Factors Associated With Colorectal Cancer Screening Behaviors Among Urban Populations in China: A Mixed‐Methods Study Using the Health Belief Model.

Shi, Bingzi; Zhang, Jing; Zhang, Yasi; Sun, Yujing; Cui, Wenming

Objective: Adherence to guideline‐recommended colorectal cancer screening (CRCS) among average‐risk urban populations in China remains significantly suboptimal. This mixed‐methods study aimed to investigate screening behaviors and associated factors among average‐risk urban populations through a multi‐center approach. Methodology: From February to July 2024, 550 participants were recruited via stratified random sampling in Harbin, China. They completed questionnaires related to health beliefs and knowledge. Additionally, semi‐structured interviews were conducted to explore CRCS behaviors, with data analyzed using directed content analysis based on the Health Belief Model (HBM). Results: Five hundred twenty two participants (95.0%) completed the survey. Identified factors influencing screening behavior among average‐risk urban populations included perceived severity of colorectal cancer (CRC), benefits of colon cancer surveillance, barriers to surveillance, and knowledge. Twenty‐six individuals were engaged in qualitative interviews. Twenty‐four themes were identified and categorized by frequency. Both quantitative and qualitative data suggest that CRCS behavior among urban average‐risk populations is suboptimal, and the identified factors can be mapped onto the HBM. Conclusions: This mixed‐methods study demonstrates that key factors influencing screening behavior among urban average‐risk populations align with the HBM. These identified factors should be meticulously considered in future systematic interventions to enhance screening behaviors.

CHINA; RISK assessment; PUBLIC health surveillance; HEALTH literacy; CROSS-sectional method; COMMUNITY health services; QUALITATIVE research; T-test (Statistics); EARLY detection of cancer; STATISTICAL sampling; QUESTIONNAIRES; INTERVIEWING; CONTENT analysis; FISHER exact test; LOGISTIC regression analysis; COLORECTAL cancer; SEVERITY of illness index; QUANTITATIVE research; JUDGMENT sampling; DESCRIPTIVE statistics; MANN Whitney U Test; CHI-squared test; MULTIVARIATE analysis; CITY dwellers; SURVEYS; ODDS ratio; RESEARCH methodology; STATISTICS; HEALTH Belief Model; DATA analysis software; CONFIDENCE intervals; PSYCHOSOCIAL factors

Public Health Nursing, 2025, Vol 42, Issue 1, p466

0737-1209

Academic Journal

10.1111/phn.13481