Predictors of colonoscopy intentions: mean scores, proportions, and unadjusted and adjusted odds ratios—results from the univariate and multivariate binary logistic regression analysis (n = 864).
| Mean item scores for respondents answering Yes probably, Not sure, No probably not, and No definitely not (range 1-5; 1 = Strongly disagree, 5 = Strongly agree) . | Mean item scores for respondents answering Yes definitely (range 1-5; 1 = Strongly disagree, 5 = Strongly agree) . | OR (95% CI) . | aOR (95% CI) . | |
|---|---|---|---|---|
| Psychological variables (R2 = 0.44) | ||||
| 1.1. Knowledge (knowledge of condition/scientific rationale) | ||||
| 3.2.1. Lack of understanding that bowel cancer can be asymptomatic and the test is looking for invisible traces of blood (Bowel cancer screening is only useful for people with symptoms) | 1.91 | 1.33 | 0.39 (0.30-0.50)*** | 0.68 (0.47-0.97)* |
| 3.5.4.2. Belief that cancer is a treatable disease (Bowel cancer is not a treatable disease) | 2.02 | 1.61 | 0.51 (0.39-0.65)*** | 0.91 (0.58-1.43) |
| 1.2. Knowledge (procedural knowledge) | ||||
| 1.3.1. Hearing other people’s experiences with colonoscopy (Other people’s experiences with colonoscopy have put me off going for colonoscopy myself) | 2.61 | 1.81 | 0.46 (0.38-0.56)*** | 1.00 (0.73-1.37) |
| 3.2.2. Lack of awareness and understanding of colonoscopy procedure (I have a good understanding of what having a colonoscopy would involve) | 2.44 | 2.15 | 0.75 (0.62-0.91)** | 0.97 (0.73-1.37) |
| 2.3. Beliefs about capabilities (self-efficacy) | ||||
| 4.2.2. Existing health conditions interfering with the ability to complete procedure or bowel prep (I have existing health conditions that would prevent me from being able to have a colonoscopy) | 1.54 | 1.27 | 0.48 (0.36-0.65)*** | 1.52 (0.92-2.51) |
| 3.1. Beliefs about consequences (beliefs) | ||||
| 1.2.4. Fatalistic beliefs (Being diagnosed with bowel cancer is a death sentence) | 2.46 | 2.06 | 0.59 (0.47-0.74)*** | 1.22 (0.83-1.79) |
| 1.2.7. Lack of trust in Western Medicine (Western medicine is not effective at treating bowel cancer) | 2.21 | 1.61 | 0.45 (0.35-0.56)*** | 0.77 (0.53-1.10) |
| 3.5.6. Perceived importance of screening (It is important to take part in bowel cancer screening) | 1.87 | 1.16 | 0.20 (0.15-0.29)*** | 0.35 (0.24-0.50)*** |
| 3.9.6. The role of God in determining the future (It is God’s decision who lives and dies, medicine cannot change that) | 1.64 | 1.28 | 0.59 (0.47-0.73)*** | 1.02 (0.71-1.47) |
| 5.2. Environmental context and resources (resources/material resources) | ||||
| 2.1.1. Language barriers (I would need an interpreter to translate during the nurse appointment) | 1.23 | 1.10 | 0.53 (0.35-0.79)** | 1.57 (0.73-3.40) |
| 5.6. Environmental context and resources (barriers and facilitators) | ||||
| 2.2.1. Transport/travel (I would find it difficult to travel to the appointment with the nurse) | 2.36 | 1.54 | 0.41 (0.33-0.50)*** | 0.57 (0.41-0.79)*** |
| 2.2.4. Lack of car parking (If I drove to the appointment, it would be difficult to find a car parking space at my local hospital) | 3.65 | 3.26 | 0.75 (0.63-0.90)** | 0.96 (0.76-1.22) |
| 2.2.5. Indirect costs (Going to the appointment (eg, parking, public transport, time off work, etc.) would cost me a lot of money) | 2.51 | 2.03 | 0.65 (0.54-0.78)*** | 0.99 (0.75-1.30) |
| 7.2. Social influences (social norms) | ||||
| 1.2.2. Colonoscopy, colon and rectum “culturally taboo” topics (I would not be able to discuss this appointment with my friends and family, as this type of thing is very sensitive) | 2.47 | 1.83 | 0.55 (0.46-0.66)*** | 1.02 (0.77-1.35) |
| 1.2.5. Unable to accept blood products (I would be worried that a blood transfusion might be needed if I had a colonoscopy, and I am unwilling to have these on religious grounds) | 1.38 | 1.14 | 0.43 (0.30-0.61)*** | 0.98 (0.58-1.65) |
