Intervention Mediators in a Randomized Controlled Trial to Increase Colonoscopy Uptake Among Individuals at Increased Risk of Familial Colorectal Cancer
Intervention Mediators in a Randomized Controlled Trial to Increase Colonoscopy Uptake Among Individuals at Increased Risk of Familial Colorectal Cancer
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DOI：
10.1007/s12160-017-9893-1
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发表时间：
2017-10-01
影响因子：
3.8
通讯作者：
Kinney, Anita Y.
中科院分区：
文献类型：
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作者：
Brumbach, Barbara H.;Birmingham, Wendy C.;Kinney, Anita Y.
了解干预措施实现行为改变的途径对于优化干预策略非常重要。目的：我们研究了一种定制风险沟通干预中行为改变的中介因素，这种干预增加了基于指南的结直肠癌筛查，增加了家族风险。方法：家族性结直肠癌风险增加的参与者（N = 481）被随机分为两组：(1)远程，量身定制的风险沟通干预（远程癌症风险评估和评估（TeleCARE））或(2)邮寄教育手册干预。结果结构方程模型显示，TeleCARE的参与者更有可能接受结肠镜检查。知觉威胁（beta = 0.12, p < 0.05）、效能信念（beta = 0.12, p < 0.05）、情绪（beta = 0.22, p < 0.001）和行为意图（beta = 0.24, p < 0.001）对影响有部分介导作用。模型拟合非常好，比较拟合指数= 0.95，近似均方根误差= 0.05，标准化均方根残差= 0.08。评估干预（TeleCARE）和主要结果（结肠镜检查）之间的中介变量有助于我们了解导致健康行为改变的潜在机制，从而导致更好地了解和设计未来的干预措施。
Background Understanding the pathways by which interventions achieve behavioral change is important for optimizing intervention strategies.Purpose We examined mediators of behavior change in a tailored-risk communication intervention that increased guideline-based colorectal cancer screening among individuals at increased familial risk.Methods Participants at increased familial risk for colorectal cancer (N = 481) were randomized to one of two arms: (1) a remote, tailored-risk communication intervention (Tele-Cancer Risk Assessment and Evaluation (TeleCARE)) or (2) a mailed educational brochure intervention.Results Structural equation modeling showed that participants in TeleCARE were more likely to get a colonoscopy. The effect was partially mediated through perceived threat (beta = 0.12, p < 0.05), efficacy beliefs (beta = 0.12, p < 0.05), emotions (beta = 0.22, p < 0.001), and behavioral intentions (beta = 0.24, p < 0.001). Model fit was very good: comparative fit index = 0.95, root-mean-square error of approximation = 0.05, and standardized root-mean-square residual = 0.08.Conclusion Evaluating mediating variables between an intervention (TeleCARE) and a primary outcome (colonoscopy) contributes to our understanding of underlying mechanisms that lead to health behavior change, thus leading to better informed and designed future interventions.