Amy Duncan

Demographic, social cognitive and social ecological predictors of intention and participation in screening for colorectal cancer

BackgroundPrevious research points to differences between predictors of intention to screen for colorectal cancer (CRC) and screening behavior, and suggests social ecological factors may influence screening behavior. The aim of this study was to compare the social cognitive and social ecological predictors of intention to screen with predictors of participation.MethodsPeople aged 50 to 74 years recruited from the electoral roll completed a baseline survey (n = 376) and were subsequently invited to complete an immunochemical faecal occult blood test (iFOBT).ResultsMultivariate analyses revealed five predictors of intention to screen and two predictors of participation. Perceived barriers to CRC screening and perceived benefits of CRC screening were the only predictor of both outcomes. There was little support for social ecological factors, but measurement problems may have impacted this finding.ConclusionsThis study has confirmed that the predictors of intention to screen for CRC and screening behaviour, although overlapping, are not the same. Research should focus predominantly on those factors shown to predict participation. Perceptions about the barriers to screening and benefits of screening are key predictors of participation, and provide a focus for intervention programs.

Comparison of mailed invitation strategies to improve fecal occult blood test participation in men: protocol for a randomized controlled trial

BackgroundMen have a significantly increased risk of being diagnosed with, and dying from, colorectal cancer (CRC) than women. Men also participate in fecal occult blood test (FOBT) screening at a lower rate than women. This study will determine whether strategies that target men’s attitudes toward screening, and matched to stage of readiness to screen, increase men’s FOBT participation compared to a standard approach.Methods/DesignEligible trial participants will be a national sample of 9,200 men aged 50 to 74 years, living in urban Australia and randomly selected from the Australian electoral roll. Trial participants will be mailed an advance notification letter, followed 2 weeks later by an invitation letter and a free fecal immunochemical test (FIT) kit. The intervention is a factorial design, randomized controlled trial (RCT) with four trial arms, including a control. The content of the advance notification and invitation letters will differ by trial arm as follows: 1) standard advance notification and standard invitation (control arm); 2) targeted advance notification and standard invitation; 3) standard advance notification and targeted invitation; and 4) targeted advance notification and targeted invitation. The standard letters will replicate as closely as possible the letters included in the Australian National Bowel Cancer Screening Program (NBCSP). Modified advance notification and invitation letters will incorporate additional messages to target men in the precontemplation (advance notification) and contemplation stages (invitation). The primary outcome is return of the completed FIT within 12 weeks of invitation. Analysts will be blinded to trial assignment and participants will be blinded to the use of varying invitational materials. Subsamples from each trial arm will complete baseline and endpoint surveys to measure the psychological impact of the intervention, and qualitative interviews will be conducted to evaluate attitudes toward the intervention.DiscussionThe outcomes of this study will have implications for the way FOBT screening is offered to men. Findings will help to identify how invitations for men to screen should be framed and delivered in order to maximize participation.Trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN12612001122842

Blood-based screening for bowel cancer may not resolve suboptimal screening participation in Australia.

Objective: Emerging blood‐based screening technologies for bowel cancer may improve screening participation compared to at‐home stool sampling. This study assessed the impact of different screening delivery scenarios with increasing health system interactions on sampling preferences and likelihood of screening participation.

Exploring the Potential of Anticipated Regret as an Emotional Cue to Improve Bowel Cancer Screening Uptake

Objective. Bowel cancer is currently the second leading cause of cancer-related death in Australia and screening participation is suboptimal. This study examined the role of emotion in the form of anticipated regret (AR) and its relationship to screening intentions. Methods. N = 173 persons aged 45 to 80 years completed a survey measuring demographic variables, readiness to screen, relative importance of health by comparison to other life priorities, satisfaction with current health, and AR if not participating in future bowel cancer screening. Results. AR was a significant predictor of future screening intentions. Those with higher levels of AR were seven times more likely (OR = 7.18) to intend to screen in the future compared to those with lower AR. This relationship was not compromised when controlling for other variables including gender and satisfaction with ones health. AR levels were significantly lower in people who had been screened previously and in those with full health insurance. Conclusions. These results demonstrate that AR is uniquely related to future bowel cancer screening intentions. Future studies should continue to consider this as a useful target for behavioural interventions and identify new ways of delivering these interventions to improve their reach.

