Journal of Cancer Education

, Volume 34, Issue 2, pp 297–303 | Cite as

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

  • Shannon M. Christy
  • Steven K. Sutton
  • Clement K. Gwede
  • Enmanuel A. Chavarria
  • Stacy N. Davis
  • Rania Abdulla
  • Ida Schultz
  • Richard Roetzheim
  • David Shibata
  • Cathy D. MeadeEmail author


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.


Colorectal cancer screening Health beliefs Intervention Health disparities Preventive Health Model 


Funding Information

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.

Compliance with Ethical Standards

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.


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Copyright information

© American Association for Cancer Education 2017

Authors and Affiliations

  • Shannon M. Christy
    • 1
    • 2
  • Steven K. Sutton
    • 1
    • 2
  • Clement K. Gwede
    • 1
    • 2
  • Enmanuel A. Chavarria
    • 1
    • 3
  • Stacy N. Davis
    • 1
    • 4
  • Rania Abdulla
    • 1
  • Ida Schultz
    • 5
  • Richard Roetzheim
    • 1
    • 2
  • David Shibata
    • 1
    • 6
  • Cathy D. Meade
    • 1
    • 2
    Email author
  1. 1.Division of Population ScienceH. Lee Moffitt Cancer Center and Research InstituteTampaUSA
  2. 2.Morsani College of MedicineUniversity of South FloridaTampaUSA
  3. 3.University of Texas Health Science Center at Houston, School of Public HealthBrownsvilleUSA
  4. 4.Department of Health Education and Behavioral ScienceRutgers School of Public HealthPiscatawayUSA
  5. 5.Premier Community HealthCare Group, Inc.Dade CityUSA
  6. 6.University of Tennessee Health Science CenterMemphisUSA

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