ISAHCQ aims to capture participants' intentions (item 1), attitudes (items 2, 3, and 4), and perceived behavioural control (items 5 and 6).
In our own research in this area, we found that asking about future intentions to get screened before asking about past CRC screening behavior, significantly lowered reports of past CRC screening and that the effect of the positioning of the future intentions item varied by survey mode [ 7].
In addition to CRC awareness, knowledge and behavioral intentions items, the post-ICAS included items on behavioral intentions to encourage others to tour the IC, the likelihood of the IC being accepted in their culture as an educational tool, and perceptions of the IC as an effective CRC educational tool.
The common issues included: the translation and coding of the 'help-seeking intentions' items, the wording of the item about 'difficulty getting an appointment with a doctor', the translation of 'embarrassment' as a barrier to seeking medical help and the wording of the screening module items because of the local characteristics of screening programmes.
These are the variables considered extremely important because of the high correlation to the intention item (Sf4) with below average positivity, which poses room for improvement in encouraging the intention to continue shadowing in the future.
Conversely, using the same example above for a behavioral intention item, people would be expected to respond to an item similarly to this one: "If I had new ideas, I would share them with my colleagues".
We found little impact of the intention item and suggestive evidence mailed surveys positively affect accuracy.
A total of 3,638 cases were available for analysis with 914, 838, 956, and 930 in the mail/future intention, mail/no future intention item, telephone/future intention, and telephone/no future intention item conditions, respectively.
An additional intention item considers time frame (i.e., quitting within the next month or within the next year).
In these multivariate models, we observed no independent impact of the future intention question on accuracy in either mode (36.7% with intention item vs 33.1%, OR = 1.18, p = 0.31).
The current results show very little impact of the intention item on CRC reporting accuracy and the observed pattern of results suggest that its inclusion may actually decrease accuracy when compared to medical records.
