Effects of Promotional Materials on Attitudes and Fear towards Colorectal Cancer Screening among Chinese Older Adults: An Experimental Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Procedure
2.3. Promotional Materials of CRC Screening
2.4. Measures
- (1)
- Screening interest: “If you were offered a CRC screening test, would you take up the offer?” measured by a four-point Likert scale ranging from ‘Definitely Not’ to ‘Definitely Yes’;
- (2)
- Screening effectiveness: “The bowel screening is effective in detecting bowel cancer” measured by a five-point Likert scale ranging from ‘Strongly Disagree’ to ‘Strongly Agree’; and
- (3)
- Trust in the results of screening: “If you completed a screening test, would you trust the results of the test?” measured by a four-point Likert scale ranging from ‘Not At All’ to ‘Very Much’.
- (i).
- Screening interest was coded as “Yes = 1” when the participant answered “Definitely Yes” or “No = 0” for the other three options,
- (ii).
- Screening effectiveness was coded as “Yes = 1” when the participant answered “Strongly Agree” or “No = 0” for other options,
- (iii).
- Trust in the screening results was coded as “Yes = 1” when the participant answered “Very Much” or “No = 0” for other options.
2.5. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Topic | Content | Pamphlet | Cartoon | Video |
---|---|---|---|---|
1. Prognosis of CRC | The development of CRC | Yes | Yes | Yes |
2. Statistics of CRC | Incidednce; and age-secific and gender-specific mortality in Hong Kong | |||
3. Symptoms of CRC | Common symptoms of CRC such as blood in stool, change in bowel habits and weight loss | Yes | No | Yes |
4. Risk factors of CRC | Common risk factors such as lifestyles, age, and family history | Yes | No | Yes |
5. CRC screening tests | Fecal occult blood test, flexible sigmoidoscopy, and colonoscopy | Yes | No | Yes |
6. Demonstration of FOBT | The process of preparation of the stool sample using clay | No | No | Yes |
7. Benefits and potential harms of CRC screening | Early detection and treatment of CRC; False alarm of CRC | Yes | No | Yes |
8. Treatments of CRC | Possible medical treatments of CRC and maintaining a good lifesty; Contact information of organizations providing support to CRC survivors | Yes | No | Yes |
Variable | Total (n = 114) | Pamphlet (n = 39) | Cartoon (n = 39) | Video (n = 36) | p |
---|---|---|---|---|---|
Age, Mean ± SD | 74.2 ± 11.5 | 71.6 ± 14.2 | 76.3 ± 8.1 | 74.6 ± 10.9 | 0.2 |
MMSE, Mean ± SD | 25.7 ± 3.3 | 26.5 ± 3.5 | 25.3 ± 3.0 | 25.7 ± 3.3 | 0.2 |
Male, n (%) | 48 (42.1) | 15 (38.5) | 16 (41.0) | 17 (47.2) | 0.7 |
No formal education/below primary school level, n (%) | 67 (58.8) | 22 (56.4) | 24 (61.5) | 21 (58.3) | 0.9 |
Married/cohabitation, n (%) | 73 (64.0) | 23 (59.0) | 29 (74.4) | 21 (58.3) | 0.2 |
Family income 1, Mean ± SD | 2.9 ±2.6 | 3.3 ± 2.8 | 2.8 ± 2.7 | 2.6 ± 2.2 | 0.4 |
Mean number of chronic disease, Mean ± SD | 1.8 ± 1.5 | 1.5 ± 1.2 | 2.0 ± 1.7 | 1.8 ± 1.6 | 0.4 |
Knowledge about CRC symptom, Mean ± SD | 1.8 ± 2.0 | 2.00 ± 2.0 | 1.7 ± 1.9 | 1.7 ± 2.2 | 0.9 |
Knowledge about CRC risk factors, Mean ± SD | 2.2 ± 2.6 | 2.6 ± 2.7 | 2.0 ± 2.4 | 1.8 ± 2.6 | 0.4 |
Had CRC screening before, n (%) | 29 (25.4) | 13 (33.3) | 7 (17.9) | 9 (25.0) | 0.3 |
Knew someone had CRC screening, n (%) | 25 (21.9) | 7 (17.9) | 11 (28.2) | 7 (19.4) | 0.5 |