| 7.5. Social influences (group norms) | ||||
| 1.2.3. Gender and engagement with healthcare (It is fine for women to have colonoscopy, but not men) | 1.46 | 1.22 | 0.30 (0.21-0.43)*** | 0.81 (0.45-1.44) |
| 7.6. Social influences (social support) 0.70 | ||||
| 1.4.1. Reliance on family and friends as unofficial interpreters (I would need to take a friend or family member with me to translate what the nurse was saying) | 1.44 | 1.13 | 0.59 (0.46-0.77)*** | 0.76 (0.49-1.18) |
| 1.4.2. Reliance on family for travel and transport (I would need a friend or family member to take me to the nurse appointment) | 2.33 | 1.94 | 0.76 (0.65-0.89)*** | 1.12 (0.81-1.56) |
| 1.4.3. Reliance on family for emotional support (I would need to take a friend or family member with me to the nurse appointment for emotional support) | 2.67 | 2.35 | 0.82 (0.70-0.95)** | 1.07 (0.80-1.43) |
| 3.9.4. Shared decision-making and family-influenced participation (I would only go to the nurse appointment if a friend or family member agreed it was in my best interest to attend) | 2.04 | 1.40 | 0.44 (0.36-0.55)*** | 0.68 (0.47-0.99)* |
| 7.7. Social influences (power) | ||||
| 3.9.3. Reliance on medical professional/authority (I would only go to the nurse appointment if my general practitioner told me I should go) | 2.19 | 1.44 | 0.39 (0.32-0.49)*** | 0.76 (0.54-1.06) |
| 8.1. Emotion (fear) 0.81 | ||||
| 3.1.2. Fear of pain and discomfort (I would be worried that the colonoscopy would be painful or uncomfortable) | 4.14 | 3.51 | 0.45 (0.34-0.59)*** | 0.63 (0.40-0.98)* |
| 3.5.4.1. Fear of cancer (I would be scared that the colonoscopy would find cancer) | 3.86 | 2.93 | 0.79 (0.63-1.00)* | 1.14 (0.80-1.64) |
| 8.2. Emotion (anxiety) | ||||
| 3.1.1. Concerns about doing the bowel preparation (I would be worried about doing the bowel preparation/drinking powerful laxatives before the colonoscopy) | 3.91 | 3.72 | 0.55 (0.46-0.66)*** | 0.81 (0.61-1.06) |
| 3.1.3. Concerns about test invasiveness (I am worried about the invasive nature of colonoscopy) | 3.66 | 2.80 | 0.48 (0.39-0.59)*** | 0.79 (0.56-1.13) |
| 3.1.4. Shame and embarrassment (Going for colonoscopy would be shameful and/or embarrassing) | 2.66 | 1.80 | 0.55 (0.47-0.65)*** | 0.81 (0.63-1.04) |
| 3.3.1. Anxiety (I would feel anxious about going to the nurse appointment) | 3.91 | 3.40 | 0.63 (0.51-0.78)*** | 1.08 (0.78-1.50) |
| 3.3.3. Avoidance (I would prefer not to know whether I had bowel cancer) | 2.00 | 1.31 | 0.41 (0.33-0.52)*** | 0.87 (0.61-1.23) |
| Demographic variables (R2 = 0.47) | ||||
| Age | ||||
| Years (continuous) | — | — | 0.99 (0.95-1.03) | — |
| Gender | ||||
| Male | 46 (12.1) | 334 (87.9) | 1.00 | — |
| Female | 67 (13.9) | 416 (86.1) | 0.86 (0.57-1.28) | — |
| Long-term conditions | ||||
| No | 71 (13.7) | 447 (86.3) | 1.00 | — |
| Yes | 42 (12.1) | 304 (87.9) | 1.15 (0.76-1.73) | — |
| Disability | ||||
| No | 101 (12.8) | 687 (87.2) | 1.00 | — |
| Yes | 12 (15.8) | 64 (84.2) | 0.78 (0.41-1.50) | — |
| Mental health | ||||
| No | 93 (12.1) | 678 (87.9) | 1.00 | 1.00 |
| Yes | 20 (21.5) | 73 (78.5) | 0.50 (0.29-0.86)* | 0.72 (0.32-1.61) |
| Main language | ||||
| English | 111 (13.0) | 746 (87.0) | 1.00 | — |
| Other | 2 (28.6) | 5 (71.4) | 0.37 (0.07-1.94) | — |
| Ethnicity | ||||
| White British/Irish | 105 (12.9) | 711 (87.1) | 1.00 | — |
| Any Other Ethnicity | 8 (16.7) | 40 (83.3) | 0.74 (0.34-1.62) | — |
| Education | ||||
| ≤O-level or GCSE Grades A–C (≤Grade 10) | 44 (24.6) | 135 (75.4) | 1.00 | 1.00 |
| ≥ONC/BTEC (≥Grade 11) | 69 (10.1) | 616 (89.9) | 2.91 (1.91-4.44)*** | 2.78 (1.57-4.94)*** |
