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Using the Transtheoretical Model of Behaviour Change to describe readiness to rescreen for colorectal cancer with faecal occult blood testing
Author(s) -
Duncan Amy,
Turnbull Deborah,
Gregory Tess,
Cole Stephen,
Young Graeme,
Flight Ingrid,
Wilson Carlene
Publication year - 2012
Publication title -
health promotion journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.515
H-Index - 32
eISSN - 2201-1617
pISSN - 1036-1073
DOI - 10.1071/he12122
Subject(s) - transtheoretical model , medicine , colorectal cancer , relative risk , self efficacy , cancer prevention , cancer , demography , behavior change , confidence interval , psychology , pathology , sociology , psychotherapist
Issue addressed This study used the Transtheoretical Model of Behaviour Change (TTM) to describe reparticipation in colorectal cancer (CRC) screening according to social cognitive and background variables. Methods A random sample of men and women aged 50–74 years living in South Australia completed a questionnaire measuring TTM stage and attitudes toward screening using a faecal occult blood test (FOBT). Participants were categorised according to four stages of readiness to rescreen: action, maintenance, relapse and inconsistent. Multivariate techniques were used to determine predictors of lower readiness stages compared with maintenance. Results Of the 849 study participants, 29.9% were either non‐adherent or had no intentions to maintain adherence (inconsistent and relapse). Compared with maintenance rescreeners, relapse participants reported less: social influences to screen (RR=0.86, p<0.001); satisfaction with prior screening (RR=0.87, p=0.03), self‐efficacy (RR=0.96, p=0.01); and screening benefits (RR=0.84, p<0.001). Relapse participants were also more likely to not have private health insurance (RR=1.33, p=0.04) and be unaware of the need to repeat screening (RR=1.41, p=0.02). Inconsistent screeners were less likely to have planned when they will next rescreen (RR= 0.84, p=0.04) and reported greater barriers to rescreening (RR=1.05, p=0.05). Action participants were younger (RR= 0.98, p=<0.001), reported less social influences to screen (RR‐0.94, p<0.001) and were less likely to have known someone who has had CRC (RR‐0.82, p‐0.01). Conclusions Social cognitive, demographic and background variables significantly differentiated screening maintenance from lower readiness stages. So what? This is one of very few studies within the CRC screening literature to address behavioural factors associated with reparticipation and to extend the use of the TTM to explain CRC rescreening. An understanding of the variables associated with differing levels of non‐adherence provides a useful foundation for the development of interventions to improve reparticipation.