorously compare the effect of motivational interviewing alone vs. in combination with other screening promotion strategies to enhance colorectal cancer screening compliance.
早期进行结直肠癌筛查可显著降低死亡率。然而，即使在已建立筛查项目的国家，筛查依从性仍低于预期。动机性访谈是一种已被探索用于促进行为改变（包括筛查依从性）的方法。本综述综合了动机性访谈在促进采用结直肠癌筛查方式方面的疗效，并且是迄今为止唯一一项单独研究动机性访谈用于结直肠癌筛查的综述。
进行了一项系统综述和荟萃分析，以研究动机性访谈对结直肠癌筛查的影响。检索了PubMed、EMBASE、CENTRAL、PsycINFO和CINAHL，以识别从开始到2021年6月的符合条件的研究，并定义了选择标准。使用Cochrane偏倚风险2.0工具评估偏倚风险。在荟萃分析中纳入的研究的统计分析中使用了DerSimonian和Laird随机效应模型。
分析了来自14项随机对照试验的14项研究，偏倚风险为低到中度。系统综述中的8项研究表明，动机性访谈优于对照组。对11项研究进行了荟萃分析，结果表明，在意向性分析和符合方案分析中，动机性访谈在提高结直肠癌筛查率方面具有统计学意义。结直肠癌筛查率数据收集的时间对动机性访谈的疗效没有显著影响。提供并接受结肠镜检查和粪便免疫化学检测等多种结直肠癌筛查方式的研究更有可能获得良好的结直肠癌筛查结果。研究之间注意到干预措施存在异质性，特别是在干预者培训、干预实施和对照组成部分方面存在差异。
动机性访谈是一种针对性的干预措施，在提高个体的结直肠癌筛查参与率方面证据不一。需要更多研究来严格比较单独的动机性访谈与与其他筛查促进策略相结合的效果，以提高结直肠癌筛查依从性。
