VALIDATION OF THE IPQ-R ADAPTED FOR COLORECTAL CANCER RISK

描述(申请人提供)：结直肠癌(CRC)是美国癌症和癌症死亡的第三大常见原因。尽管有基于证据的结直肠癌筛查和预防方法可用，筛查依从率一直处于次优水平。大多数旨在增加结直肠癌筛查(CRC)的行为干预措施收效甚微。基于理论模型的干预可能更有效地促进癌症筛查行为，例如莱文塔尔的自我调节模型(或疾病陈述常识模型)，该模型包含了认知和情感对行为的影响。了解疾病陈述(即原因、控制、时间线、结果、身份、一致性、情感)特别有价值，因为它确定了重建疾病相关信念的干预目标，这将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度，从而提高以健康传播为基础的干预措施的有效性。很少有研究像我们在目前的研究中建议的那样，检查健康个体中疾病威胁或健康风险的疾病表现。此外，在少数检查疾病风险表示的研究中，使用了不同的测量方法，并不是在每项研究中都对所有领域进行了评估，这突显了在健康人中对疾病风险表示进行标准的、有效的测量的必要性。修订后的疾病认知问卷(IPQ-R)适用于多种疾病和状况，并适用于确诊和健康的个人，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衡量标准，并且无法涵盖疾病特有的信念；因此，我们根据我们的形成工作和对文献的审查，将IPQ-R扩展到包括额外的条目和子量表。这项研究的目的是制造一种新的有效工具来衡量结直肠癌风险的疾病表现。我们将通过大规模的横断面调查来实现以下具体目标：目的1)确定适应于结直肠癌风险的新IPQ-R的因素结构(域的数量)；目的2)确定适应于CRC风险的新IPQ-R在由性别、种族、糖尿病状况和CRCs状态定义的特定亚组中的测量等价性；以及目的3)检查适应于CRC风险的新IPQ-R的结构有效性和其他相关因素。这项新仪器将成为研究人员寻找新途径改进干预研究的重要资源，以增加CRC和其他癌症预防行为，从而降低CRC发病率和死亡率。

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.