VALIDATION OF THE IPQ-R ADAPTED FOR COLORECTAL CANCER RISK

描述（由申请人提供）：结直肠癌（CRC）是美国第三大常见的癌症和癌症死亡原因。尽管有基于证据的结直肠癌筛查和预防方法，但筛查依从率仍不理想。大多数旨在增加CRC筛查（CRCS）的行为干预措施的成功有限。基于理论模型的干预措施，如Leventhal的自我调节模型（或疾病表征的常识模型），结合了认知和情感对行为的影响，可能更有效地促进癌症筛查行为。理解疾病表征（即原因、控制、时间线、后果、身份、一致性、情感）特别有价值，因为它确定了干预目标，以重组与疾病相关的信念，从而导致更有利的健康行为和疾病结果。它还可以提高对特定信息的接受程度，从而提高基于卫生传播的干预措施的有效性。正如我们在当前研究中提出的那样，很少有研究检查健康个体中疾病威胁或健康风险的疾病表征。此外，在少数检查疾病风险表征的研究中，使用了不同的测量方法，并不是每项研究都评估了所有领域，这突出表明需要对健康人的疾病风险表征进行标准、有效的测量。修订后的疾病认知问卷（IPQ-R）已适用于许多疾病和病症，并适用于诊断和健康的个体，但不适用于结直肠癌或结直肠癌风险。对IPQ-R的批评表明，简单的适应将产生不精确的测量，无法捕捉到特定疾病的信念；因此，我们扩展了IPQ-R，根据我们的形成性工作和文献综述，增加了额外的项目和子量表。该研究的目的是产生一种新的有效的工具来测量CRC风险的疾病表征。我们将通过一项大型横断面调查来实现这一目标，以解决以下具体目标：目标1)确定适用于结直肠癌风险的新IPQ-R的因子结构（域数）；目的2)确定适用于结直肠癌风险的新IPQ-R在由性别、种族、糖尿病状态和结直肠癌状态定义的特定亚组中的测量等效性；目的3)检验适用于结直肠癌风险的新IPQ-R的结构有效性和其他相关因素。新仪器将为研究人员确定新的途径，以改善干预研究，增加CRC和其他癌症预防行为，从而降低CRC发病率和死亡率提供重要资源。

DESCRIPTION (provided by applicant): Colorectal cancer (CRC) is the third most common cause of cancer and cancer death in the USA. Despite the availability of evidence-based screening and prevention methods for CRC, rates of screening adherence have been suboptimal. Most behavioral interventions designed to increase CRC screening (CRCS) have had limited success. Interventions based on a theoretical model such as Leventhal's Self-Regulation Model (or Common-Sense Model of Illness Representations) that incorporates both the cognitive and emotional influences on behavior may be more effective for promoting cancer screening behaviors. Understanding illness representations (i.e., cause, control, timeline, consequences, identity, coherence, emotional) is particularly valuable because it identifies targets for interventions to restructure disease-related beliefs, which then would lead to more favorable health behaviors and disease outcomes. It also may increase receptivity to specific messages, thereby improving the effectiveness of health communication-based interventions. Few studies have examined illness representations for disease threats or health risks among healthy individuals, as we propose in the current study. Additionally, among the few studies that have examined illness risk representations, different measures are used and not all domains are assessed in every study, which highlights the need for standard, validated measures of illness risk representations among healthy persons. The Revised Illness Perceptions Questionnaire (IPQ-R) has been adapted for numerous diseases and conditions and used with diagnosed and healthy individuals, but not CRC or CRC risk. Critiques of the IPQ-R suggest that simple adaptations will produce imprecise measures and fail to capture disease-specific beliefs; therefore, we extended the IPQ-R to include additional items and subscales based on our formative work and reviews of the literature. The objective of the study is to produce a novel validated instrument to measure illness representations of CRC risk. We will accomplish this with a large cross-sectional survey to address the following specific aims: Aim 1) Determine the factor structure (number of domains) of the new IPQ-R adapted for CRC risk; Aim 2) Determine the measurement equivalence of the new IPQ-R adapted for CRC risk across specific subgroups defined by gender, race, diabetes status, and CRCS status; and Aim 3) Examine the construct validity and additional correlates of the new IPQ-R adapted for CRC risk. The new instrument will be an important resource for researchers for identifying new avenues for improving intervention research to increase CRCS and other cancer prevention behaviors which would then reduce CRC morbidity and mortality.