| Mean item scores for respondents answering Yes probably, Not sure, No probably not, and No definitely not (range 1-5; 1 = Strongly disagree, 5 = Strongly agree) . | Mean item scores for respondents answering Yes definitely (range 1-5; 1 = Strongly disagree, 5 = Strongly agree) . | OR (95% CI) . | aOR (95% CI) . | |
|---|---|---|---|---|
| Psychological variables (R2 = 0.44) | ||||
| 1.1. Knowledge (knowledge of condition/scientific rationale) | ||||
| 3.2.1. Lack of understanding that bowel cancer can be asymptomatic and the test is looking for invisible traces of blood (Bowel cancer screening is only useful for people with symptoms) | 1.91 | 1.33 | 0.39 (0.30-0.50)*** | 0.68 (0.47-0.97)* |
| 3.5.4.2. Belief that cancer is a treatable disease (Bowel cancer is not a treatable disease) | 2.02 | 1.61 | 0.51 (0.39-0.65)*** | 0.91 (0.58-1.43) |
| 1.2. Knowledge (procedural knowledge) | ||||
| 1.3.1. Hearing other people’s experiences with colonoscopy (Other people’s experiences with colonoscopy have put me off going for colonoscopy myself) | 2.61 | 1.81 | 0.46 (0.38-0.56)*** | 1.00 (0.73-1.37) |
| 3.2.2. Lack of awareness and understanding of colonoscopy procedure (I have a good understanding of what having a colonoscopy would involve) | 2.44 | 2.15 | 0.75 (0.62-0.91)** | 0.97 (0.73-1.37) |
| 2.3. Beliefs about capabilities (self-efficacy) | ||||
| 4.2.2. Existing health conditions interfering with the ability to complete procedure or bowel prep (I have existing health conditions that would prevent me from being able to have a colonoscopy) | 1.54 | 1.27 | 0.48 (0.36-0.65)*** | 1.52 (0.92-2.51) |
| 3.1. Beliefs about consequences (beliefs) | ||||
| 1.2.4. Fatalistic beliefs (Being diagnosed with bowel cancer is a death sentence) | 2.46 | 2.06 | 0.59 (0.47-0.74)*** | 1.22 (0.83-1.79) |
| 1.2.7. Lack of trust in Western Medicine (Western medicine is not effective at treating bowel cancer) | 2.21 | 1.61 | 0.45 (0.35-0.56)*** | 0.77 (0.53-1.10) |
| 3.5.6. Perceived importance of screening (It is important to take part in bowel cancer screening) | 1.87 | 1.16 | 0.20 (0.15-0.29)*** | 0.35 (0.24-0.50)*** |
| 3.9.6. The role of God in determining the future (It is God’s decision who lives and dies, medicine cannot change that) | 1.64 | 1.28 | 0.59 (0.47-0.73)*** | 1.02 (0.71-1.47) |
| 5.2. Environmental context and resources (resources/material resources) | ||||
| 2.1.1. Language barriers (I would need an interpreter to translate during the nurse appointment) | 1.23 | 1.10 | 0.53 (0.35-0.79)** | 1.57 (0.73-3.40) |
| 5.6. Environmental context and resources (barriers and facilitators) | ||||
| 2.2.1. Transport/travel (I would find it difficult to travel to the appointment with the nurse) | 2.36 | 1.54 | 0.41 (0.33-0.50)*** | 0.57 (0.41-0.79)*** |
| 2.2.4. Lack of car parking (If I drove to the appointment, it would be difficult to find a car parking space at my local hospital) | 3.65 | 3.26 | 0.75 (0.63-0.90)** | 0.96 (0.76-1.22) |
| 2.2.5. Indirect costs (Going to the appointment (eg, parking, public transport, time off work, etc.) would cost me a lot of money) | 2.51 | 2.03 | 0.65 (0.54-0.78)*** | 0.99 (0.75-1.30) |
| 7.2. Social influences (social norms) | ||||
| 1.2.2. Colonoscopy, colon and rectum “culturally taboo” topics (I would not be able to discuss this appointment with my friends and family, as this type of thing is very sensitive) | 2.47 | 1.83 | 0.55 (0.46-0.66)*** | 1.02 (0.77-1.35) |
| 1.2.5. Unable to accept blood products (I would be worried that a blood transfusion might be needed if I had a colonoscopy, and I am unwilling to have these on religious grounds) | 1.38 | 1.14 | 0.43 (0.30-0.61)*** | 0.98 (0.58-1.65) |
| 7.5. Social influences (group norms) | ||||
