scholarly journals Mediators of screening uptake in a colorectal cancer screening intervention among Hispanics

BMC Cancer ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Navkiran K. Shokar ◽  
Jennifer Salinas ◽  
Alok Dwivedi
Keyword(s):  
Colorectal Cancer ◽  
Self Efficacy ◽  
Screening Test ◽  
Structural Equation ◽  
Structural Equation Models ◽  
Psychosocial Health ◽  
Screening Tests ◽  
Perceived Benefits ◽  
Crc Screening ◽  
Test Completion

Abstract Background Colorectal cancer (CRC) is the second leading cause of cancer deaths in the USA. Although a number of CRC screening tests have been established as being effective for CRC prevention and early detection, rates of CRC screening test completion in the US population remain suboptimal, especially among the uninsured, recent immigrants and Hispanics. In this study, we used a structural equation modelling approach to identify factors influencing screening test completion in a successful CRC screening program that was implemented in an uninsured Hispanic population. This information will enhance our understanding of influences on CRC screening among historically underscreened populations. Methods We used generalized structural equation models (SEM) utilizing participant reported information collected through a series of surveys. We identified direct and indirect pathways through which cofactors, CRC knowledge and individual Health Belief Model constructs (perceived benefits, barriers, susceptibility, fatalism and self-efficacy) and a latent psychosocial health construct mediated screening in an effective prospective randomized CRC screening intervention that was tailored for uninsured Hispanic Americans. Results Seven hundred twenty-three participants were eligible for inclusion; mean age was 56 years, 79.7% were female, and 98.9% were Hispanic. The total intervention effect was comparable in both models, with both having a direct and indirect effect on screening completion (n = 715, Model 1: RC = 2.46 [95% CI: 2.20, 2.71, p < 0.001]; n = 699, Model 2 RC =2.45, [95% CI: 2.18, 2.72, p < 0.001]. In Model 1, 32% of the overall effect was mediated by the latent psychosocial health construct (RC = 0.79, p < 0.001) that was in turn mainly influenced by self-efficacy, perceived benefits and fatalism. In Model 2, the most important individual mediators were self-efficacy (RC = 0.24, p = 0.013), and fatalism (RC = 0.07, p = 0.033). Conclusion This study contributes to our understanding of mediators of CRC screening and suggests that targeting self-efficacy, perceived benefits and fatalism could maximize the effectiveness of CRC screening interventions particularly in Hispanic populations.

Patterns of diagnosis for colorectal cancer (CRC): Screening detected versus symptomatic presentation

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 1023-1023
Author(s):  
S. R. Smiljanic ◽  
S. Gill
Keyword(s):  
Colorectal Cancer ◽  
British Columbia ◽  
Health Care Access ◽  
Screening Test ◽  
Distal Colon ◽  
Screening Tests ◽  
Crc Screening ◽  
Care Access ◽  
New Diagnosis ◽  
Screening History

1023 Background: Colorectal cancer (CRC) is a leading cause of cancer death in North America; studies have shown that screening improves survival. Conducted in British Columbia, Canada, this study was conducted to identify the proportion of screening-eligible patients with sporadic CRC who are detected by screening tests versus symptomatic presentation,and to compare baseline patient and tumor characteristics of these two groups. Methods: This retrospective cohort study identified 571 cases via the BC Cancer Registry of patients age 50 years and older presenting with first diagnosis of invasive CRC between Nov. 2002 and Apr. 2003. Patients with non-adenocarcinoma histology, HNPCC or FAP were not included. Self completed questionnaires were mailed to all patients to capture: prior screening history, screening versus symptomatic presentation, and demographic information. All respondents charts were then reviewed to corroborate screening information, and to obtain pathological information including TNM stage, grade and site (proximal versus distal colon versus rectal). Results: Of 212 eligible respondents (37% response), only 14 of 212 (6.6%) patients with a new CRC were detected via screening versus 198 of 212 (93.4%) presenting with symptoms. Respondents were average age at diagnosis 69 years, 59% male, 91% Caucasian, 37%rectal, and 18% M1 at diagnosis. No significant differences in the age, gender, ethnicity, socioeconomic status, tumour stage and site were detected between the screened versus symptomatic groups. Only 33 of 212 patients (15.6%) reported ever having a screening test. 19 of 198 cancers (9.6%) were diagnosed by symptomatic presentation despite a compliant screening history. Conclusion: Despite universal health-care access in British Columbia, only 7% of patients with a new diagnosis of CRC were detected via a screening test. Furthermore, only 15% of screening-eligible respondents have ever been screened. There were no differences in patient demographics or stage of disease at presentation but numbers in the screening cohort were limited. Significant effort is required to increase knowledge and compliance for CRC screening. No significant financial relationships to disclose.

