Wendy C Birmingham1, Man Hung2, Watcharaporn Boonyasiriwat3, Wendy Kohlmann4, Scott T Walters5, Randall W Burt4, Antoinette M Stroup6, Sandie L Edwards4, Marc D Schwartz7, Jan T Lowery8, Deirdre A Hill9, Charles L Wiggins9, John C Higginbotham10, Philip Tang2, Shirley D Hon2, Jeremy D Franklin2, Sally Vernon11, Anita Y Kinney12. 1. Department of Psychology, Brigham Young University, Provo, UT, USA. 2. Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA. 3. Faculty of Psychology, Chulalongkorn University, Bangkok, Thailand. 4. Huntsman Cancer Institute, Salt Lake City, UT, USA. 5. Department of Behavioral and Community Health, University of North Texas, Houston, TX, USA. 6. New Jersey State Cancer Registry, Rutgers University, New Brunswick, NJ, USA. 7. Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA. 8. University of Colorado Cancer Center, Denver, CO, USA. 9. University of New Mexico Cancer Research and Treatment Center, Albuquerque, NM, USA. 10. Institute for Rural Health, University of Alabama, Tuscaloosa, AL, USA. 11. Division of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center, Houston, TX, USA. 12. University of New Mexico Cancer Center and School of Medicine, Albuquerque, NM, USA.
Abstract
OBJECTIVE: Relatives of colorectal cancer (CRC) patients are at increased risk for the disease, yet screening rates still remain low. Guided by the Extended Parallel Process Model, we examined the impact of a personalized, remote risk communication intervention on behavioral intention and colonoscopy uptake in relatives of CRC patients, assessing the original additive model and an alternative model in which each theoretical construct contributes uniquely. METHODS: We collected intention-to-screen and medical record-verified colonoscopy information on 218 individuals who received the personalized intervention. RESULTS: Structural equation modeling showed poor main model fit (root mean square error of approximation (RMSEA) = 0.109; standardized root mean residual (SRMR) = 0.134; comparative fit index (CFI) = 0.797; Akaike information criterion (AIC) = 11,601; Bayesian information criterion (BIC) = 11,884). However, the alternative model (RMSEA = 0.070; SRMR = 0.105; CFI = 0.918; AIC = 11,186; BIC = 11,498) showed good fit. Cancer susceptibility (B = 0.319, p < 0.001) and colonoscopy self-efficacy (B = 0.364, p < 0.001) perceptions predicted intention to screen, which was significantly associated with colonoscopy uptake (B = 0.539, p < 0.001). CONCLUSIONS: Our findings provide support of the utility of Extended Parallel Process Model for designing effective interventions to motivate CRC screening in persons at increased risk when individual elements of the model are considered.
OBJECTIVE: Relatives of colorectal cancer (CRC) patients are at increased risk for the disease, yet screening rates still remain low. Guided by the Extended Parallel Process Model, we examined the impact of a personalized, remote risk communication intervention on behavioral intention and colonoscopy uptake in relatives of CRCpatients, assessing the original additive model and an alternative model in which each theoretical construct contributes uniquely. METHODS: We collected intention-to-screen and medical record-verified colonoscopy information on 218 individuals who received the personalized intervention. RESULTS: Structural equation modeling showed poor main model fit (root mean square error of approximation (RMSEA) = 0.109; standardized root mean residual (SRMR) = 0.134; comparative fit index (CFI) = 0.797; Akaike information criterion (AIC) = 11,601; Bayesian information criterion (BIC) = 11,884). However, the alternative model (RMSEA = 0.070; SRMR = 0.105; CFI = 0.918; AIC = 11,186; BIC = 11,498) showed good fit. Cancer susceptibility (B = 0.319, p < 0.001) and colonoscopy self-efficacy (B = 0.364, p < 0.001) perceptions predicted intention to screen, which was significantly associated with colonoscopy uptake (B = 0.539, p < 0.001). CONCLUSIONS: Our findings provide support of the utility of Extended Parallel Process Model for designing effective interventions to motivate CRC screening in persons at increased risk when individual elements of the model are considered.
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