Colorectal cancer remains the third leading cause of cancer death in the United States despite increased attention to early detection and prevention behaviors. Interventions to increase screening for cancer often focus on impacting behavior change by altering beliefs and knowledge. The primary aim of this study is to test the effectiveness of tailored and non-tailored interventions designed to increase the use of FOBT and sigmoidoscopy among non-adherent men and women aged 50 years or older. According to the Transtheoretical Model, behavior change occurs, not as a dichotomous event, but as a series of incremental stages. Effective interventions must focus on altering beliefs at each stage to impact behavior change. The Health Belief Model provides guidance for tailoring education at each of the stages for behavior change. In this prospective, randomized intervention study participants (N=206) were randomly assigned to one of 3 groups: 1) usual care, 2) tailored print communication, and 3) non-tailored print communication. Data were collected via telephone at baseline and 2 months post-intervention. The sample was primarily Caucasian, female, middle class, reported at least a high school education, with a mean age of 60. Several beliefs differed by stage of behavior adoption post-intervention. For stool blood test, there were significant differences in barriers (F=9.48, p< .001), benefits (F=3.17, p <.01), and self-efficacy (F=2.39, p<.05). Precontemplators had significantly lower benefits and self-efficacy, and higher barriers than those in action. For sigmoidoscopy, barriers (F=9.05, p< .001) and self-efficacy (F=2.58, p<.05) were significantly different by stage; precontemplators had significantly higher barriers and lower self-efficacy than contemplators and actors. Results indicate that individuals differ significantly in beliefs according to their stage of screening adoption. This could guide future research to develop interventions tailored to individual beliefs and stage of behavior adoption.
Session #1185 - Oncology Nursing Research
The 29th Annual MNRS Research Conference (April 1-4, 2005)