title: Effectiveness of the extended parallel process model in promoting colorectal cancer screening.
abstract: OBJECTIVE
  Relatives of colorectal cancer (CRC) patients are at increased risk for the disease, yet screening rates still remain low. Guided by the Extended Parallel Process Model, we examined the impact of a personalized, remote risk communication intervention on behavioral intention and colonoscopy uptake in relatives of CRC patients, assessing the original additive model and an alternative model in which each theoretical construct contributes uniquely.
  
  
  METHODS
  We collected intention-to-screen and medical record-verified colonoscopy information on 218 individuals who received the personalized intervention.
  
  
  RESULTS
  Structural equation modeling showed poor main model fit (root mean square error of approximation (RMSEA) = 0.109; standardized root mean residual (SRMR) = 0.134; comparative fit index (CFI) = 0.797; Akaike information criterion (AIC) = 11,601; Bayesian information criterion (BIC) = 11,884). However, the alternative model (RMSEA = 0.070; SRMR = 0.105; CFI = 0.918; AIC = 11,186; BIC = 11,498) showed good fit. Cancer susceptibility (B = 0.319, p < 0.001) and colonoscopy self-efficacy (B = 0.364, p < 0.001) perceptions predicted intention to screen, which was significantly associated with colonoscopy uptake (B = 0.539, p < 0.001).
  
  
  CONCLUSIONS
  Our findings provide support of the utility of Extended Parallel Process Model for designing effective interventions to motivate CRC screening in persons at increased risk when individual elements of the model are considered. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Department of Psychology, Brigham Young University, Provo, UT, USA.
authors.forename: Wendy C
authors.initials: WC
authors.lastname: Birmingham
authors.affiliation: Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA.
authors.forename: Man
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authors.lastname: Hung
authors.affiliation: Faculty of Psychology, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Watcharaporn
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authors.lastname: Boonyasiriwat
authors.affiliation: Huntsman Cancer Institute, Salt Lake City, UT, USA.
authors.forename: Wendy
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authors.lastname: Kohlmann
authors.affiliation: Department of Behavioral and Community Health, University of North Texas, Houston, TX, USA.
authors.forename: Scott T
authors.initials: ST
authors.lastname: Walters
authors.affiliation: Huntsman Cancer Institute, Salt Lake City, UT, USA.
authors.forename: Randall W
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authors.affiliation: New Jersey State Cancer Registry, Rutgers University, New Brunswick, NJ, USA.
authors.forename: Antoinette M
authors.initials: AM
authors.lastname: Stroup
authors.affiliation: Huntsman Cancer Institute, Salt Lake City, UT, USA.
authors.forename: Sandie L
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authors.lastname: Edwards
authors.affiliation: Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA.
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authors.initials: MD
authors.lastname: Schwartz
authors.affiliation: University of Colorado Cancer Center, Denver, CO, USA.
authors.forename: Jan T
authors.initials: JT
authors.lastname: Lowery
authors.affiliation: University of New Mexico Cancer Research and Treatment Center, Albuquerque, NM, USA.
authors.forename: Deirdre A
authors.initials: DA
authors.lastname: Hill
authors.affiliation: University of New Mexico Cancer Research and Treatment Center, Albuquerque, NM, USA.
authors.forename: Charles L
authors.initials: CL
authors.lastname: Wiggins
authors.affiliation: Institute for Rural Health, University of Alabama, Tuscaloosa, AL, USA.
authors.forename: John C
authors.initials: JC
authors.lastname: Higginbotham
authors.affiliation: Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Tang
authors.affiliation: Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA.
authors.forename: Shirley D
authors.initials: SD
authors.lastname: Hon
authors.affiliation: Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA.
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Franklin
authors.affiliation: Division of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center, Houston, TX, USA.
authors.forename: Sally
authors.initials: S
authors.lastname: Vernon
authors.affiliation: University of New Mexico Cancer Center and School of Medicine, Albuquerque, NM, USA.
authors.forename: Anita Y
authors.initials: AY
authors.lastname: Kinney