While uptake rates for colorectal cancer screening (CRCS) have been increasing, participation in screening remains relatively low. Novel approaches for improving CRCS need to be developed. A number of individually-focused interventions have been developed for individuals who are not compliant with CRCS. Although some of these interventions have reported significant effects upon CRCS, other studies have not reported significant effects. One possible limitation of individual-level interventions is that they do not take advantage of the social context in which most health behavior occurs. The marital relationship is an example of a social context factor that has not been incorporated into CRCS intervention efforts. In the proposed study, we seek to develop an innovative, couple-based intervention (CBI) whose goal is to increase uptake of CRCS among couples in which neither partner is on-schedule with regard to CRCS. We will develop CBI and conduct a pilot and feasibility study. Our intervention is based primarily on the Interdependence Model, which is a dyad-level social psychological theory proposes that partners influence both their own as well as their partner's behavior and that interventions which transform the motivation for health behavior change to ascribe meaning for the relationship should be more successful than interventions that ascribe meaning for the change only for oneself. The goal of CBI is to increase the degree to which couples constructively discuss CRCS and the degree to which couples think about CRCS as important to their relationship. The ultimate goal is to increase participants'uptake of CRCS. We will achieve this goal by conducting two studies. The goal of Study 1 is to refine CBI by conducting interviews with screened and unscreened couples to gather information regarding the role of the marital relationship in colon cancer screening and by having a sample of unscreened couples evaluate the provisional CBI materials we have developed. The goal of Study 2 is to conduct a small-scale pilot study to provide preliminary information regarding the impact of CBI by comparing it with a widely-available pamphlet about CRCS. The primary aim of this study is to develop CBI and evaluate its feasibility and acceptability. The secondary aims are to gather preliminary information regarding the impact of CBI versus Minimal Care (MC) on CRCS and CRCS intentions and to gather preliminary information regarding the impact of CBI versus MC on possible mechanisms of change.

Public Health Relevance

While uptake rates for colorectal cancer screening have been increasing, participation in screening remains relatively low, particularly in comparison with other cancers and when considering prevention objectives set forth in Healthy People 2010. Novel approaches for improving CRCS need to be developed. In the proposed study, we seek to develop and pilot test an innovative, theoretically-guided, couple-based intervention whose goal is to encourage couples to constructively discuss having CRCS, with the ultimate goal of increasing the uptake of CRCS among couples in which neither partner is on-schedule with regard to CRCS.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21CA128779-02
Application #
7774303
Study Section
Psychosocial Risk and Disease Prevention Study Section (PRDP)
Program Officer
Breslau, Erica S
Project Start
2009-03-01
Project End
2011-02-28
Budget Start
2010-03-01
Budget End
2011-02-28
Support Year
2
Fiscal Year
2010
Total Cost
$180,481
Indirect Cost
Name
Fox Chase Cancer Center
Department
Type
DUNS #
073724262
City
Philadelphia
State
PA
Country
United States
Zip Code
19111
Manne, Sharon L; Kashy, Deborah A; Weinberg, David S et al. (2013) A pilot evaluation of the efficacy of a couple-tailored print intervention on colorectal cancer screening practices among non-adherent couples. Psychol Health 28:1046-65
Heckman, Carolyn J; Darlow, Susan; Manne, Sharon L et al. (2013) Correspondence and correlates of couples' skin cancer screening. JAMA Dermatol 149:825-30
Manne, Sharon; Etz, Rebecca S; Hudson, Shawna V et al. (2012) A qualitative analysis of couples' communication regarding colorectal cancer screening using the Interdependence Model. Patient Educ Couns 87:18-22
Manne, Sharon; Kashy, Deborah; Weinberg, David S et al. (2012) Using the interdependence model to understand spousal influence on colorectal cancer screening intentions: a structural equation model. Ann Behav Med 43:320-9