IDDF2024-ABS-0054 What influences colorectal screening adherence? A cross-sectional study using the transtheoretical model

<h3>Background</h3> Singapore’s national colorectal cancer (CRC) screening programme recommends residents complete faecal occult blood testing (FOBT) once a year or a colonoscopy once every 10 years. The transtheoretical model of behaviour change suggests that individuals progress from pre-contemplation (e.g., not thinking about screening) to maintenance (e.g., consistently screening at the recommended frequency). This study sought to understand factors associated with individuals at key stages of the model. <h3>Methods</h3> 529 individuals were recruited from a public polyclinic. 109 (20.6%) were in the maintenance stage. Of the 420 pre-maintenance individuals, 143 (34.0%) were in the preparation stage (i.e., never screened but intended to begin). Individuals completed a questionnaire measuring sociodemographic data, behavioural factors based on health belief model (HBM), and sources of screening information. <h3>Results</h3> Compared to pre-maintenance, the maintenance group had more males (57.8% versus 41.9%), higher socioeconomic status (22.0% versus 13.4% in private property) and were older (56.2 versus 54.8 years). Compared to preparation, the pre-preparation group had more lower-income individuals (52.9% versus 40.1% earning &lt;S$2000/month). Maintenance and preparation groups scored significantly higher for cues to action and perceived susceptibility versus their respective comparators (p&lt;0.05). Both factors were associated with screening intention and adherence in multivariate regression. More maintenance individuals (74.0% vs 51.8%) received screening information from polyclinics. <h3>Conclusions</h3> Increasing perceived susceptibility and consistent cues to screening are crucial for moving individuals into becoming screen-adherent. Nuances relating to socioeconomic status should be further explored.