Journal of Behavioral Medicine

, Volume 37, Issue 5, pp 1019–1029 | Cite as

Effectiveness of a theory-based intervention to increase colorectal cancer screening among Iranian health club members: a randomized trial

  • Hamideh Salimzadeh
  • Hassan EftekharEmail author
  • Reza Majdzadeh
  • Ali Montazeri
  • Alireza Delavari


Colorectal cancer is the third most commonly diagnosed cancer and the fourth leading cause of death in the world. There are few published studies that have used theory-based interventions designed to increase colorectal cancer screening in community lay health organizations. The present study was guided by the theoretical concepts of the preventive health model. Twelve health clubs of a municipal district in Tehran were randomized to two study groups with equal ratio. The control group received usual services throughout the study while the intervention group also received a theory-based educational program on colorectal cancer screening plus a reminder call. Screening behavior, the main outcome, was assessed 4 months after randomization. A total of 360 members aged 50 and older from 12 health clubs completed a baseline survey. Participants in the intervention group reported increased knowledge of colorectal cancer and screening tests at 4 months follow-up (p’s < .001). Moreover, exposure to the theory-based intervention significantly improved self-efficacy, perceived susceptibility, efficacy of screening, social support, and intention to be screened for colorectal cancer, from baseline to 4 months follow-up (p’s < .001). The screening rate for colorectal cancer was significantly higher in the intervention group compared to the control group (odds ratio = 15.93, 95 % CI = 5.57, 45.53). Our theory-based intervention was found to have a significant effect on colorectal cancer screening use as measured by self-report. The findings could have implications for colorectal cancer screening program development and implementation in primary health care settings and through other community organizations.


Cancer early detection Health education Patient education Standards 



The authors would like to thank to Amy McQueen for providing copies of survey items, and providing extensive comments on an earlier version of the manuscript. We also thank health clubs managers in the selected district for their helpful cooperation with data collection. This study was funded by Grant No. 12010 from the Tehran University of Medical Sciences.

Conflict of interest

All authors report no declarations of interest.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Hamideh Salimzadeh
    • 4
  • Hassan Eftekhar
    • 1
    Email author
  • Reza Majdzadeh
    • 2
  • Ali Montazeri
    • 3
  • Alireza Delavari
    • 4
  1. 1.Department of Health Education, School of Public HealthTehran University of Medical SciencesTehranIran
  2. 2.Department of Epidemiology and Biostatics, Knowledge Utilization Research Center, School of Public HealthTehran University of Medical SciencesTehranIran
  3. 3.Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences ResearchACECRTehranIran
  4. 4.Digestive Diseases Research Center, Shariati HospitalTehran University of Medical SciencesTehranIran

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