Background Colorectal cancer (CRC) screening is crucial in reducing its mortality yet its success depends on long-term participation. To promote the screening programme, there is a need for understanding the factors associated with its uptake. Nevertheless, most previous studies only evaluated the factors associated with screening adherence as a binary outcome. The Stages of Change model (SOC) provides an alternative means to categorise prospective participants into more precise groups. This study aims to investigate the social-demographic factors associated with readiness to CRC screening using the SOC.
Methods A population-based telephone survey was conducted among 2,400 individuals aged 61–70 years old. Data on the social-demographic factors (age, gender, educational level, marital status, occupation, income, smoking and self-perceived health status), past experience; current status; and future intention to receive CRC screening were collected for each individual. Based on the SOC, participants were categorised into different groups, consisting of pre-contemplation, contemplation, preparation, action, relapse, and maintenance. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were evaluated using binary logistic regression analyses.
Results Participants at the pre-contemplation stage were more likely to be older (AOR=1.07; 95% CI=1.04–1.11), of female gender (AOR=1.54; 95% CI=1.15–2.07), and have lower income (AOR=0.68; 95% CI=0.48–0.98) compared with those at contemplation, preparation or action stages. Relapse screeners were more likely to be older (AOR=1.08; 95% CI=1.03–1.13), at lower education level (AOR=0.54; 95% CI=0.35–0.82), and smokers (AOR=1.92; 95% CI=1.09–3.38) compared with maintenance screeners. The association was not found to be associated with marital status, occupation and self-perceived health status.
Conclusions The goal for promoting health programs is to facilitate forward movement from the pre-contemplation stage to contemplation, preparation, action and finally maintenance. This is one of the very few studies investigated factors associated with readiness to CRC screening by using the SOC. Our findings provide a foundation for developing interventions to improve long-term participation of CRC screening.
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