Health Beliefs Colorectal Cancer Screening Change With a Screening Navigation Program for Deprived Persons

Abstract

Background: To decrease social inequalities in colorectal cancer screening participation, Screening Navigation Programs (SNPs) focusing on a global view of individual barriers (transportation, cultural difficulties, knowledge) have shown to be effective. However, psychological mechanisms of SNP efficacy are not well known. We hypothesized that SNP should change health beliefs about screening and reduce social inequalities on them. Methods: From a French SNP protocol, the study included two independent variables: SNP Intervention (Screening Navigation vs. Usual Screening) x Socioeconomic Status of the living place (Townsend Index). We measured health beliefs following the Protection Motivation Theory by a mailed questionnaire, in 261 non-compliant persons regarding screening and targeted to participate to screening. Findings: We found significant interactions between SNP Intervention and Socioeconomic Status on several health beliefs. More specifically, our results show that social inequalities on perceived efficacy of the screening and on perceived facility were reduced by the SNP. Discussion: Health beliefs are a way to understand SNP efficacy to reduce social inequalities.