scholarly journals Primary care providers’ beliefs and practices on colorectal cancer screening in Kuwait

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
E L Tolma ◽  
S M Aljunid ◽  
M N Amrizal ◽  
J Longenecker ◽  
A Al-Basmy ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Primary Care ◽  
Cancer Screening ◽  
Health System ◽  
Screening Test ◽  
Primary Care Providers ◽  
Screening Tests ◽  
Care Providers ◽  
Beliefs And Practices ◽  
Crc Screening

Abstract Background Colorectal cancer (CRC) is a major public health issue in the Arab region. In Kuwait, CRC is the second most frequent cancer, with an age-standardized (world) incidence rate of 13.2 cases/100,000 in 2018. Despite the national efforts to promote CRC screening the current participation rate is very low (5 to 17%). Primary Care Providers (PCPs) are considered as the gatekeepers of cancer screening globally. This is one of the first studies in Kuwait that examined the current beliefs/practices of PCPs on CRC screening. Methods This cross-sectional study was conducted at governmental primary care centers in Kuwait from 2015-2017. Of 564 PCPs invited to participate from all centers, 255 completed the self-administered questionnaires. The 14-page survey contained 75 questions on PCPs’ beliefs and practices of CRC screening. Data were analyzed by using descriptive statistics. Results The study sample consisted primarily of females (52.0%) and non-Kuwaiti (79%) physicians, with mean age =43.3 (SD: 11.2) years. Most respondents (92%) believed that colonoscopy is the most effective screening tool. The majority (78%) reported that they recommend CRC screening to their patients, with colonoscopy as the most frequent modality (87%) followed by the Faecal Occult Blood Test (FOBT) (52%). Around 40% of the respondents stated that they did not have time to discuss CRC screening with their patients. The majority (72%) believed that their patients did not complete their CRC screening tests. Health system related barriers included difficulties in obtaining test results from the gastroenterologist (61.4%), ordering follow-up test after a positive screening test (50.6%) and shortage of trained staff to conduct the screening test (44.2%). Conclusions A majority of PCPs in Kuwait recommend CRC screening to their patients, but not all patients follow through their recommendation. More research is needed to find out how to further enhance patient uptake of CRC screening. Key messages Colonoscopy is the most frequent screening CRC modality used in Kuwait. Health system related factors can be important future intervention targets to promote CRC screening.

scholarly journals Multilevel Pathways of Colorectal Cancer Screening Among Low-Income Vietnamese Americans: A Structural Equation Modeling Analysis

2021 ◽  
Vol 28 ◽  
pp. 107327482110110
Author(s):  
Grace X. Ma ◽  
Lin Zhu ◽  
Timmy R. Lin ◽  
Yin Tan ◽  
Phuong Do
Keyword(s):  
Health Beliefs ◽  
Low Income ◽  
Self Efficacy ◽  
Limited English Proficiency ◽  
Structural Equation ◽  
Vietnamese Americans ◽  
Equation Modeling ◽  
Community Based ◽  
Related Factors ◽  
Crc Screening

Background: Colorectal cancer (CRC) disproportionately affects Vietnamese Americans, especially those with low income and were born outside of the United States. CRC screening tests are crucial for prevention and early detection. Despite the availability of noninvasive, simple-to-conduct tests, CRC screening rates in Asian Americans, particularly Vietnamese Americans, remain suboptimal. The purpose of this study was to evaluate the interplay of multilevel factors – individual, interpersonal, and community – on CRC screening behaviors among low-income Vietnamese Americans with limited English proficiency. Methods: This study is based on the Sociocultural Health Behavior Model, a research-based model that incorporates 6 factors associated with decision-making and health-seeking behaviors that result in health care utilization. Using a community-based participatory research approach, we recruited 801 Vietnamese Americans from community-based organizations. We administered a survey to collect information on sociodemographic characteristics, health-related factors, and CRC screening-related factors. We used structural equation modeling (SEM) to identify direct and indirect predictors of lifetime CRC screening. Results: Bivariate analysis revealed that a greater number of respondents who never screened for CRC reported limited English proficiency, fewer years of US residency, and lower self-efficacy related to CRC screening. The SEM model identified self-efficacy (coefficient = 0.092, P < .01) as the only direct predictor of lifetime CRC screening. Educational attainment (coefficient = 0.13, P < .01) and health beliefs (coefficient = 0.040, P < .001) had a modest significant positive relationship with self-efficacy. Health beliefs (coefficient = 0.13, P < .001) and educational attainment (coefficient = 0.16, P < .01) had significant positive relationships with CRC knowledge. Conclusions: To increase CRC screening uptake in medically underserved Vietnamese American populations, public health interventions should aim to increase community members’ confidence in their abilities to screen for CRC and to navigate associated processes, including screening preparation, discussions with doctors, and emotional complications.

