Abstract
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.
Highlights
Colorectal cancer (CRC) is a worldwide public health challenge, which has the fourth highest cancer-related mortality rate with an estimated 694,000 people dying from CRC in 2012 [1]
The findings from this study show that no differential effect was observed among the three interventions in the promotion of CRC screening interest among Chinese older adults, FOBT was the most preferred screening modality
The use of a cartoon may be an effective approach to promote screening interest in colonoscopy, and recommendation from healthcare professionals without direct contact might not be effective in promoting CRC screening
Summary
Colorectal cancer (CRC) is a worldwide public health challenge, which has the fourth highest cancer-related mortality rate with an estimated 694,000 people dying from CRC in 2012 [1]. CRC is highly treatable in its early stage. CRC screening presents a cost-effective prevention and control strategy because early detection and treatment of CRC among asymptomatic patients can result in a. Res. Public Health 2017, 14, 769; doi:10.3390/ijerph14070769 www.mdpi.com/journal/ijerph
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