Thinking Style as a Predictor of Men’s Participation in Cancer Screening:

Men’s participation in cancer screening may be influenced by their thinking style. Men’s need for cognition (NFC) and faith in intuition were measured to explore whether they varied by demographic variables or predicted screening behavior. Australian males (n = 585, aged 50-74 years) completed surveys about past screening and were subsequently offered mailed fecal occult blood tests (FOBTs). Demographic predictors included age, socioeconomic status, educational attainment, and language spoken at home. The screening behaviors were self-reported prostate cancer screening (prostate-specific antigen testing and digital rectal examinations [DREs]), and colorectal cancer screening (self-reported FOBT participation and recorded uptake of the FOBT offer). Analysis comprised principal component analysis and structural equation modelling. NFC was positively related to demographic variables education, socioeconomic status, and speaking English at home. Faith in intuition was negatively related to educational attainment. NFC predicted variance in self-reported DRE participation (r = .11, p = .016). No other relationships with thinking style were statistically significant. The relationship of NFC to DRE participation may reflect the way certain attributes of this screening method are processed, or alternatively, it may reflect willingness to report participation. The relationship of thinking style to a range of healthy behaviors should be further explored.

The relationship between participant evaluations of faecal occult blood tests (FOBT) and re-participation in screening

Are socioeconomic position, work stress, and work complexity associated to mobility after retirement?Abstracts from the ICBM 2014 Meetings from the ICBM 2014 MeetingIntroduction: Attitudinal ambivalence occurs when individuals endorse both positive and negative attitudes toward the same target object. Ambivalent attitudes are particularly relevant for addictive behaviours, as these behaviours may have both positive and negative evaluations associated with them. For example, drinking alcohol may make someone relaxed but can also produce feelings of nausea. Despite this, the majority of research focused on attitudes toward addictive behaviours assume that these attitudes are either positive or negative, not positive and negative. By assessing ambivalence toward addictive behaviours, a greater understanding of the nature of attitudes underlying these behaviours can be realised. Method: A total of 247 participants (M= 28.76 years) took part in this study. A measure of potential ambivalence, which asks participants to indicate their positive and negative evaluations on split semantic differential scales, was completed for five different health behaviours: drinking on a weekday and a weekend, exercising, increasing fruit and vegetable intake and smoking. Results: Attitudes toward alcohol consumption were found to be the most ambivalent. When examining drinking behaviour, a pattern emerged suggesting that the greater the quantity of alcohol consumed, the more ambivalent participants were toward drinking. Similar patterns were found for smoking. Conclusions: The results suggest that attitudinal ambivalence is an important aspect of addictive behaviours, as participants engaging in greater levels of these behaviours also reported higher levels of ambivalence. This indicates that individuals are aware of the positives and negatives of addictive behaviours but continue to perform them anyway.Salivary cortisol and alpha-amylase (sAA) that reflect hypothalamopituitary-adrenal axis (HPA-axis) activity and sympathetic activity within the autonomic nervous system (ANS) respectively, are bio ...Introduction: Previous research has developed an 11-item self-report measure assessing activation and pressure stress among adolescents. However, the biological correlates of this measure are uncle ...

Looking towards the future: consumer preferences for blood-based screening for colorectal cancer

Nadine Köhle 1, Constance Drossaert2, Cornelia van Uden-Kraan3, Irma Verdonck -de Leeuw4, Ernst Bohlmeijer5 1University of Twente, Enschede, Overijssel, The Netherlands, 2University of Twente, Enschede, Overijssel, The Netherlands, 3VU University, Amsterdam, Noord-Holland, The Netherlands, 4VU University, Amsterdam, Noord-Holland, The Netherlands, 5University of Twente, Enschede, Overijssel, The NetherlandsFrom Vision to Action - Innovation and Implementation of an Integrated Cancer Rehabilitation Within Clinical Practice

Mo1200 Demographic and Behavioural Predictors of Ongoing Adherence to Faecal Occult Blood Test Screening for Colorectal Cancer

cancers as those diagnosed in patients with colonoscopy between 6-36 months previously, and all others to have detected cancers. The presence of diverticulosis was identified through diagnosis codes during the previous three years. We compared the prevalence of diverticulosis in interval and detected cancers according to tumor location. The independent association of diverticulosis was then evaluated in a logistic model with generalized estimating equations accounting for clustering by endoscopists and stratified by tumor location. The model adjusted for demographics, comorbidity and endoscopist characteristics. Results: We identified 57,839 patients, including 53,647 with detected cancers and 4,192 (7.2%) with interval cancers. A previous diagnosis of diverticulosis was documented in 69.3% of interval cancers and 26.9% of detected cancers (p,0.001). In all segments of the colon, the prevalence of a diverticulosis diagnosis was higher in interval cancers than in detected cancers (Table) (p,0.001 for all comparisons). In the multivariable analysis, diverticulosis was strongly associated with interval cancer risk in both the proximal colon (cecum to splenic flexure) (Adjusted Odds Ratio (AOR) 5.43, 95% CI 4.98-5.93) and distal colon (descending, sigmoid) (AOR 6.59, CI 5.65-7.69). Conclusions: A previous diagnosis of diverticulosis is a strong risk factor for interval colon cancer regardless of tumor location. Given the greater prevalence and extent of diverticulosis in the left colon, it suggests that factors other than impaired visualization of neoplasia between diverticuli are involved in the pathogenesis of interval cancer. Prevalence of Diverticulosis