Table 1 Key concepts identified
Key concepts Scoping study [9] | Key concepts Focus group study [10] | Conceptual definition | Candidate measures* |
|---|---|---|---|
Low self-perceived risk of CRC Not a risk: Most prevalent in western populations Not necessary—no symptoms | Lack of knowledge of risk Screening not necessary: No symptoms or healthy | Perceived susceptibility [HBM] Is concerned with the self-perceived risk of a diagnosis of CRC | Leung et al. [46] Ozsoy et al. [47] |
Fear of cancer and diagnosis CRC not curable Consequences of cancer (stigma) | Cancer is scary: Fear associated with test or waiting for results, and diagnosis Consequences of cancer (bring on illness or poor outcomes) | Perceived severity [HBM] An individual’s belief of the serious nature of a CRC, its impact (medical, clinical, social, and physical) and evaluation if not treated | Leung et al. [46] Ozsoy et al. [47] |
Screening increases chance of survival or cure | Early detection is good Start treatment soon Better survival and cure Screening reduces worry | Perceived benefits [HBM] An individual’s belief that a change of behaviour results in a benefit; thus reducing the threat of CRC. This could relate to health and social consequences (i.e. detect polyp early, reduced worry or appease family by doing screening), which can also influence decision-making | Leung et al. [46] Ozsoy et al. [47] Rawl et al. [45] |
Lack of knowledge—not heard about cancer, risks or screening, and do not know how to do test Fear, nervous, worry, pain, embarrassment, or unpleasant Language, cost, time, no transportation Lack of physician recommendation | Lack knowledge: Not heard about CRC, risks, or screening Aversion to collecting stool Language of physician | Perceived barriers [HBM] Is linked to factors that impede decisions to act by having CRC screening; the pros and cons are weighed | Leung et al. [46] Ozsoy et al. [47] Rawl et al. [45] |
Low confidence in completing screening Confidence to do test |  | Perceived self-efficacy [HBM] An individual’s confidence in the ability to complete a home stool test or preparation for colonoscopy | Flight et al. [48] |
Family as central—provide advice and support Loss of social support Physician recommendation | Family and friends Family physician, nurse practitioner or other HCP Physician recommendation, responsibility, explanation and enforcement | Subjective norm [TPB] The individual’s perception of others expectations of performing CRC screening, and the ability of the individual to comply with others | Flight et al. [48] Ozsoy et al. [47] |
Screening for breast, cervical and CRC low among SA immigrants Not heard of or had cancer screening | Not heard of CRC, risks and screening Not had CRC screening (FOBT) | INTENTION & ADHERENCE Self-report information that reflects having heard of and/or use of the home stool test and colonoscopy screening. Plans to have CRC screening | Vernon et al. [49] |