Effect of Education on Knowledge, Attitude and Behavioral Intention in Family Relative with Colorectal Cancer Patients Based on Theory of Planned Behavior

  • Baghianimoghadam, Mohammad Hosein (Department of Health Services, Faculty of Health, Shahid Sadoughi University of Medical Sciences) ;
  • Ardakani, Mojtaba Fattahi (Faculty of Health, Shahid Sadoughi University of Medical Sciences) ;
  • Akhoundi, Mohsen (Department of Internal Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences) ;
  • Mortazavizadeh, Mohammad Reza (Islamic Azad University, Aliebn Abitaleb Medical Faculty) ;
  • Fallahzadeh, Mohammad Hosein (Department of Biostatistics, Faculty of Health, Shahid Sadoughi University of Medical Sciences) ;
  • Baghianimoghadam, Behnam (Department of Health Services, Faculty of Health, Shahid Sadoughi University of Medical Sciences)
  • Published : 2012.12.31


Background: Colorectal cancer is one of most common cancers in women and men and one of the major causes of death due to neoplasia. Colonoscopy is considered as the most accurate diagnostic procedure to detect colorectal cancer at the earlier stages. Objectives: The current study aimed to evaluate the effects of an education program using the Theory of Planned Behavior on promoting behavioral intention among first degree relatives of colorectal cancer patients. Materials and Methods: A quasi-experimental study conducted to evaluate the effectiveness of an educational program to promote attitudinal factors associated with early detection of colorectal cancer in 99 first degree relatives of colorectal cancer patients aged more than 20 years in Yazd city, Iran. A researcher made questionnaire forwhich validity and reliability were confirmed by expert point of view and pilot testing was employed for data collection. Questionnaires were filled in before and after educational intervention. The registered data were transferred to SPSS 19 and analyzed by paired T-test, Man-Whitney and Wilcaxon. Results: Mean scores of knowledge, attitude, perceived behavioral control and intention regarding colorectal cancer increased after education significantly (P<0.05). Conclusions: Application of the Theory of Planned Behavior has positive influence on promoting intention behavior. It is therefore recommended to apply educational programs to promote behavioral intention.


Colorectal cancers;first degree family;knowledge;attitude;intention;Iran


  1. Juon H, Choi S, Klassen A, Roter D (2006). Impact of breast cancer screening intervention on Korean-American women in Maryland. Cancer Detect Prev, 30, 297-305.
  2. Kang SH BJ (1993). Social support and cancer screening among older black Americans. J Natl Cancer Inst, 85, 737-42.
  3. Kim YH SL (2004). An intervention to increase mammography use by Korean American women. Oncol Nurs Forum, 31, 105-10.
  4. Makoul G, Cameron KA, Baker DW, et al (2009). A multimedia patient education program on colorectal cancer screening increases knowledge and willingness to consider screening among Hispanic/Latino patients. Patient Educ Couns, 76, 220-6.
  5. Mazloomy S, Zare M, Feisal M, et al (2006). Effects of health education on knowledge, attitude and practice of female teachers in Yazd intermediate schools on breast cancer. J Birjand University of Med Sci, 13, 12-8.
  6. Meng W, Wen XB, Bai XY, et al (2009). Barrier-focused intervention to increase colonoscopy attendance among nonadherent high-risk populations. World J Gastroenterology, 15, 3920-5.
  7. Ministry of Health and Medical Education of Iran (2011), Department of Non-communicable deseases, Cancer management. A recorded cancer cases reported 2009. Ministry of health and medical education publication, Tehran, Iran.
  8. Moattari M, Ruzitalab M, Firuzi S, et al (2009). Survey of eductionin knowledge and participation in people moderate risk: based on health belief model. Shahid Beheshti University Med J, 33, 47-54.
  9. Philip E, DuHamel K, Jandorf L (2010). Evaluating the impact of an educational intervention to increase CRC screening rates in the African American community: a preliminary study. Cancer Causes Control, 21, 1685-91.
  10. Rimer B, Halabi S, Skinner CS, et al (2001). The shortterm impact of tailored mammography decision-making interventions. Patient Educ Couns, 43, 269-85.
  11. Steele CB, Cardinez CJ, Richardson LC, et al (2008). Surveillance for health behaviors of American Indians and Alaska Natives-findings from the behavioral risk factor surveillance system, 2000-2006. Cancer, 113, 1131-41.
  12. Tabeshian A, Farah F (2009). Effect of health education in pap smear test for cervical cancer prevention in esfahan city school teachers. Med J Islamic Azad University, 19, 43-8.
  13. Weinrich S, Mester F (1992). Knowledge of colorectal cancer amomg older persons. Cancer Nur, 15, 322-9.
  14. Abdollahmahani F (2001). Survey education to knowledge over 50 years about colorectal cancer. J Tabriz Med University, 52, 52-6.
  15. Allen JD SA, Sorensen G (2008). Do social network characteristics predict mammography screening practices? Hlth Educ Behav, 35, 763-76.
  16. American Cancer Society (1999). Cancer facts and figures.
  17. Antonio Z, Gimeno G, Quintero K, et al (2009). Impact of an educational video-based strategy on the behavior process DA associated with colorectal cancer screening: a randomized controlled study. Cancer Epidemiology, 33, 216-22.
  18. Armitage CJ, Conner M (2001). Efficacy of the Theory of Planned Behaviour: a meta-analytic review. Br J Soc Psychol, 40, 471-99.
  19. Ajzen I (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179-211.
  20. Bat L, Pines A, Rom E, et al (1986). A community based program of colorectal screening in an asymptomatic population:evaluation of screening tests and compliance. Am J Gastroenterol, 81, 647-51.
  21. Besharati F, Hazavehei S, Moeini B, et al (2011). Effect of educational interventions based on theory of planned behavior (TPB) in selecting delivery mode among pregnant women referred to rasht health centers. J Zanjan Med Sci Uni, 19, 94-106.
  22. Breslier RS. Colorectal Cancer. In: Feldman M, Friedman, Lawrence J, et al (2010). Sleisenger and Fordtran's gastrointestinal and liver disease 9ed. Canada: Elsevier's Rights Department.
  23. Caffrey S, Broughton C, Marks C (1993). Faecal occult blood screening for colorectal neoplasia in a targeted high-risk population. Br J Surg, 80, 1399-400.
  24. Champion VL SC (1997). Reliability and validity of breast cancer screening belief scales in African American women. Nurs Res, 46, 331-7.
  25. Collins V, Halliday J, Warren R, et al (2000). Assessment of education and counselling offered by a familial colorectal cancer clinic. Clin Genet, 57, 48-55.
  26. Fletcher S, Harris R, Gonzalez J, et al (1993). Increasing mammography utilization: a controlled study. J Natal Cancer Inst, 85, 112-20.
  27. Harris M, Byles J (1997). A survey of screening compliance among first degree relatives of people with colon cancer in New South Wales. J Med Screening, 4, 29-34.
  28. Hatefnia E, Niknami S, Mahmudi M (2010). The effects of "Theory of Planned Behavior" based education on the promotion of mammography performance in employed women. J Birjand University of Med Sci, 17, 150-8.
  29. Ishii N, Arai M, Koyama Y, et al (2011). Factors affecting encouragement of relatives amongfamiliesFamilial Cancer with Lynch syndrome to seek medical assessment. Familial Cancer, 10, 649-54
  30. Jillian JF, Martin PE, Marie J, et al (2004). Constracting questionnaires based on the theory of planned behaviour, a manual for health services. Centre for Health Services Research University of Newcastle, United Kingdom.