Volume 42, Issue 1 pp. 466-477
FOCUS ON RESEARCH METHODS

Factors Associated With Colorectal Cancer Screening Behaviors Among Urban Populations in China: A Mixed-Methods Study Using the Health Belief Model

Bingzi Shi

Bingzi Shi

Nursing Department, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China

School of Nursing, Harbin Medical University, Harbin, China

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Jing Zhang

Corresponding Author

Jing Zhang

Nursing Department, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China

Correspondence: Jing Zhang ([email protected])

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Yasi Zhang

Yasi Zhang

Nursing Department, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China

School of Nursing, Harbin Medical University, Harbin, China

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Yujing Sun

Yujing Sun

School of Nursing, Harbin Medical University, Harbin, China

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Wenming Cui

Wenming Cui

General Practice Clinic, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China

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First published: 08 November 2024

Funding: This study was supported by a grant from the China Social Welfare Foundation (20200125).

ABSTRACT

Objective

Adherence to guideline-recommended colorectal cancer screening (CRCS) among average-risk urban populations in China remains significantly suboptimal. This mixed-methods study aimed to investigate screening behaviors and associated factors among average-risk urban populations through a multi-center approach.

Methodology

From February to July 2024, 550 participants were recruited via stratified random sampling in Harbin, China. They completed questionnaires related to health beliefs and knowledge. Additionally, semi-structured interviews were conducted to explore CRCS behaviors, with data analyzed using directed content analysis based on the Health Belief Model (HBM).

Results

Five hundred twenty two participants (95.0%) completed the survey. Identified factors influencing screening behavior among average-risk urban populations included perceived severity of colorectal cancer (CRC), benefits of colon cancer surveillance, barriers to surveillance, and knowledge. Twenty-six individuals were engaged in qualitative interviews. Twenty-four themes were identified and categorized by frequency. Both quantitative and qualitative data suggest that CRCS behavior among urban average-risk populations is suboptimal, and the identified factors can be mapped onto the HBM.

Conclusions

This mixed-methods study demonstrates that key factors influencing screening behavior among urban average-risk populations align with the HBM. These identified factors should be meticulously considered in future systematic interventions to enhance screening behaviors.

Conflicts of Interest

The authors have no conflicts of interest to disclose.

Data Availability Statement

The data results of this study can be obtained from the corresponding author as required.

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