Awan Asma T, Grigsby Timothy J, Johansen Christopher, Dai Chia-Liang, Sharma Manoj
Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA.
Department of Teaching and Learning, College of Education, University of Nevada, Las Vegas, NV 89102, USA.
Int J Environ Res Public Health. 2025 Jan 12;22(1):98. doi: 10.3390/ijerph22010098.
Colorectal cancer (CRC) ranks third in terms of global cancer prevalence and is the second most common cause of cancer-related mortality. Although CRC rates are decreasing in the United States, inequalities still exist despite the effectiveness of invasive screening methods, such as colonoscopy, flexible sigmoidoscopy, and computed tomography (CT) colonography in detecting colorectal cancer. Many current interventions promoting CRC screening do not utilize a modern theory-based approach, which has led to the low utilization of these screening methods. This cross-sectional study aims to address the lack of theory-based treatments for promoting visual CRC screening examinations by applying the multi-theory model (MTM) of health behavior change to explicate the health-related factors for individuals to seek visual colorectal cancer screening examinations for CRC screening. A 57-item validated questionnaire assessing MTM constructs and CRC screening was administered online. The survey questionnaire was administered to a sample of 640 adults from the United States. The participants were between the ages of 45 and 75 years. Hierarchical multiple regression was used to assess the relationship between MTM constructs with the initiation and sustenance of CRC screening behaviors. Out of the total participants in this nationwide sample, 71.4% (n = 457) reported that they had undergone a visual CRC screening examination. MTM subscales, specifically participatory dialogue, changes in the physical environment along with age, recommendation for CRC screening from a healthcare provider, and previous experience with colonoscopy, were found to be significant factors in predicting the initiation of visual CRC screening behavior. These factors accounted for 22% of the variation in initiation among this group (R = 0.222, F = 3.521, < 0.001). The MTM can be a valuable framework for designing educational media, information media, social media platforms, and clinical interventions to promote visual colorectal cancer screening examinations.
结直肠癌(CRC)在全球癌症患病率中排名第三,是癌症相关死亡率的第二大常见原因。尽管美国的结直肠癌发病率正在下降,但尽管结肠镜检查、乙状结肠镜检查和计算机断层扫描(CT)结肠成像等侵入性筛查方法在检测结直肠癌方面很有效,但不平等现象仍然存在。目前许多促进结直肠癌筛查的干预措施并未采用基于现代理论的方法,这导致了这些筛查方法的利用率较低。这项横断面研究旨在通过应用健康行为改变的多理论模型(MTM)来解决促进可视化结直肠癌筛查检查缺乏基于理论的治疗方法的问题,以阐明个体进行可视化结直肠癌筛查检查的健康相关因素。一份评估MTM结构和结直肠癌筛查的57项经过验证的问卷通过在线方式进行发放。该调查问卷被发放给来自美国的640名成年人样本。参与者年龄在45岁至75岁之间。采用分层多元回归来评估MTM结构与结直肠癌筛查行为的启动和维持之间的关系。在这个全国性样本的总参与者中,71.4%(n = 457)报告称他们已经接受了可视化结直肠癌筛查检查。MTM子量表,特别是参与性对话、物理环境的变化以及年龄、医疗保健提供者对结直肠癌筛查的建议以及之前的结肠镜检查经历,被发现是预测可视化结直肠癌筛查行为启动的重要因素。这些因素占该组启动差异的22%(R = 0.222,F = 3.521,< 0.001)。MTM可以成为设计教育媒体、信息媒体、社交媒体平台和临床干预措施以促进可视化结直肠癌筛查检查的有价值框架。