Understanding intention to undergo colonoscopy among intermediate-risk siblings of colorectal cancer patients: A test of a mediational model Journal Article


Authors: Manne, S.; Markowitz, A.; Winawer, S.; Guillem, J.; Meropol, N. J.; Haller, D.; Jandorf, L.; Rakowski, W.; Babb, J.; Duncan, T.
Article Title: Understanding intention to undergo colonoscopy among intermediate-risk siblings of colorectal cancer patients: A test of a mediational model
Abstract: Background. There is a need for research to identify factors influencing intentions to undergo colorectal cancer (CRC) screening among family members at risk for CRC. This study tested a mediational model primarily guided by Ronis' elaboration of the Health Belief Model in predicting intention to have colorectal cancer screening among siblings of individuals diagnosed with colorectal cancer prior to age 56 years. Methods. Data were collected from 534 siblings of individuals diagnosed with CRC. A baseline survey was administered by telephone. Measures included perceived susceptibility, CRC severity, physician and family support for CRC screening, cancer-specific distress, the closeness of the relationship with the affected sibling, and future intention to have a colonoscopy. Participant age, gender, and number of prior colonoscopies, as well as the stage of the affected patient's cancer and time from the patient's diagnosis to the interview, were controlled for in the analyses. Results. The proposed model was not a good fit to the data. A respecified model was fit to the data. In this model, physician support, family support, and sibling closeness were significantly associated with both perceived benefits and barriers. Perceived severity was associated with barriers. Benefits and barriers, as well as cancer-specific distress, were directly associated with colonoscopy intentions. Results were consistent with a mediational role for benefits and barriers in the associations of sibling closeness and with a mediational role for barriers in the association between perceived severity and colonoscopy intentions. Family and physician support impacted intentions both directly and indirectly through effects on benefits and barriers. Perceived risk was not associated with benefits, barriers, or colonoscopy intentions. Conclusion. Intervention efforts to increase colonoscopy intentions may benefit from targeting family in-fluences, particularly the affected proband in the family, as well as physician influence, cancer-related distress, perceived CRC severity, and perceived benefits and barriers to colonoscopy. © 2002 American Health Foundation and Elsevier Science (USA).
Keywords: adult; controlled study; aged; middle aged; major clinical study; cancer risk; cancer patient; cancer diagnosis; colorectal cancer; cancer susceptibility; demography; cancer prevention; risk factors; health behavior; patient education; cancer screening; health survey; prediction; siblings; models, theoretical; colorectal neoplasms; disease severity; colonoscopy; physician-patient relations; distress syndrome; physician; interview; sibling; model; telephone; sibling relations; family; perception; colorectal cancer screening; humans; human; male; female; priority journal; article; intermediate risk persons; screening intentions
Journal Title: Preventive Medicine
Volume: 36
Issue: 1
ISSN: 0091-7435
Publisher: Elsevier Inc.  
Date Published: 2003-01-01
Start Page: 71
End Page: 84
Language: English
DOI: 10.1006/pmed.2002.1122
PUBMED: 12473427
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 12 September 2014 -- Source: Scopus
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  1. Arnold J Markowitz
    138 Markowitz
  2. Jose Guillem
    414 Guillem
  3. Sidney J Winawer
    274 Winawer