Variable | Pamphlet (n = 39) | Cartoon (n = 39) | Video (n = 36) | p | |||
---|---|---|---|---|---|---|---|
Overall 1 | Pairwise Comparison 2 | ||||||
Pamphlet vs. Cartoon | Pamphlet vs. Video | Cartoon vs. Video | |||||
Screening interest | |||||||
FOBT, n (%) | 23 (59.0) | 18 (46.2) | 16 (44.4) | 0.38 | |||
Flexible Sigmoidoscopy, n (%) | 9 (23.1) | 15 (38.5) | 7 (19.4) | 0.15 | |||
Colonoscopy, n (%) | 10 (25.6) | 15 (38.5) | 7 (19.4) | 0.17 | |||
Screening effectiveness | |||||||
FOBT, n (%) | 13 (33.3) | 17 (43.6) | 21 (58.3) | 0.09 | |||
Flexible Sigmoidoscopy, n (%) | 17 (43.6) | 23 (59.0) | 29 (80.6) | 0.004 | 0.3 | 0.002 | 0.049 |
Colonoscopy, n (%) | 23 (59.0) | 25 (64.1) | 29 (80.6) | 0.12 | |||
Trust in the results of screening | |||||||
FOBT, n (%) | 3 (7.7) | 9 (23.1) | 11 (30.6) | 0.04 | 0.1 | 0.02 | 0.5 |
Flexible Sigmoidoscopy, n (%) | 10 (25.6) | 18 (46.2) | 19 (52.8) | 0.04 | 0.1 | 0.02 | 0.6 |
Colonoscopy, n (%) | 17 (43.6) | 20 (51.3) | 18 (50.0) | 0.77 | |||
Cancer fear, Mean ± SD | 3.30 ± 0.96 | 3.17 ± 1.08 | 2.96 ± 1.00 | 0.34 |
Factors | FOBT | Flexible Sigmoidoscopy | Colonoscopy | ||||||
---|---|---|---|---|---|---|---|---|---|
OR | 95% CI | p | OR | 95% CI | p | OR | 95% CI | p | |
Block 1 variables | |||||||||
Number of chronic diseases | 0.75 | 0.54–1.02 | 0.070 | ||||||
Knowledge about CRC symptoms | 1.28 | 1.00–1.64 | 0.049 | 1.28 | 0.99–1.67 | 0.06 | |||
Had CRC screening before | 3.9 | 1.4-10.8 | 0.007 | 3.7 | 1.19–11.6 | 0.02 | |||
Knew someone had CRC screening | 7.2 | 1.84–28.0 | 0.005 | ||||||
Intervention | |||||||||
Video | 1 | ||||||||
Pamphlet | 1.70 | 0.44–6.5 | 0.4 | ||||||
Cartoon | 4.0 | 1.16–14.1 | 0.03 | ||||||
Block 2 Variables | |||||||||
Cancer fear | 0.95 | 0.89–1.02 | 0.2 | 0.95 | 0.83–1.10 | 0.5 | 0.86 | 0.76–0.99 | 0.03 |
Screening effectiveness | 1.55 | 0.14–17.1 | 0.2 | 4.7 | 0.84–26.8 | 0.04 | 1.72 | 0.28–10.4 | 0.5 |
Trust in the screening results | 0.15 | 0.004–5.0 | 0.3 | 0.10 | 0.01–7.1 | 0.3 | 0.05 | 0.01–2.96 | 0.2 |
Cancer fear × Screening effectiveness | 0.91 | 0.77–1.07 | 0.3 | 0.90 | 0.79–1.04 | 0.1 | 0.98 | 0.85–1.12 | 0.7 |
Cancer fear × Trust in the screening results | 1.08 | 0.95–1.23 | 0.2 | 1.13 | 0.95–1.34 | 0.2 | 1.19 | 1.01–1.41 | 0.04 |
Nagelkerke R2 | 0.325 | 0.284 | 0.328 |
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Leung, D.Y.P.; Chen, J.M.T.; Lou, V.W.Q.; Wong, E.M.L.; Chan, A.W.K.; So, W.K.W.; Chan, C.W.H. Effects of Promotional Materials on Attitudes and Fear towards Colorectal Cancer Screening among Chinese Older Adults: An Experimental Study. Int. J. Environ. Res. Public Health 2017, 14, 769. https://doi.org/10.3390/ijerph14070769
Leung DYP, Chen JMT, Lou VWQ, Wong EML, Chan AWK, So WKW, Chan CWH. Effects of Promotional Materials on Attitudes and Fear towards Colorectal Cancer Screening among Chinese Older Adults: An Experimental Study. International Journal of Environmental Research and Public Health. 2017; 14(7):769. https://doi.org/10.3390/ijerph14070769
Chicago/Turabian StyleLeung, Doris Y. P., Joanne M. T. Chen, Vivian W. Q. Lou, Eliza M. L. Wong, Aileen W. K. Chan, Winnie K. W. So, and Carmen W. H. Chan. 2017. "Effects of Promotional Materials on Attitudes and Fear towards Colorectal Cancer Screening among Chinese Older Adults: An Experimental Study" International Journal of Environmental Research and Public Health 14, no. 7: 769. https://doi.org/10.3390/ijerph14070769