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Examining the Durability of Colorectal Cancer Screening Awareness and Health Beliefs Among Medically Underserved Patients: Baseline to 12 months Post-Intervention

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Abstract

The current study examines changes in awareness and health beliefs from baseline to 12 months post-intervention following receipt of one of two colorectal cancer (CRC) educational interventions that aimed to promote CRC screening among a racially and ethnically diverse and medically underserved population. Participants (N = 270) were enrolled in a randomized controlled trial to increase CRC screening and completed both baseline and 12-month follow-up assessments. Participants were aged 50–75, at average CRC risk, not up-to-date with CRC screening guidelines, and receiving care at one of three community-based clinics. Participants were randomized to receive either a targeted, low-literacy intervention informed by the Preventive Health Model [PHM] (photonovella and DVD plus fecal immunochemical test [FIT]) or a non-targeted intervention (standard educational brochure plus FIT). Changes in CRC awareness and health beliefs from baseline to 12 months were examined both within and between intervention groups using Student’s t tests. Participants in both intervention conditions demonstrated an increase in CRC awareness, PHM social influence, and trust in the healthcare system (all p’s < .0001), with no significant between-group differences. Among those receiving the targeted intervention, there also was an increase in PHM salience (p < .05). Among individuals receiving the non-targeted intervention, there was an increase in PHM response efficacy (p < .01) and PHM self-efficacy (p < .0001). Both CRC screening interventions promoted positive changes in awareness and several health beliefs from baseline to 12 months, suggesting important benefits of CRC education. Regardless of whether education was targeted or non-targeted, providing CRC screening education successfully promoted durable changes in awareness and health beliefs.

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Funding

The study was funded by grant no. 1U54CA153509 from the Center to Reduce Cancer Health Disparities at the National Cancer Institute (PIs C.D. Meade and C.K. Gwede). The efforts of Drs. Christy, Davis, and Chavarria were supported by grant no. R25CA090314 (PI: P. B. Jacobsen [prior PI]/T. H. Brandon [current PI]) from the National Cancer Institute. This work was also supported in part by the Biostatistics Core and the Survey Methods Core at the H. Lee Moffitt Cancer Center & Research Institute, a National Cancer Institute-designated Comprehensive Cancer Center (NIH/NCI Grant Number: P30-CA076292). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute.

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Authors and Affiliations

  1. Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, MFC-EDU, Tampa, FL, 33612, USA

    Shannon M. Christy, Steven K. Sutton, Clement K. Gwede, Enmanuel A. Chavarria, Stacy N. Davis, Rania Abdulla, Richard Roetzheim, David Shibata & Cathy D. Meade

  2. Morsani College of Medicine, University of South Florida, Tampa, FL, USA

    Shannon M. Christy, Steven K. Sutton, Clement K. Gwede, Richard Roetzheim & Cathy D. Meade

  3. University of Texas Health Science Center at Houston, School of Public Health, Brownsville, TX, USA

    Enmanuel A. Chavarria

  4. Department of Health Education and Behavioral Science, Rutgers School of Public Health, Piscataway, NJ, USA

    Stacy N. Davis

  5. Premier Community HealthCare Group, Inc., Dade City, FL, USA

    Ida Schultz

  6. University of Tennessee Health Science Center, Memphis, TN, USA

    David Shibata

Authors
  1. Shannon M. Christy
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  2. Steven K. Sutton
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  3. Clement K. Gwede
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  4. Enmanuel A. Chavarria
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  5. Stacy N. Davis
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  6. Rania Abdulla
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  7. Ida Schultz
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  8. Richard Roetzheim
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  9. David Shibata
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  10. Cathy D. Meade
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Corresponding author

Correspondence to Cathy D. Meade.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

At the time of manuscript preparation and submission, Dr. Christy was a Postdoctoral Fellow at Moffitt Cancer Center and a Postdoctoral Fellow at Morsani College of Medicine, University of South Florida, Tampa, FL. Dr. Christy is now an Assistant Professor at the University of Tennessee Health Science Center, Memphis, TN.

A portion of the results for the current study were presented at the 2016 American Association for Cancer Research Conference on The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved, Fort Lauderdale, FL.

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Christy, S.M., Sutton, S.K., Gwede, C.K. et al. Examining the Durability of Colorectal Cancer Screening Awareness and Health Beliefs Among Medically Underserved Patients: Baseline to 12 months Post-Intervention. J Canc Educ 34, 297–303 (2019). https://doi.org/10.1007/s13187-017-1301-9

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  • DOI: https://doi.org/10.1007/s13187-017-1301-9

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