scholarly journals Career Decision, Work Adjustment, and Person–Job Fit of Adolescents: Moderating Effects of Parental Support

2021 ◽  
pp. 089484532199596
Author(s):  
Markus P. Neuenschwander ◽  
Jan Hofmann
Keyword(s):  
Parental Support ◽  
Self Efficacy ◽  
Structural Equation ◽  
Social Cognitive ◽  
Structural Equation Models ◽  
Cognitive Model ◽  
Career Decision ◽  
Work Conditions ◽  
Job Fit ◽  
The Social

We applied the social cognitive model of work satisfaction to the transition from lower secondary education to work in Switzerland and combined career decision and adjustment to work. The model assumes that self-efficacy affects career decision outcomes and adjustment after transition to work. Self-efficacy interacts with parental support during career decision making. We tested the model using a longitudinal sample of 603 adolescents who filled out questionnaires in seventh grade, ninth grade, and 1 year after starting work. Structural equation models showed that parental support weakens the effect of self-efficacy on anticipated person–job fit and expectations of work conditions (moderation). Expectations of work conditions and a company’s support help newcomers to attain a high perceived person–job fit. These findings have several implications on how to support adolescents’ school-to-work transition.

scholarly journals Framework and Strategies to Eliminate Disparities in Colorectal Cancer Screening Outcomes

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Chyke A. Doubeni ◽  
Kevin Selby ◽  
Samir Gupta
Keyword(s):  
Colorectal Cancer ◽  
Community Engagement ◽  
Health Equity ◽  
Screening Tests ◽  
Annual Review ◽  
Publication Date ◽  
Structural Barriers ◽  
Screening Process ◽  
Crc Screening ◽  
Racial Ethnic

Preventable differences in colorectal cancer (CRC) mortality across racial/ethnic, economic, geographic, and other groups can be eliminated by assuring equitable access and quality across the care continuum, but few interventions have been demonstrated to do so. Multicomponent strategies designed with a health equity framework may be effective. A health equity framework takes into account social determinants of health, multilevel influences (policy, community, delivery, and individual levels), screening processes, and community engagement. Effective strategies for increasing screening uptake include patient navigation and other interventions for structural barriers, reminders and clinical decision support, and data to continuously track metrics and guide targets for improvement. Community resource gaps should be addressed to assure high-quality services irrespective of racial/ethnic and socioeconomic status. One model combines population-based proactive outreach screening with delivery screening at in-person or virtual points of contact, as well as community engagement. Patient- and provider-based behavioral interventions may be considered for increasing screening demand and delivery. Providing a choice of screening tests is recommended for CRC screening, and access to colonoscopy is required for completion of the CRC screening process. Expected final online publication date for the Annual Review of Medicine, Volume 72 is January 27, 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Preferences of Iranian average risk population for colorectal cancer screening tests

2019 ◽  
Vol 32 (4) ◽  
pp. 677-687
Author(s):  
Vajiheh Ramezani_Doroh ◽  
Alireza Delavari ◽  
Mehdi Yaseri ◽  
Sara Emamgholipour Sefiddashti ◽  
Ali Akbarisari
Keyword(s):  
Colorectal Cancer ◽  
Health Status ◽  
Discrete Choice ◽  
Choice Model ◽  
Screening Tests ◽  
Average Risk ◽  
Risk Population ◽  
Content Type ◽  
Crc Screening ◽  
Complication Risk

Purpose The purpose of this paper is to explore the preferences of the average risk Iranian population for colorectal cancer (CRC) screening tests. Design/methodology/approach A standard stated-preferences method with discrete choice models was used to identify the preferences. Data about socio-demographic status, health status and preferences for CRC screening tests were collected by a structured questionnaire that was completed by 500 people aged 50–75 years. Mixed logit model was used to analyze the preferences. Findings The regression model showed that the test process, pain, place, frequency, preparation, sensitivity, complication risk, mortality rate and cost were the final attributes; that had a statistically significant correlation with the preferences of the people in choosing CRC screening tests. The socio-demographic and health status of participants had no significant correlation with the individuals’ preferences. Practical implications This study provides insight into how different characteristics of a CRC screening test might influence the preferences of individuals about that test. Originality/value This was the first study of this type in Iran to elicit the preferences of the average risk population for CRC screening tests using a discrete choice model.

scholarly journals Effects of Entrepreneurial Characteristics and University Environment on Entrepreneurial Intention

