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Table 3 Facilitators for Colorectal Cancer Screeninga

From: Reasons for never and intermittent completion of colorectal cancer screening after receiving multiple rounds of mailed fecal tests

 

Never screeners (N = 13)

Stopped - screened once before year 3 (N = 5)

Converted - screened once after year 3 (N = 5)

Repeated - screened once before year 3 and at least once After (N = 18)

Test Specific Facilitators

“[FOBT] was a little hard. Because you had to watch your diet and you had to do everything. This one sounds – I haven’t done it yet, but [FIT] sounds so much better.”

“I don’t know how long they’ve been doing this, but if they had some kind of brief update as far as how effective the test was. So, for example, if they did screening and X percentage of the screened samples were positive and then out of those that were positive, they do follow up and X percentage of those were found to be accurate or something like that. Demonstrate the effectiveness of the screening.”

“They gave me a new type of product for [the] test, which you don’t have to have a specific diet to do anymore, so ...not as complicated as having to wait three days without eating certain products…It was easy, it really wasn’t handling anything, you just collected it in a swab and stuck it in a tube rather than having to spread it on a card...”

“Well, first of all, it’s kind of a personal body function sort of thing so the sooner I could do the test and get over with it and hear the results, I would be happier….So if I could do one thing and be tested, that would be great. That would be my opinion. The quicker and the more complete the test could be, that would be great.”

“That [one-sample test] makes it much more appealing.”

“That one was easy because you didn’t have to watch what you ate or nothing like that, you just did the sample and then sent it in which was really easy compared to when my husband did one years ago, where he couldn’t eat certain kind of food for so many days and then do it.”

“Well, what really kind of helped turn things around, I was really impressed – but an easier test…the package came with a system that was much more doable and much clearer in the instructions. None of this, three blank pieces of cardboard that you have to swipe and that crap…the testing procedure itself was greatly improved.”

“And then the last time when I went in for an exam, they said here’s one, take it, it’s new, it’s easier to do, the latest test for the bowel. It was a lot easier. It’ll be quicker and you can either bring it in or mail it in…It didn’t have as many steps, and the restrictions from what you could eat and not eat - because I would just forget, and think I’m going to do it today and then oh, I can’t because I ate red meat. So the dietary wasn’t as restrictive as it has been in the past several years. So I just decided I’m going to get it done.”

Social influence

Family

“I think I would be more motivated if I had some kind of family history. I don’t have any family history of colorectal cancer.”

 

“Well, that [family and friends] always has influence, but you know, I’m not married, I’m a single man. So it’s not as if I had a wife here to badger me. I don’t.”

“The reason it helps me is that my sister had breast cancer. So I just focus on that. They caught hers early enough that she’s a survivor, so I tend not to take tests and stuff for granted.”

“It’s just what really pushed me over to finally complying, at least this year, was internal pressure, my own pressure on myself and family pressure.”

Social influence: Doctor

“If the doctor recommended [screening], based on his or her experience. Or if they said maybe based on research that a certain type [of test] is more effective.”

“But if I ran into health issues, let’s say I had blood in my stool or something or I had real irritable bowel, I would definitely talk to my doctor’s office.”

“I think the doctor badgering me is about the best thing. I think Dr. O’s a really good doctor and I think he’s really got my interest at heart. I think you can’t hardly beat that.”

“…that’s also showing that the doctor cares for you, it’s not only because your arm hurts or something, why you’re going to the doctor, it is beyond that, and looking out for you… It’s preventive.”

Prevention

“Well, I know if it’s detected early enough, it’s – what’s the word I want to use? Curable.”

“I think again anything that’s an early indicator to let you know if something’s going wrong, and it’s not that hard to do.”

“Especially with a little bit of a family history, but I think I come down slightly on the side of it’s better to know and deal with it just from having people who died of cancer and various things. Yeah, I think I would want to know. That for me personally isn’t a real barrier, it’s more just details of the test itself.”

“I: So it helps that the doctor’s reminding you or mails [the test kit] to you? That’s a good thing that Group Health is doing?

“P: I think it is. It’s part of what we pay for. Group Health is into some degree of preventive medicine and I think there’s nothing wrong with preventive medicine, we need more of it.”

“Oh, I do what I need to do to keep healthy, so yeah, if I can stay ahead of anything that shows up, I always feel we’re ahead of the game. And I need to be able to work until I retire, so I have to stay healthy.”

“But it helped me say this is preventive, not preventive of colon cancer but early recognition of what could happen on that… just an urging to get something done in time rather than wishing later on that… you had done it earlier…”

“It’s very dangerous, it’s deadly, and I wouldn’t want to be one of the statistics.”

“Things that could go wrong…these kinds of things can happen and creep up on you without you knowing.”

  1. aWithin the context of receiving a pamphlet about colorectal cancer screening choices and at least two mailed fecal tests