Predicting the Determinants of Colorectal Cancer Screening Behaviors Using Protection Motivation Theory: A...

Area of Science:

• Public Health
• Health Behavior Research
• Cancer Prevention

Background:

• Colorectal cancer (CRC) screening significantly reduces mortality but faces low global participation.
• Understanding the determinants of CRC screening behavior is crucial for improving public health outcomes.

Purpose of the Study:

• To apply Protection Motivation Theory (PMT) to identify factors influencing CRC screening behavior in Iran.
• To analyze the cognitive determinants of CRC screening intention and behavior using PLS-SEM.

Main Methods:

• A cross-sectional study involving 433 adults over 50 in Neyshabur, Iran.
• Validated PMT questionnaire assessing perceived sensitivity, severity, self-efficacy, response efficacy, response costs, fear, and rewards.
• Partial Least Squares Structural Equation Modeling (PLS-SEM) to analyze relationships between PMT constructs and self-reported screening behavior.

Main Results:

• Perceived severity (β=0.118) and response efficacy (β=0.172) positively predicted behavioral intention.
• Perceived rewards negatively impacted intention (β=-0.197), while fear mediated sensitivity/severity effects (β=0.155).
• Self-efficacy and response costs did not significantly relate to intention; actual screening behavior was notably low (26.1/100).

Conclusions:

• A significant intention-behavior gap for CRC screening was observed, with moderate intention (54.8/100) but low behavior.
• PMT constructs explained screening intention but not behavior, suggesting the influence of unmeasured contextual barriers.
• Interventions should combine PMT-based education with system-level strategies to address barriers and improve CRC screening rates.