Evento: 40th Annual Conference of the European Health Psychology Society, 01-04 September, 2026, Pafos, Cyprus 

Contributo: Addressing psychosocial heterogeneity in colorectal cancer screening: Clustering non-adherers to inform targeted and tailored interventions

Autori: M. Bianchi, M. Capasso, R. Fabbricatore, A.R. Donizzetti, D. Caso

Abstract: Despite public health initiatives, colorectal cancer screening (CRCS) adherence remains suboptimal in Southern Italy, including Campania. Drawing on prior studies identifying key determinants of participation, this study aimed to identify empirically derived psychosocial profiles among adults with irregular CRCS participation to inform targeted and tailored intervention approaches. A sample of 1,089 screening-eligible adults in Campania (aged 50–74; 50.7% men) with irregular past participation completed a survey assessing attitude, subjective norms, perceived behavioural control, anticipated regret, self-identity, and action and coping planning. Reduced k-means clustering was applied to jointly reduce dimensionality and identify homogeneous subgroups. Cluster stability was evaluated using bootstrap resampling. ANOVAs examining intention and individual reasons for screening participation further explored differences among clusters. A stable two-dimensional and three-cluster solution emerged, explaining 61% of between-cluster variance and demonstrating high stability (Jaccard indices > .87). The clusters meaningfully defined the psychosocial profiles: (1) Interested-but-unprepared (43%); (2) Psychosocially resourceful (31%); (3) Vulnerable and disengaged (26%). Clusters also differed significantly in screening intention (η² = .35) and in reasons for participation in cancer screenings. Findings demonstrate substantial psychosocial heterogeneity among individuals eligible for CRCS. The identified profiles reflect different psychological pathways to non-participation, underscoring the need for differentiated communication strategies. These findings provide an empirical foundation for experimentally testing targeted vs targeted plus tailored scalable text-message interventions for promoting CRCS among Campania citizens.