| 1.2.3. Gender and engagement with healthcare (It is fine for women to have colonoscopy, but not men) | 1.46 | 1.22 | 0.30 (0.21-0.43)*** | 0.81 (0.45-1.44) |
| 7.6. Social influences (social support) 0.70 | ||||
| 1.4.1. Reliance on family and friends as unofficial interpreters (I would need to take a friend or family member with me to translate what the nurse was saying) | 1.44 | 1.13 | 0.59 (0.46-0.77)*** | 0.76 (0.49-1.18) |
| 1.4.2. Reliance on family for travel and transport (I would need a friend or family member to take me to the nurse appointment) | 2.33 | 1.94 | 0.76 (0.65-0.89)*** | 1.12 (0.81-1.56) |
| 1.4.3. Reliance on family for emotional support (I would need to take a friend or family member with me to the nurse appointment for emotional support) | 2.67 | 2.35 | 0.82 (0.70-0.95)** | 1.07 (0.80-1.43) |
| 3.9.4. Shared decision-making and family-influenced participation (I would only go to the nurse appointment if a friend or family member agreed it was in my best interest to attend) | 2.04 | 1.40 | 0.44 (0.36-0.55)*** | 0.68 (0.47-0.99)* |
| 7.7. Social influences (power) | ||||
| 3.9.3. Reliance on medical professional/authority (I would only go to the nurse appointment if my general practitioner told me I should go) | 2.19 | 1.44 | 0.39 (0.32-0.49)*** | 0.76 (0.54-1.06) |
| 8.1. Emotion (fear) 0.81 | ||||
| 3.1.2. Fear of pain and discomfort (I would be worried that the colonoscopy would be painful or uncomfortable) | 4.14 | 3.51 | 0.45 (0.34-0.59)*** | 0.63 (0.40-0.98)* |
| 3.5.4.1. Fear of cancer (I would be scared that the colonoscopy would find cancer) | 3.86 | 2.93 | 0.79 (0.63-1.00)* | 1.14 (0.80-1.64) |
| 8.2. Emotion (anxiety) | ||||
| 3.1.1. Concerns about doing the bowel preparation (I would be worried about doing the bowel preparation/drinking powerful laxatives before the colonoscopy) | 3.91 | 3.72 | 0.55 (0.46-0.66)*** | 0.81 (0.61-1.06) |
| 3.1.3. Concerns about test invasiveness (I am worried about the invasive nature of colonoscopy) | 3.66 | 2.80 | 0.48 (0.39-0.59)*** | 0.79 (0.56-1.13) |
| 3.1.4. Shame and embarrassment (Going for colonoscopy would be shameful and/or embarrassing) | 2.66 | 1.80 | 0.55 (0.47-0.65)*** | 0.81 (0.63-1.04) |
| 3.3.1. Anxiety (I would feel anxious about going to the nurse appointment) | 3.91 | 3.40 | 0.63 (0.51-0.78)*** | 1.08 (0.78-1.50) |
| 3.3.3. Avoidance (I would prefer not to know whether I had bowel cancer) | 2.00 | 1.31 | 0.41 (0.33-0.52)*** | 0.87 (0.61-1.23) |
| Demographic variables (R2 = 0.47) | ||||
| Age | ||||
| Years (continuous) | — | — | 0.99 (0.95-1.03) | — |
| Gender | ||||
| Male | 46 (12.1) | 334 (87.9) | 1.00 | — |
| Female | 67 (13.9) | 416 (86.1) | 0.86 (0.57-1.28) | — |
| Long-term conditions | ||||
| No | 71 (13.7) | 447 (86.3) | 1.00 | — |
| Yes | 42 (12.1) | 304 (87.9) | 1.15 (0.76-1.73) | — |
| Disability | ||||
| No | 101 (12.8) | 687 (87.2) | 1.00 | — |
| Yes | 12 (15.8) | 64 (84.2) | 0.78 (0.41-1.50) | — |
| Mental health | ||||
| No | 93 (12.1) | 678 (87.9) | 1.00 | 1.00 |
| Yes | 20 (21.5) | 73 (78.5) | 0.50 (0.29-0.86)* | 0.72 (0.32-1.61) |
| Main language | ||||
| English | 111 (13.0) | 746 (87.0) | 1.00 | — |
| Other | 2 (28.6) | 5 (71.4) | 0.37 (0.07-1.94) | — |
| Ethnicity | ||||
| White British/Irish | 105 (12.9) | 711 (87.1) | 1.00 | — |
| Any Other Ethnicity | 8 (16.7) | 40 (83.3) | 0.74 (0.34-1.62) | — |
| Education | ||||
| ≤O-level or GCSE Grades A–C (≤Grade 10) | 44 (24.6) | 135 (75.4) | 1.00 | 1.00 |
| ≥ONC/BTEC (≥Grade 11) | 69 (10.1) | 616 (89.9) | 2.91 (1.91-4.44)*** | 2.78 (1.57-4.94)*** |
Abbreviations: aOR, adjusted odds ratio; BTEC, Business and Technology Education Council; ONC, Ordinary National Certificate; OR, odds ratio.
*p<0.05 **p<0.01***p<0.001.
Odds ratios and confidence intervals in bold indicates results are statistically significant.
