title: The impact of supplementary narrative-based information on colorectal cancer screening beliefs and intention.
abstract: BACKGROUND
  The potential benefits of colorectal cancer screening are limited by low uptake. This study tested whether providing narrative accounts of the colorectal cancer (CRC) screening experience positively affected beliefs about CRC screening and intention to be screened.
  
  
  METHODS
  4125 adults aged 45-59.5 years, from three general practices in England, were randomised to be sent the standard information on CRC screening or the standard information plus a narrative-based leaflet describing CRC screening experiences. Both groups were asked to complete and return a questionnaire on beliefs about CRC screening after reading the study materials. Between-group differences on responses were assessed with t-tests. A mediation analysis then addressed the mediating role of CRC screening beliefs on the group and intention relationship.
  
  
  RESULTS
  Relative to the standard information group (n = 590), the standard information plus narrative leaflet group (n = 631) showed higher perceived vulnerability to CRC, higher perceived test response efficacy, a stronger belief that the screening test would provide peace of mind and less disgust with the test procedure. There were no between group differences on perceived self-efficacy or the understanding that the screening test should be done in the absence of symptoms. Respondents who received the additional narrative leaflet reported significantly higher CRC screening intentions than respondents who received the standard information only. Controlling for the CRC screening beliefs reduced the effect of group on intention to non-significance.
  
  
  CONCLUSIONS
  An additional narrative leaflet had a positive impact on beliefs about CRC screening which led to stronger screening intentions.
authors.affiliation: Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK. l.mcgregor@ucl.ac.uk.
authors.forename: Lesley M
authors.initials: LM
authors.lastname: McGregor
authors.affiliation: Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK. c.wagner@ucl.ac.uk.
authors.forename: Christian
authors.initials: C
authors.lastname: von Wagner
authors.affiliation: Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK. gemma.vart@roehampton.ac.uk.
authors.forename: Gemma
authors.initials: G
authors.lastname: Vart
authors.affiliation: Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK. gigiyuen@vista-china.net.
authors.forename: Wing Chee
authors.initials: WC
authors.lastname: Yuen
authors.affiliation: Department of Applied Health Research, University College London, London, UK. r.raine@ucl.ac.uk.
authors.forename: Rosalind
authors.initials: R
authors.lastname: Raine
authors.affiliation: Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK. j.wardle@ucl.ac.uk.
authors.forename: Jane
authors.initials: J
authors.lastname: Wardle
authors.affiliation: Medical Research Council/Chief Scientist's Office, Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK. katie.robb@glasgow.ac.uk.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Robb
mesh_terms: D000328:Adult; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000523:psychology*; D003469:Culture; D055088:Early Detection of Cancer / Q000379:methods / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D033262:Narration; D011897:Random Allocation; D012307:Risk Factors; D011795:Surveys and Questionnaires