Patient attitudes towards changes in colorectal cancer surveillance: An application of the Health Belief Model
Corresponding Author
Maddison Dix
Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
Correspondence
Maddison Dix, Level 4 Flinders Centre for Innovation in Cancer, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia, 5042, Australia.
Email: [email protected]
Search for more papers by this authorCarlene J. Wilson
Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
Austin Health, Olivia Newton-John Cancer Wellness and Research Centre, Heidelberg, Victoria, Australia
Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
Search for more papers by this authorIngrid H. Flight
Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
Search for more papers by this authorMolla M. Wassie
Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
Search for more papers by this authorGraeme P. Young
Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
Search for more papers by this authorCharles Cock
Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia
Search for more papers by this authorSarah Cohen-Woods
Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
College of Education, Psychology, and Social Work, Flinders University, Bedford Park, South Australia, Australia
Orama Institute for Mental Health and Well-Being, Flinders University, Bedford Park, South Australia, Australia
Search for more papers by this authorErin L. Symonds
Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
Bowel Health Service, Flinders Medical Centre, Bedford Park, South Australia, Australia
Search for more papers by this authorCorresponding Author
Maddison Dix
Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
Correspondence
Maddison Dix, Level 4 Flinders Centre for Innovation in Cancer, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia, 5042, Australia.
Email: [email protected]
Search for more papers by this authorCarlene J. Wilson
Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
Austin Health, Olivia Newton-John Cancer Wellness and Research Centre, Heidelberg, Victoria, Australia
Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
Search for more papers by this authorIngrid H. Flight
Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
Search for more papers by this authorMolla M. Wassie
Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
Search for more papers by this authorGraeme P. Young
Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
Search for more papers by this authorCharles Cock
Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, South Australia, Australia
Search for more papers by this authorSarah Cohen-Woods
Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
College of Education, Psychology, and Social Work, Flinders University, Bedford Park, South Australia, Australia
Orama Institute for Mental Health and Well-Being, Flinders University, Bedford Park, South Australia, Australia
Search for more papers by this authorErin L. Symonds
Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
Cancer Research, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
Bowel Health Service, Flinders Medical Centre, Bedford Park, South Australia, Australia
Search for more papers by this authorSarah Cohen-Woods and Erin L. Symonds are equal senior authors.
Funding information: This work was supported by a Health Seeding Grant funded by the Flinders Foundation, Bedford Park, South Australia (grant number N/A).
Abstract
Objective
This is to determine whether health beliefs regarding colorectal cancer (CRC) screening could predict discomfort with a change to CRC surveillance proposing regular faecal immunochemical tests (FIT) instead of colonoscopy.
Methods
Eight hundred individuals enrolled in a South Australian colonoscopy surveillance programme were invited to complete a survey on surveillance preferences. Responses were analysed using binary logistic regression predicting discomfort with a hypothetical FIT-based surveillance change. Predictor variables included constructs based on the Health Belief Model: perceived threat of CRC, perceived confidence to complete FIT and colonoscopy (self-efficacy), perceived benefits from current surveillance and perceived barriers to FIT and colonoscopy.
Results
A total of 408 participants (51%) returned the survey (complete data n = 303; mean age 62 years, 52% male). Most participants (72%) were uncomfortable with FIT-based surveillance reducing colonoscopy frequency. This attitude was predicted by a higher perceived threat of CRC (OR = 1.03 [95% CI 1.01–1.04]), higher colonoscopy self-efficacy (OR = 1.34 [95% CI 1.13–1.59]) and lower perceived barriers to colonoscopy (OR = 0.92 [95% CI 0.86–0.99]).
Conclusions
Health beliefs regarding colonoscopy and perceived threat of CRC may be important to consider when changing CRC surveillance protocols. If guideline changes were introduced, these factors should be addressed to provide patients reassurance concerning the efficacy of the alternative protocol.
CONFLICT OF INTEREST
The authors declare no potential conflicts of interest.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
Supporting Information
| Filename | Description |
|---|---|
| ecc13713-sup-0001-DIX_Appen1_SuppInfo.docxWord 2007 document , 24.7 KB |
Appendix S1. Health Belief Model item sources and examples |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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