Predictors of colonoscopy intentions: mean scores, proportions, and unadjusted and adjusted odds ratios—results from the univariate and multivariate binary logistic regression analysis (n = 864).
| Mean item scores for respondents answering Yes probably, Not sure, No probably not, and No definitely not (range 1-5; 1 = Strongly disagree, 5 = Strongly agree) . | Mean item scores for respondents answering Yes definitely (range 1-5; 1 = Strongly disagree, 5 = Strongly agree) . | OR (95% CI) . | aOR (95% CI) . | |
|---|---|---|---|---|
| Psychological variables (R2 = 0.44) | ||||
| 1.1. Knowledge (knowledge of condition/scientific rationale) | ||||
| 3.2.1. Lack of understanding that bowel cancer can be asymptomatic and the test is looking for invisible traces of blood (Bowel cancer screening is only useful for people with symptoms) | 1.91 | 1.33 | 0.39 (0.30-0.50)*** | 0.68 (0.47-0.97)* |
| 3.5.4.2. Belief that cancer is a treatable disease (Bowel cancer is not a treatable disease) | 2.02 | 1.61 | 0.51 (0.39-0.65)*** | 0.91 (0.58-1.43) |
| 1.2. Knowledge (procedural knowledge) | ||||
| 1.3.1. Hearing other people’s experiences with colonoscopy (Other people’s experiences with colonoscopy have put me off going for colonoscopy myself) | 2.61 | 1.81 | 0.46 (0.38-0.56)*** | 1.00 (0.73-1.37) |
| 3.2.2. Lack of awareness and understanding of colonoscopy procedure (I have a good understanding of what having a colonoscopy would involve) | 2.44 | 2.15 | 0.75 (0.62-0.91)** | 0.97 (0.73-1.37) |
| 2.3. Beliefs about capabilities (self-efficacy) | ||||
| 4.2.2. Existing health conditions interfering with the ability to complete procedure or bowel prep (I have existing health conditions that would prevent me from being able to have a colonoscopy) | 1.54 | 1.27 | 0.48 (0.36-0.65)*** | 1.52 (0.92-2.51) |
| 3.1. Beliefs about consequences (beliefs) | ||||
| 1.2.4. Fatalistic beliefs (Being diagnosed with bowel cancer is a death sentence) | 2.46 | 2.06 | 0.59 (0.47-0.74)*** | 1.22 (0.83-1.79) |
| 1.2.7. Lack of trust in Western Medicine (Western medicine is not effective at treating bowel cancer) | 2.21 | 1.61 | 0.45 (0.35-0.56)*** | 0.77 (0.53-1.10) |
| 3.5.6. Perceived importance of screening (It is important to take part in bowel cancer screening) | 1.87 | 1.16 | 0.20 (0.15-0.29)*** | 0.35 (0.24-0.50)*** |
| 3.9.6. The role of God in determining the future (It is God’s decision who lives and dies, medicine cannot change that) | 1.64 | 1.28 | 0.59 (0.47-0.73)*** | 1.02 (0.71-1.47) |
| 5.2. Environmental context and resources (resources/material resources) | ||||
| 2.1.1. Language barriers (I would need an interpreter to translate during the nurse appointment) | 1.23 | 1.10 | 0.53 (0.35-0.79)** | 1.57 (0.73-3.40) |
| 5.6. Environmental context and resources (barriers and facilitators) | ||||
| 2.2.1. Transport/travel (I would find it difficult to travel to the appointment with the nurse) | 2.36 | 1.54 | 0.41 (0.33-0.50)*** | 0.57 (0.41-0.79)*** |
| 2.2.4. Lack of car parking (If I drove to the appointment, it would be difficult to find a car parking space at my local hospital) | 3.65 | 3.26 | 0.75 (0.63-0.90)** | 0.96 (0.76-1.22) |
| 2.2.5. Indirect costs (Going to the appointment (eg, parking, public transport, time off work, etc.) would cost me a lot of money) | 2.51 | 2.03 | 0.65 (0.54-0.78)*** | 0.99 (0.75-1.30) |
| 7.2. Social influences (social norms) | ||||
| 1.2.2. Colonoscopy, colon and rectum “culturally taboo” topics (I would not be able to discuss this appointment with my friends and family, as this type of thing is very sensitive) | 2.47 | 1.83 | 0.55 (0.46-0.66)*** | 1.02 (0.77-1.35) |
| 1.2.5. Unable to accept blood products (I would be worried that a blood transfusion might be needed if I had a colonoscopy, and I am unwilling to have these on religious grounds) | 1.38 | 1.14 | 0.43 (0.30-0.61)*** | 0.98 (0.58-1.65) |
