Document Type : Original Article
Authors
1 Department of Epidemiology and Biostatistics, Social Determinants of Health Research Center, School of Health, Birjand University of Medical Sciences, Birjand, Iran
2 department of Health Education and Health Promotion, Social Determinants of Health Research Center, School of Health, Birjand University of Medical Sciences, Birjand, Iran
Abstract
BACKGROUND: Colorectal cancer is the most common cancer of the gastrointestinal tract. Health
beliefs play an important role in the development of health behaviors. In this study, the effect of
educational intervention based on Health Belief Model on colorectal cancer screening behavior was
investigated.
MATERIALS AND METHODS: This study was performed as a randomized controlled intervention.
The study population was 50–70‑years old in Khosf city. Initially, 120 eligible populations were
randomly divided into intervention and control groups (60 people in each group). The data collection
tool was a standard colorectal cancer screening questionnaire that was completed before, immediately,
and 3 months after the intervention. The intervention consisted of eight 60‑min training sessions.
The collected data were analyzed using SPSS19 software and statistical tests.
RESULTS: The mean age of the intervention and control groups was 63.53 ± 5.67 and
57.73 ± 5.77 years. In terms of mean scores of knowledge, perceived susceptibility, perceived severity,
and perceived barriers were homogeneous before intervention. After the intervention, the mean score
of the model constructs showed significant changes, which was statistically significant (P < 0.05).
The rate of occult blood test in stool 3 months after training reached 90% in the intervention group
and 15% in the control group.
CONCLUSIONS: The results of this study showed that by taking measures to reduce perceived
barriers as well as increase knowledge, perceived susceptibility, severity, benefits and self-efficacy,
the rate of participation in occult blood testing in feces can be significantly increased.
Keywords
Iran. J Mazandaran Univ Med Sci 2015;24:391‑6.
2. Siegel RL, Miller KD, Goding Sauer A, Fedewa SA, Butterly LF,
Anderson JC, et al. Colorectal cancer statistics, 2020. CA Cancer
J Clin 2020;70:145‑64.
3. Roshandel G, Ghanbari‑Motlagh A, Partovipour E, Salavati F,
Hasanpour‑Heidari S, Mohammadi G, et al. Cancer incidence in
Iran in 2014: Results of the Iranian National Population‑based
Cancer Registry. Cancer Epidemiol 2019;61:50‑8.
4. Ghanbari A, Rahmatpour P, KhaliliM, Mokhtari N. Health literacy
and its relationship with cancer screening behaviors among the
employees of Guilan University of Medical Sciences. J Health
Care 2017;18:306‑15.
5. Bandi P, Cokkinides V, Smith RA, Jemal A. Trends in colorectal
cancer screening with home‐based fecal occult blood tests in
adults ages 50 to 64 years, 2000‐2008. Cancer 2012;118:5092‑9.
6. Javadzade SH, Reisi M, Mostafavi F, Hasanzade A, Shahnazi H,
Sharifirad G. Factors associated with the fecal occult blood testing
for colorectal cancer screening based on health belief model
structures in moderate risk individuals, Isfahan, 2011. J Educ
Health Promot 2012;1:18.
7. Salimzadeh H, Delavari A, Montazeri A, Mirzazadeh A.
Knowledge and practice of iranians toward colorectal cancer,
and barriers to screening. Int J Prev Med 2012;3:29‑35.
8. Ramazani AA, Norozi E, AmirabadiZadeh H, Ehteshampour AR,
Salehiniya H. Predictors of colorectal cancer screening
participation in Southern Khorasan (Iran). J Gastrointest Cancer
2021;52:187‑91.
9. Shin DW, Chang D, Jung JH, Han K, Kim SY, Choi KS, et al.
Disparities in the participation rate of colorectal cancer screening
by fecal occult blood test among people with disabilities:
A national database study in South Korea. Cancer Res Treat
2020;52:60‑73.
10. Tastan S, Andsoy II, Iyigun E. Evaluation of the knowledge,
behavior and health beliefs of individuals over 50 regarding
colorectal cancer screening. Asian Pac J Cancer Prev
2013;14:5157‑63.
