Socio-psychological factors in the Expanded Health Belief Model and subsequent colorectal cancer screening

PATIENT EDUCATION AND COUNSELING

卷:98

Article

Sohler, Nancy L.¹  Jerant, Anthony²  Franks, Peter² 

[1] CUNY City Coll, Community Hlth & Social Med, Sophie Davis Sch Biomed Educ, New York, NY 10031 USA

[2] Univ Calif Davis, Sch Med, Dept Family & Community Med, Sacramento, CA 95817 USA

关键词: Expanded Health Belief Model;    Colorectal cancer;    Theoretical models;    Screening behavior;    Socio-psychological factors;   

DOI  :  10.1016/j.pec.2015.03.023

来源: Elsevier

【 摘 要 】

Objective: CRC screening interventions tailored to the Expanded Health Belief Model (EHBM) socio-psychological factors have been developed, but the contributions of individual factors to screening outcomes are unclear. Methods: In observational analyses of data from a randomized intervention trial, we examined the independent associations of five EHBM factors - CRC screening knowledge, self-efficacy, stage of readiness, barriers, and discussion with a provider - with objectively measured CRC screening after one year. Results: When all five factors were added simultaneously to a base model including other patient and visit characteristics, three of the factors were associated with CRC screening: self-efficacy (OR = 1.32, p = 0.001), readiness (OR = 2.72, p < 0.001), and discussion of screening with a provider (OR = 1.59, p = 0.009). Knowledge and barriers were not independently associated with screening. Adding the five socio-psychological factors to the base model improved prediction of CRC screening (area under the curve) by 7.7%. Conclusion: Patient CRC screening self-efficacy, readiness, and discussion with a provider. each independently predicted subsequent screening. Practice implications: Self-efficacy and readiness measures might be helpful in parsimoniously predicting which patients are most likely to engage in CRC screening. The importance of screening discussion with a provider suggests the potential value of augmenting patient-focused EHBM-tailored interventions with provider-focused elements. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

Free