Behavioural and demographic predictors of adherence to three consecutive faecal occult blood test screening opportunities: a population study

BMC Public Health

Graeme P Young²  Ingrid Flight³  Stephen R Cole²  Joanne M Osborne²  Carlene Wilson¹  Deborah Turnbull⁴  Amy Duncan⁴ 

[1]Flinders Centre for Innovation in Cancer, Flinders University, Bedford Park 5042, South Australia, Australia

[2]Bowel Health Service, Repatriation General Hospital, Daw Park 5041, South Australia, Australia

[3]Preventative Health Flagship, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Adelaide 5000, South Australia, Australia

[4]School of Psychology, The University of Adelaide, Adelaide 5005, South Australia, Australia

关键词: Psychological factors;    Adherence;    Rescreening;    Faecal occult blood test;    Colorectal cancer;   

Others  :  1132203
DOI  :  10.1186/1471-2458-14-238

 received in 2013-09-12, accepted in 2014-03-03,  发布年份 2014

【 摘 要 】

Background

Social cognitive variables are often examined for their association with initial participation in colorectal cancer screening. Few studies have examined the association of these variables with adherence to multiple screening offers i.e., rescreening. This study aimed to describe patterns of participatory behaviour after three rounds of screening using faecal immunochemical tests (FIT) and to determine social cognitive, demographic and background variables predictive of variations in adherence.

Methods

Participants were 1,540 men and women aged 50 to 75 living in South Australia who completed a behavioural survey measuring demographic (for example, age, gender) and social cognitive variables relevant to FIT screening (for example, perceived barriers, benefits, self-efficacy). The survey was followed by three, free FIT screening offers mailed on an annual basis from 2008 to 2010. Patterns of participation after three screening rounds were described as one of five screening behaviours; 1) consistent re-participation (adherent with all screening rounds), 2) consistent refusal (adherent with no screening rounds), 3) drop out (adherent with earlier but not later rounds), 4) intermittent re-participation (adherent with alternate rounds) and 5) delayed entry (adherent with later but not initial round(s)). Univariate (Chi Square and Analysis of Variance) and multivariate (Generalised Estimating Equations) analyses were conducted to determine variables predictive of each category of non-adherence (those that did not participate in every screening offer, groups 2, 3, 4 and 5) relative to consistent re-participation.

Results

Significant social cognitive predictors of non-adherence were; less self-efficacy (drop out and consistent refusal), greater perceived barriers (drop out) and lower levels of response efficacy (consistent refusal). Demographic predictors of non-adherence included; male gender (delayed entry), younger age (intermittent, delayed and consistent refusal), less frequent GP visits (intermittent re-participation) and 'ancillary only' private health insurance (drop out). Less satisfaction with screening at baseline predicted drop out, consistent refusal and delayed entry.

Conclusions

Different combinations of demographic and behavioural variables predicted different patterns of rescreening adherence. Rescreening interventions may benefit from a targeted approach that considers the different needs of the population subgroups. Satisfaction with past FOBT screening measured prior to the study screening offers was an important predictor of adherence.

【 授权许可】

   
2014 Duncan et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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