title: Familial risk and colorectal cancer screening health beliefs and attitudes in an insured population.
abstract: OBJECTIVE
  To examine the relationship between health beliefs and attitudes toward colorectal cancer screening, strength of family history risk, and being appropriately screened for colorectal cancer.
  
  
  METHODS
  In February 2004, 7000 randomly selected members of a multi-specialty group practice located in Boston, MA were mailed a brief survey that was used to ascertain colorectal cancer family history. A follow-up survey that contained questions representing selected constructs of the Health Belief Model, Theory of Planned Behavior, and healthcare experiences was then mailed to all 355 individuals who reported a family history in the initial survey and 710 randomly selected participants with no colorectal cancer family history.
  
  
  RESULTS
  Participants who were appropriately screened had higher mean scores for perceived cancer risk, subjective norms, and perceived benefits and lower scores for perceived barriers. Multivariate findings indicate that having high perceptions of risk for colorectal cancer was a significant correlate of being screened appropriately among individuals with a strong family history.
  
  
  CONCLUSIONS
  For those at greatest colorectal cancer risk due to family history, ensuring that these individuals understand their personal risk might lead to increased colorectal cancer screening participation. Future intervention research is warranted to examine if raising perceptions of risk can increase screening behaviors in individuals with colorectal cancer risk due to family history.
authors.affiliation: Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA 02115, USA. richard.palmer@fiu.edu
authors.forename: Richard C
authors.initials: RC
authors.lastname: Palmer
authors.forename: Karen M
authors.initials: KM
authors.lastname: Emmons
authors.forename: Robert H
authors.initials: RH
authors.lastname: Fletcher
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lobb
authors.forename: Irina
authors.initials: I
authors.lastname: Miroshnik
authors.forename: James Alan
authors.initials: JA
authors.lastname: Kemp
authors.forename: Mark
authors.initials: M
authors.lastname: Bauer
mesh_terms: D000328:Adult; D001900:Boston; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics* / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D020022:Genetic Predisposition to Disease / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009780:Occult Blood; D012306:Risk