| 7.5. Social influences (group norms) | ||||
| 1.2.3. Gender and engagement with healthcare (It is fine for women to have colonoscopy, but not men) | 1.46 | 1.22 | 0.30 (0.21-0.43)*** | 0.81 (0.45-1.44) |
| 7.6. Social influences (social support) 0.70 | ||||
| 1.4.1. Reliance on family and friends as unofficial interpreters (I would need to take a friend or family member with me to translate what the nurse was saying) | 1.44 | 1.13 | 0.59 (0.46-0.77)*** | 0.76 (0.49-1.18) |
| 1.4.2. Reliance on family for travel and transport (I would need a friend or family member to take me to the nurse appointment) | 2.33 | 1.94 | 0.76 (0.65-0.89)*** | 1.12 (0.81-1.56) |
| 1.4.3. Reliance on family for emotional support (I would need to take a friend or family member with me to the nurse appointment for emotional support) | 2.67 | 2.35 | 0.82 (0.70-0.95)** | 1.07 (0.80-1.43) |
| 3.9.4. Shared decision-making and family-influenced participation (I would only go to the nurse appointment if a friend or family member agreed it was in my best interest to attend) | 2.04 | 1.40 | 0.44 (0.36-0.55)*** | 0.68 (0.47-0.99)* |
| 7.7. Social influences (power) | ||||
| 3.9.3. Reliance on medical professional/authority (I would only go to the nurse appointment if my general practitioner told me I should go) | 2.19 | 1.44 | 0.39 (0.32-0.49)*** | 0.76 (0.54-1.06) |
| 8.1. Emotion (fear) 0.81 | ||||
| 3.1.2. Fear of pain and discomfort (I would be worried that the colonoscopy would be painful or uncomfortable) | 4.14 | 3.51 | 0.45 (0.34-0.59)*** | 0.63 (0.40-0.98)* |
| 3.5.4.1. Fear of cancer (I would be scared that the colonoscopy would find cancer) | 3.86 | 2.93 | 0.79 (0.63-1.00)* | 1.14 (0.80-1.64) |
| 8.2. Emotion (anxiety) | ||||
| 3.1.1. Concerns about doing the bowel preparation (I would be worried about doing the bowel preparation/drinking powerful laxatives before the colonoscopy) | 3.91 | 3.72 | 0.55 (0.46-0.66)*** | 0.81 (0.61-1.06) |
| 3.1.3. Concerns about test invasiveness (I am worried about the invasive nature of colonoscopy) | 3.66 | 2.80 | 0.48 (0.39-0.59)*** | 0.79 (0.56-1.13) |
| 3.1.4. Shame and embarrassment (Going for colonoscopy would be shameful and/or embarrassing) | 2.66 | 1.80 | 0.55 (0.47-0.65)*** | 0.81 (0.63-1.04) |
| 3.3.1. Anxiety (I would feel anxious about going to the nurse appointment) | 3.91 | 3.40 | 0.63 (0.51-0.78)*** | 1.08 (0.78-1.50) |
| 3.3.3. Avoidance (I would prefer not to know whether I had bowel cancer) | 2.00 | 1.31 | 0.41 (0.33-0.52)*** | 0.87 (0.61-1.23) |
| Demographic variables (R2 = 0.47) | ||||
| Age | ||||
| Years (continuous) | — | — | 0.99 (0.95-1.03) | — |
| Gender | ||||
| Male | 46 (12.1) | 334 (87.9) | 1.00 | — |
| Female | 67 (13.9) | 416 (86.1) | 0.86 (0.57-1.28) | — |
| Long-term conditions | ||||
| No | 71 (13.7) | 447 (86.3) | 1.00 | — |
| Yes | 42 (12.1) | 304 (87.9) | 1.15 (0.76-1.73) | — |
| Disability | ||||
| No | 101 (12.8) | 687 (87.2) | 1.00 | — |
| Yes | 12 (15.8) | 64 (84.2) | 0.78 (0.41-1.50) | — |
| Mental health | ||||
| No | 93 (12.1) | 678 (87.9) | 1.00 | 1.00 |
| Yes | 20 (21.5) | 73 (78.5) | 0.50 (0.29-0.86)* | 0.72 (0.32-1.61) |
| Main language | ||||
| English | 111 (13.0) | 746 (87.0) | 1.00 | — |
| Other | 2 (28.6) | 5 (71.4) | 0.37 (0.07-1.94) | — |
| Ethnicity | ||||
| White British/Irish | 105 (12.9) | 711 (87.1) | 1.00 | — |
| Any Other Ethnicity | 8 (16.7) | 40 (83.3) | 0.74 (0.34-1.62) | — |
| Education | ||||
| ≤O-level or GCSE Grades A–C (≤Grade 10) | 44 (24.6) | 135 (75.4) | 1.00 | 1.00 |
| ≥ONC/BTEC (≥Grade 11) | 69 (10.1) | 616 (89.9) | 2.91 (1.91-4.44)*** | 2.78 (1.57-4.94)*** |
