Using the Multi-Theory Model (MTM) of Health Behavior Change to Explain the Seeking of Stool-Based Tests for...

Area of Science:

• Health Behavior Change
• Cancer Screening
• Public Health Interventions

Background:

• Colorectal cancer (CRC) is a leading cause of cancer deaths globally, despite declining rates in the US.
• Non-invasive stool-based tests are effective for CRC detection, yet current interventions often lack theoretical grounding.
• Disparities in CRC screening persist, highlighting the need for theory-informed approaches.

Purpose of the Study:

• To apply the Multi-Theory Model (MTM) of health behavior change to understand the seeking of stool-based tests for CRC screening.
• To identify key MTM constructs that predict the initiation of CRC screening behaviors in adults aged 45-75.
• To provide a theoretical framework for developing effective interventions to promote CRC screening.

Main Methods:

• A cross-sectional study utilizing an online 57-item questionnaire with established psychometric validity.
• Data collected from a nationwide US sample of 640 adults aged 45-75 years.
• Bivariate, multivariate statistical analyses, and structural equation modeling (SEM) were employed.

Main Results:

• 39.2% of participants reported undergoing stool-based CRC screening.
• For those not screened, MTM subscales (participatory dialogue, behavioral confidence, social environment changes) significantly predicted screening initiation.
• These MTM constructs explained 48% of the variance in screening initiation (adjusted R² = 0.481).

Conclusions:

• The Multi-Theory Model (MTM) offers a robust framework for understanding and promoting stool-based CRC screening.
• Educational, mass media, social media, and clinical interventions can be effectively designed using MTM principles.
• Targeting MTM constructs can help reduce disparities and increase uptake of CRC screening among adults aged 45-75.