2018 ◽  
Vol 22 (2) ◽  
pp. 226-248 ◽  
Author(s):  
Gustavo Hermínio Salati Marcondes de Moraes ◽  
Edson Sadao Iizuka ◽  
Matheus Pedro
Keyword(s):  
Risk Taking ◽  
Self Efficacy ◽  
Structural Equation ◽  
Structural Equation Models ◽  
Entrepreneurial Intention ◽  
Quantitative Methodology ◽  
State University ◽  
University Environment ◽  
Entrepreneurial Characteristics ◽  
The University

Abstract This study aimed to investigate the effects of entrepreneurial and university environment characteristics on the entrepreneurial intention of the undergraduate student. We developed a model that considers the university environment, self-efficacy, and risk-taking as direct influencers of entrepreneurial intention, and entrepreneurial characteristics as influencers of self-efficacy. We employed quantitative methodology and data were analyzed by Structural Equation Models using the Partial Least Squares (PLS-SEM) technique. The sample consisted of 287 students in the final year of undergraduate programs at the State University of Campinas (Unicamp). The results indicate that the entrepreneurial intention of students is influenced by the university environment and the attitude toward risk-taking and self-efficacy. Self-efficacy, in turn, is influenced by student characteristics regarding planning, leadership, and innovation. The research corroborates with complementary reflections on entrepreneurship studies, showing a model for evaluation of entrepreneurial characteristics of students and of the entrepreneurial context in educational institutions, and proving that there is a positive relationship between the context, entrepreneurial education and entrepreneurial intention of the students.

scholarly journals Information and Trust in Parent-Teacher Cooperation – Connections with Educational Inequality

2020 ◽  
Vol 2 (3) ◽  
pp. 19-28
Author(s):  
Markus P. Neuenschwander
Keyword(s):  
Student Achievement ◽  
Self Efficacy ◽  
Primary Schools ◽  
Structural Equation ◽  
Structural Equation Models ◽  
Educational Inequality ◽  
Language Instruction ◽  
School Year ◽  
Efficacy Expectation ◽  
Parent Trust

There is an ongoing debate on how parents and the cooperation between parents and teachers contribute to educational inequality. In this study, the assumption that information and trust in parent–teacher cooperation mediate the effects of parent socioeconomic status (SES) on student achievement in mathematics and instruction language (German) was examined. The effects of information and trust on achievement were assumed to be mediated by parent self-efficacy expectation in German. The hypotheses were tested using a sample with 1001 students from 4th to 6th grade and their parents in Swiss primary schools using questionnaires and achievement tests at the beginning and the end of a school year. Results from structural equation models with longitudinal data showed that parent trust and parent self-efficacy expectation fully mediated the effect of SES and student achievement in language instruction but not in mathematics. Information did not correlate with SES nor with student achievement, but with trust. Parental trust in the cooperation with teachers affected achievement in both mathematics and German. The model combines the research on parental involvement with the research on educational inequality in school. Teachers need to establish trust in cooperation with low-SES parents to reduce educational inequality in school.

scholarly journals Towards Novel Non-Invasive Colorectal Cancer Screening Methods: A Comprehensive Review

2021 ◽  
Author(s):  
Allegra Ferrari ◽  
Isabelle Neefs ◽  
Sarah Hoeck ◽  
Marc Peeters ◽  
Guido Van Hal
Keyword(s):  
Colorectal Cancer ◽  
Early Stage ◽  
Screening Tests ◽  
Screening Methods ◽  
Exhaled Breath ◽  
Sample Collection ◽  
Screening Programs ◽  
Crc Screening ◽  
Low Sensitivity ◽  
Standard Colonoscopy

Colorectal cancer (CRC) is one of the leading cancer-related causes of death in the world. Since the 70s, many countries have adopted different CRC screening programs which has resulted in a decrease in mortality. However, current screening test options still present downsides. The commercialized stool-based tests present high false-positive rates and low sensitivity, which negatively affects the detection of early stage carcinogenesis. The gold standard colonoscopy has low uptake due to its invasiveness and the perception of discomfort and embarrassment that the procedure may bring.In this review, we collected and described the latest data about alternative CRC screening techniques that can overcome these disadvantages. Web of Science and PubMed were employed as search engines for studies reporting on CRC screening tests and future perspectives. The searches generated 555 articles, of which 93 titles were selected. Finally, a total of 50 studies, describing 14 different CRC alternative tests, were included. Among the investigated techniques the main feature that could have an impact on CRC screening perception and uptake was the ease of sample collection. Urine, exhaled breath and blood-based tests promise to achieve good diagnostic performance (sensitivity of 63-100%, 90-95%, 47-97%, respectively) while minimizing stress and discomfort for the patient.

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