| Mean item scores for respondents answering Yes probably, Not sure, No probably not, and No definitely not (range 1-5; 1 = Strongly disagree, 5 = Strongly agree) . | Mean item scores for respondents answering Yes definitely (range 1-5; 1 = Strongly disagree, 5 = Strongly agree) . | OR (95% CI) . | aOR (95% CI) . | |
|---|---|---|---|---|
| Psychological variables (R2 = 0.44) | ||||
| 1.1. Knowledge (knowledge of condition/scientific rationale) | ||||
| 3.2.1. Lack of understanding that bowel cancer can be asymptomatic and the test is looking for invisible traces of blood (Bowel cancer screening is only useful for people with symptoms) | 1.91 | 1.33 | 0.39 (0.30-0.50)*** | 0.68 (0.47-0.97)* |
| 3.5.4.2. Belief that cancer is a treatable disease (Bowel cancer is not a treatable disease) | 2.02 | 1.61 | 0.51 (0.39-0.65)*** | 0.91 (0.58-1.43) |
| 1.2. Knowledge (procedural knowledge) | ||||
| 1.3.1. Hearing other people’s experiences with colonoscopy (Other people’s experiences with colonoscopy have put me off going for colonoscopy myself) | 2.61 | 1.81 | 0.46 (0.38-0.56)*** | 1.00 (0.73-1.37) |
| 3.2.2. Lack of awareness and understanding of colonoscopy procedure (I have a good understanding of what having a colonoscopy would involve) | 2.44 | 2.15 | 0.75 (0.62-0.91)** | 0.97 (0.73-1.37) |
| 2.3. Beliefs about capabilities (self-efficacy) | ||||
| 4.2.2. Existing health conditions interfering with the ability to complete procedure or bowel prep (I have existing health conditions that would prevent me from being able to have a colonoscopy) | 1.54 | 1.27 | 0.48 (0.36-0.65)*** | 1.52 (0.92-2.51) |
| 3.1. Beliefs about consequences (beliefs) | ||||
| 1.2.4. Fatalistic beliefs (Being diagnosed with bowel cancer is a death sentence) | 2.46 | 2.06 | 0.59 (0.47-0.74)*** | 1.22 (0.83-1.79) |
| 1.2.7. Lack of trust in Western Medicine (Western medicine is not effective at treating bowel cancer) | 2.21 | 1.61 | 0.45 (0.35-0.56)*** | 0.77 (0.53-1.10) |
| 3.5.6. Perceived importance of screening (It is important to take part in bowel cancer screening) | 1.87 | 1.16 | 0.20 (0.15-0.29)*** | 0.35 (0.24-0.50)*** |
| 3.9.6. The role of God in determining the future (It is God’s decision who lives and dies, medicine cannot change that) | 1.64 | 1.28 | 0.59 (0.47-0.73)*** | 1.02 (0.71-1.47) |
| 5.2. Environmental context and resources (resources/material resources) | ||||
| 2.1.1. Language barriers (I would need an interpreter to translate during the nurse appointment) | 1.23 | 1.10 | 0.53 (0.35-0.79)** | 1.57 (0.73-3.40) |
| 5.6. Environmental context and resources (barriers and facilitators) | ||||
| 2.2.1. Transport/travel (I would find it difficult to travel to the appointment with the nurse) | 2.36 | 1.54 | 0.41 (0.33-0.50)*** | 0.57 (0.41-0.79)*** |
| 2.2.4. Lack of car parking (If I drove to the appointment, it would be difficult to find a car parking space at my local hospital) | 3.65 | 3.26 | 0.75 (0.63-0.90)** | 0.96 (0.76-1.22) |
| 2.2.5. Indirect costs (Going to the appointment (eg, parking, public transport, time off work, etc.) would cost me a lot of money) | 2.51 | 2.03 | 0.65 (0.54-0.78)*** | 0.99 (0.75-1.30) |
| 7.2. Social influences (social norms) | ||||
| 1.2.2. Colonoscopy, colon and rectum “culturally taboo” topics (I would not be able to discuss this appointment with my friends and family, as this type of thing is very sensitive) | 2.47 | 1.83 | 0.55 (0.46-0.66)*** | 1.02 (0.77-1.35) |
| 1.2.5. Unable to accept blood products (I would be worried that a blood transfusion might be needed if I had a colonoscopy, and I am unwilling to have these on religious grounds) | 1.38 | 1.14 | 0.43 (0.30-0.61)*** | 0.98 (0.58-1.65) |
| 7.5. Social influences (group norms) | ||||
| 1.2.3. Gender and engagement with healthcare (It is fine for women to have colonoscopy, but not men) | 1.46 | 1.22 | 0.30 (0.21-0.43)*** | 0.81 (0.45-1.44) |
