Abstract B15: Feasibility and acceptability of promoting colorectal cancer screening in an Internet weight loss community through narratives and navigational guidance
Authors: Hwang Kevin O. , Trickey Amber W. , Graham Amanda L. , Thomas Eric J. , Street Richard L. , Vernon Sally W. 
Published: January 2011

Abstract
Because obesity increases the risk for colorectal cancer (CRC), efficient and sustainable interventions are needed to promote colorectal cancer screening (CRCS) among obese individuals. A novel approach would be to empower members of Internet weight loss communities to promote CRCS screening among other members by sharing personal narratives about CRCS experiences or providing navigational guidance through the healthcare system to undergo CRCS. However, feasibility and acceptability of this strategy have not been evaluated. Therefore, we conducted an online survey of members of an Internet weight loss community who were eligible for CRCS to assess: CRCS status (colonoscopy within 10 years, sigmoidoscopy within 5 years, or fecal occult blood test within 1 year was considered up-to-date with CRCS); predictors of CRCS; stage of change for CRCS; attitudes towards CRCS (4-point Likert-type items — strongly agree, agree, disagree, strongly disagree); and interest in an intervention featuring narratives or navigation. The 2508 respondents were primarily female (92%) and white (90%). Sixty-eight percent were up-to-date with CRCS, mostly by colonoscopy. Being up-to-date with CRCS was associated with male gender, older age, lower body mass index, being married, Bachelor's degree education, healthcare provider's CRCS recommendation, other cancer screening in the past year, primary care visit in the past year, health insurance, and non-smoking. Among those not up-to-date with CRCS, taking steps to be screened for CRC (compared to earlier stages) was associated with a one point increase in scores for social influence of others (OR = 7.5, 95% CI: 4.5-12.6), perceived salience of CRCS (OR = 5.1, 95% CI: 3.1-8.5), self-efficacy for navigating the healthcare system (OR = 3.8, 95% CI: 2.3-6.2), self-efficacy for CRCS (OR = 2.0, 95% CI: 1.4-2.9), and perceived susceptibility to CRC (OR = 1.9, 95% CI: 1.2-3.1). Considering CRCS within 6 months or taking steps to be screened (compared to earlier stages) was associated with a one point increase in scores for social influence of others (OR = 12.2, 95% CI: 7.8-19.1), perceived salience of CRCS (OR = 5.8, 95% CI: 4.1-8.3), self-efficacy for navigating the healthcare system (OR = 3.7, 95% CI: 2.6-5.3), perceived susceptibility to CRC (OR = 2.5, 95% CI: 1.7-3.5), perceived efficacy of CRCS (OR = 2.2, 95% CI: 1.6-3.0), self-efficacy for CRCS (OR = 1.5, 95% CI: 1.2-2.0), and CRC worries (OR = 1.3, 95% CI: 1.1-1.6). Among those not up-to-date, 63% were interested in learning about other members’ CRCS narratives and 36% were interested in receiving navigational guidance for undergoing CRCS. Among those who were up-to-date, 39% were interested in promoting CRCS by sharing narratives and 37% by providing navigational guidance. In conclusion, leveraging social relationships within Internet weight loss communities may be a feasible and acceptable strategy for promoting CRCS among obese individuals. Results inform how we could tailor the intervention according to demographic characteristics and healthcare experiences; target specific attitudes; and utilize narratives and navigational guidance.
Citation Information: Cancer Prev Res 2010;3(12 Suppl):B15.