Study On The Comprehensive Intervention And Analysis Of Results Based On BCW Theory On Colonoscopy Compliance In High-risk Population Of Colorectal Cancer

Objective:To probe into the effect of comprehensive intervention based on the Behavior Change Wheel(BCW)theory on the health cognition,health belief awareness and colonoscopy compliance of high-risk population for colorectal cancer(CRC).And to analyze the results of colonoscopy to provide reference for improving compliance and screening quality.Methods:1.The part one was the construction of the program.To consulted the current situation of improving the compliance of colonoscopy in high-risk population of CRC at home and abroad and the application of BCW theory through literature review,the research group discussed and formed a preliminary health education intervention plan.Then,the Delphi inquire by letter to improve the plan,collected the opinions of the pre-experimental subjects and modified the content,and finally formed a comprehensive intervention program based on the BCW theory.2.The part two was the application of the program.This study is a quasi-experimental randomized controlled trial in the same period.Based on the " National CRC Ten Thousand Community Screening Project ",according to the inclusion and exclusion criteria,196 asymptomatic high-risk population of CRC in Wuxi who participated the project from April to December 2021 were enrolled research by convenient sampling method.With the help of the "big data platform for colorectal early cancer screening ",the research objects were uniformly filed and managed.Then,98 participants were enrolled in the intervention group and 98 in the control group.Besides,the reasearch used the randomized digital table method to devide participants into the intervention group and control group.The intervention group implemented BCW theory comprehensive intervention based on the unified implementation program formulated by the project team of " National CRC Ten Thousand Community Screening Project".The nursing intervention such as,the We Chat video education from Monday to Sunday,expert popular science lectures on Friday,community learning activities,peer education,endoscopy center visit,radio broadcast and other means on Saturday and Sunday.The control group also received the routine nursing of the unified implementation program formulated by the project team of " National CRC Ten Thousand Community Screening Project ".The period was 2 weeks.Before and 2 weeks after the intervention,the general information questionnaire,Colorectal Cancer Health Belief Scale,Self-Rating Anxiety Scale(SAS),Social Support Rating Scale(SSRS),the Newcastle Satisfaction with Nursing Scales(NSNS)and the compliance rate of colonoscopy were used to evaluate the intervention effect of the two groups.Six months after the intervention,this study analyzed the colonoscopy compliance rate and the characteristics of the high-risk population of CRC,the detection of lesion results during colonoscopy and compare the differences in lesion diagnosis among different genders and age groups.In this study,SPSS25.0 was used to analyze the data.3.Results:1.Construction of intervention program.By reviewing literature and discussing in groups,this study completed two rounds of Delphi expert correspondence.The recovery rates of 15 experts of questionnaire were all 100%,and the opinion submission rates were 53.33%and 20%.Then the average authority coefficient of correspondence consultation were 0.873 and 0.887,and the coefficient of variation(CV)ranges from 0.00 to 0.25,and Kendall’s W ranges from 0.451 to 0.534,the difference were statistically significant all(P<0.001).According to the suggestions after Delphi,a health education program based on BCW theory,including 8 first-level entries,30 second-level entries and 57 third-level entries,was finally formed.2.Application of intervention program.(1)There was no statistically significant difference in general data between the two groups before intervention(all P>0.05).(2)Comparison between groups before and after intervention in this study.Before intervention,as for the intervention group and the control group of the Colorectal Cancer Health Belief Scale scores,SAS scores and SSRS scores,there were all no statistical significance between the two groups(all P>0.05).After intervention,the colonoscopy compliance rate in the intervention group showed a great advantage,which was significantly higher than that in the control group(57.14% vs.29.60%,P<0.001);and the Colorectal Cancer Health Belief Scale scores,SAS scores and SSRS scores of the intervention group were(138.85±7.09),(29.66±2.18)and(52.62±3.24)points,respectively,which were significantly better than that of the control group(131.64±6.76),(34.90±2.27)and(46.70±3.18)points,respectively,the difference between the two groups were all statistically significant(all P<0.001);and NSNS scores and the satisfaction rate of the intervention group were higher than that of the control group [(82.64±6.76)vs.(79.12±7.71),98.98% vs.88.78%,all P<0.05].(3)Comparison intra-group before and after intervention in this study.Comparison of colorectal cancer health Belief Scale scores,SAS scores and SSRS scores in the intervention group showed that the results of the after intervention were all more excellent than before intervention(all P<0.001).(4)Six months after the intervention,the colonoscopy compliance rate in the intervention group increased significantly and was significantly better than that in the control group(76.53% vs.35.71%,P<0.001).A total of 110 high-risk population completed colonoscopy,including 67 males(60.91%)and 43 females(39.09%).There were 2 cases of CRC(1.82%),25 cases of advanced adenoma(22.73%),46 cases of low-grade intraepithelial neoplasia(41.82%),68 cases of tubular adenoma(61.82%),16 cases of tubular villous adenoma(14.55%),15 cases of serrated adenoma(13.64%),and 1 case of severe glandular dysplasia(0.91%).The detection rate of advanced adenoma in males(29.85%)was significantly higher than that in females(11.63%).Conclusions:1.The construction of comprehensive intervention program based on BCW theory reflected a certain degree of the authority of expert opinions,with scientificity and reliability.2.The comprehensive intervention program based on BCW theory accurately and efficiently established the health awareness and the motivation of health examination colonoscopy among high-risk population of CRC,and effectively improved the compliance of colonoscopy with significantly increased to 76.53% after intervention.At the same time,they had the ability to relieve anxiety,improve the level of social support,and improve intervention satisfaction.The early screening and early diagnosis and early treatment of colonoscopy in high-risk population of CRC had a certain value of intervention effect and popularization.3.High quality colonoscopy detected intestinal lesions such as advanced adenoma and CRC as early as possible,which was the key to improving the quality of CRC screening and the quality of life of high-risk population.It had important educational significance for improving the compliance of colonoscopy in high-risk population for CRC.