| 7.6. Social influences (social support) 0.70 | ||||
| 1.4.1. Reliance on family and friends as unofficial interpreters (I would need to take a friend or family member with me to translate what the nurse was saying) | 1.44 | 1.13 | 0.59 (0.46-0.77)*** | 0.76 (0.49-1.18) |
| 1.4.2. Reliance on family for travel and transport (I would need a friend or family member to take me to the nurse appointment) | 2.33 | 1.94 | 0.76 (0.65-0.89)*** | 1.12 (0.81-1.56) |
| 1.4.3. Reliance on family for emotional support (I would need to take a friend or family member with me to the nurse appointment for emotional support) | 2.67 | 2.35 | 0.82 (0.70-0.95)** | 1.07 (0.80-1.43) |
| 3.9.4. Shared decision-making and family-influenced participation (I would only go to the nurse appointment if a friend or family member agreed it was in my best interest to attend) | 2.04 | 1.40 | 0.44 (0.36-0.55)*** | 0.68 (0.47-0.99)* |
| 7.7. Social influences (power) | ||||
| 3.9.3. Reliance on medical professional/authority (I would only go to the nurse appointment if my general practitioner told me I should go) | 2.19 | 1.44 | 0.39 (0.32-0.49)*** | 0.76 (0.54-1.06) |
| 8.1. Emotion (fear) 0.81 | ||||
| 3.1.2. Fear of pain and discomfort (I would be worried that the colonoscopy would be painful or uncomfortable) | 4.14 | 3.51 | 0.45 (0.34-0.59)*** | 0.63 (0.40-0.98)* |
| 3.5.4.1. Fear of cancer (I would be scared that the colonoscopy would find cancer) | 3.86 | 2.93 | 0.79 (0.63-1.00)* | 1.14 (0.80-1.64) |
| 8.2. Emotion (anxiety) | ||||
| 3.1.1. Concerns about doing the bowel preparation (I would be worried about doing the bowel preparation/drinking powerful laxatives before the colonoscopy) | 3.91 | 3.72 | 0.55 (0.46-0.66)*** | 0.81 (0.61-1.06) |
| 3.1.3. Concerns about test invasiveness (I am worried about the invasive nature of colonoscopy) | 3.66 | 2.80 | 0.48 (0.39-0.59)*** | 0.79 (0.56-1.13) |
| 3.1.4. Shame and embarrassment (Going for colonoscopy would be shameful and/or embarrassing) | 2.66 | 1.80 | 0.55 (0.47-0.65)*** | 0.81 (0.63-1.04) |
| 3.3.1. Anxiety (I would feel anxious about going to the nurse appointment) | 3.91 | 3.40 | 0.63 (0.51-0.78)*** | 1.08 (0.78-1.50) |
| 3.3.3. Avoidance (I would prefer not to know whether I had bowel cancer) | 2.00 | 1.31 | 0.41 (0.33-0.52)*** | 0.87 (0.61-1.23) |
| Demographic variables (R2 = 0.47) | ||||
| Age | ||||
| Years (continuous) | — | — | 0.99 (0.95-1.03) | — |
| Gender | ||||
| Male | 46 (12.1) | 334 (87.9) | 1.00 | — |
| Female | 67 (13.9) | 416 (86.1) | 0.86 (0.57-1.28) | — |
| Long-term conditions | ||||
| No | 71 (13.7) | 447 (86.3) | 1.00 | — |
| Yes | 42 (12.1) | 304 (87.9) | 1.15 (0.76-1.73) | — |
| Disability | ||||
| No | 101 (12.8) | 687 (87.2) | 1.00 | — |
| Yes | 12 (15.8) | 64 (84.2) | 0.78 (0.41-1.50) | — |
| Mental health | ||||
| No | 93 (12.1) | 678 (87.9) | 1.00 | 1.00 |
| Yes | 20 (21.5) | 73 (78.5) | 0.50 (0.29-0.86)* | 0.72 (0.32-1.61) |
| Main language | ||||
| English | 111 (13.0) | 746 (87.0) | 1.00 | — |
| Other | 2 (28.6) | 5 (71.4) | 0.37 (0.07-1.94) | — |
| Ethnicity | ||||
| White British/Irish | 105 (12.9) | 711 (87.1) | 1.00 | — |
| Any Other Ethnicity | 8 (16.7) | 40 (83.3) | 0.74 (0.34-1.62) | — |
| Education | ||||
| ≤O-level or GCSE Grades A–C (≤Grade 10) | 44 (24.6) | 135 (75.4) | 1.00 | 1.00 |
| ≥ONC/BTEC (≥Grade 11) | 69 (10.1) | 616 (89.9) | 2.91 (1.91-4.44)*** | 2.78 (1.57-4.94)*** |
Abbreviations: aOR, adjusted odds ratio; BTEC, Business and Technology Education Council; ONC, Ordinary National Certificate; OR, odds ratio.
*p<0.05 **p<0.01***p<0.001.
Odds ratios and confidence intervals in bold indicates results are statistically significant.
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