Abstract
BackgroundThe potential benefits of colorectal cancer screening are limited by low uptake. This study tested whether providing narrative accounts of the colorectal cancer (CRC) screening experience positively affected beliefs about CRC screening and intention to be screened.Methods4125 adults aged 45-59.5 years, from three general practices in England, were randomised to be sent the standard information on CRC screening or the standard information plus a narrative-based leaflet describing CRC screening experiences. Both groups were asked to complete and return a questionnaire on beliefs about CRC screening after reading the study materials. Between-group differences on responses were assessed with t-tests. A mediation analysis then addressed the mediating role of CRC screening beliefs on the group and intention relationship.ResultsRelative to the standard information group (n = 590), the standard information plus narrative leaflet group (n = 631) showed higher perceived vulnerability to CRC, higher perceived test response efficacy, a stronger belief that the screening test would provide peace of mind and less disgust with the test procedure. There were no between group differences on perceived self-efficacy or the understanding that the screening test should be done in the absence of symptoms. Respondents who received the additional narrative leaflet reported significantly higher CRC screening intentions than respondents who received the standard information only. Controlling for the CRC screening beliefs reduced the effect of group on intention to non-significance.ConclusionsAn additional narrative leaflet had a positive impact on beliefs about CRC screening which led to stronger screening intentions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-1167-3) contains supplementary material, which is available to authorized users.
Highlights
The potential benefits of colorectal cancer screening are limited by low uptake
These results show that even a generic, narrative-based paper leaflet mailed to participants along with standard material has the potential to influence beliefs about colorectal cancer (CRC) screening that can act as barriers or motivators to uptake, and in so doing increase intention to be screened
This study describes the initial assessment of newly developed narrative information material for possible use in the National Health Service (NHS) CRC screening programme
Summary
The potential benefits of colorectal cancer screening are limited by low uptake. This study tested whether providing narrative accounts of the colorectal cancer (CRC) screening experience positively affected beliefs about CRC screening and intention to be screened. In England, a national CRC screening programme was introduced in 2006 and is offered biennially to all men and women between 60 and 74. It is based on the home-based guaiac faecal occult blood test (FOB test) with follow-up. Delivery of the CRC screening programme uses strategies known to maximise screening participation such as automated mailing of the FOB test to homes [7], prenotification [8], and reminders
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