11. Rajabi R, Sharifi A, Shamsi M, Almasi Hashyani A, Dejam S.
Investigating the effect of package theory‑based training in the
prevention of gastrointestinal cancers. J Arak Univ Med Sci
2014;17:41‑51.
12. Shouri Bidgoli AR, Taheri Kharame Z, Asayesh H, Sharififard F,
Sheydaiyan Arani M, Hajaligol A, et al. A study of knowledge attitude, and practiceoncolorectal cancer screening among
individuals older than 50 years based on health belief model.
Qom Univ Med Sci J 2015;9:59‑65.
13. Almadi MA, Mosli MH, Bohlega MS, Al Essa MA, AlDohan MS,
Alabdallatif TA, et al. Effect of public knowledge, attitudes, and
behavior on willingness to undergo colorectal cancer screening
using the health belief model. Saudi J Gastroenterol 2015;21:71‑7.
14. Armitage CJ, Conner M. Social cognition models and health
behaviour: A structured review. Psychol Health 2000;15:173‑89.
15. Garcés DM. Applying the health belief model to cervical cancer
screening. CES Med 2006;20:55‑63.
16. Glanz K, Rimer BK, Viswanath K. Health Behavior and Health
Education: Theory, Research, and Practice. San Francisco: John
Wiley & Sons; 2008.
17. Tahmasebi R, Noroozi A, Dashdebi KG. Psychometric evaluation
of the colorectal cancer screening belief scale based on health
belief model’s constructs for the fecal occult blood test. Asian Pac
J Cancer Prev 2016;17:225‑9.
18. Gholampour Y, Jaderipour A, Khani Jeihooni A, Kashfi SM,
Afzali Harsini P. The effect of educational intervention based on
health belief model and social support on the rate of participation
of individuals in performing fecal occult blood test for colorectal
cancer screening. Asian Pac J Cancer Prev 2018;19:2777‑87.
19. Alavi Langroodi S, Fallahzadeh H, Mostafavi F. The effect of
education based on health belief model on knowledge and attitude
of health care workers towards colon cancer screening in Yazd.
Iran J Health Syst Res 2019;15:177‑83.
20. Moattar M, Roozitalab M, Gholamzadeh S, Firoozi M, Zare N.
Practical application of health belief model to enhance the uptake
of colorectal cancer screening. J Community Med Health Educ
2014;4:297.
21. Cameron KA, Persell SD, Brown T, Thompson J, Baker DW.
Patient outreach to promote colorectal cancer screening among
patients with an expired order for colonoscopy: A randomized
controlled trial. Arch Intern Med 2011;171:642‑6.
22. Khani Jeihooni A, Kashfi SM, Shokri A, Kashfi SH, Karimi S.
Investigating factors associated with FOBT screening for
colorectal cancer based on the components of health belief model
and social support. Asian Pac J Cancer Prev 2017;18:2163‑9.
23. Rakhshanderou S, Maghsoudloo M, Safari‑Moradabadi A,
Ghaffari M. Theoretically designed interventions for colorectal
cancer prevention: A case of the health belief model. BMC Med
Educ 2020;20:270.
24. Saffari M, Shojaeizadeh D, Ghofranipour F, Heydarnia A,
Pakpour A. Health Education & Promotion‑Theories, Models &
Methods. Tehran: Sobhan Pub; 2009. p. 21‑12.
25. Champion VL, Skinner CS. The health belief model. In: Health
Behavior and Health Education: Theory, Research, and Practice.
Vol. 4. Jossey-Bass, San Francisco; 2008. p. 45‑65.
26. Bae N, Park S, Lim S. Factors associated with adherence to fecal
occult blood testing for colorectal cancer screening among adults
in the Republic of Korea. Eur J Oncol Nurs 2014;18:72‑7.
27. Hughes AG, Watanabe‑Galloway S, Schnell P, Soliman AS.
Rural‑urban differences in colorectal cancer screening barriers
in Nebraska. J Community Health 2015;40:1065‑74.
28. Al‑Dahshan A, Abushaikha S, Chehab M, Bala M, Kehyayan V,
Omer M, et al. Perceived barriers to colorectal cancer screening
among eligible adults in Qatar and the associated factors:
A cross‑ sectional study. Asian Pac J Cancer Prev 2021;22:45‑51.
)