Event: XIV National Congress of the Italian Society of Health Psychology – SIPSA

Location: Cagliari, 25-27 May 2023

Contribution: Psychosocial factors affecting access to colorectal screenings in the Campania Region.

Authors: Marcella Bianchi, Anna Rosa Donizzetti, Francesco Palumbo, Daniela Caso

Abstract: Introduction: Colorectal cancer is among the leading causes of death globally. Despite the proven effectiveness of population screening programs in reducing mortality, adherence is below recommended thresholds, and regions in Southern Italy, including Campania, show particularly low rates. Therefore, identifying the psychological determinants of participation in colorectal screenings (CRS) in this population is of fundamental importance. In this regard, the Theory of Planned Behavior (TPB) offers a valid starting framework. This study aims to test an integrated TPB model applied to CRS adherence. This model simultaneously considers some additional predictors of intention at a proximal level (anticipated regret and self-identity) and distal level (trust in institutions and perceived risk in the affective and cognitive dimension). Moreover, to bridge the gap between intention and behavior, two possible mediators were considered: action and coping planning. Method: 435 Campanian citizens (50-73; M = 59.09; SD = 6.85; 54.3% women) residing in Campania completed an online questionnaire to assess the variables of interest. Results: The results of the Structural Equation Model confirmed most of the hypotheses. Intention directly predicts action and coping planning, which significantly impact behavior. Intention is influenced by attitude, subjective norms, perceived behavioral control, anticipated regret, and self-identity. Attitude is predicted by trust in institutions and affective perceived risk. Moreover, the parallel mediation analysis confirmed the role of action and coping planning as mediators between intention and behavior. Conclusions: The proposed model can inform future interventions and guide the improvement of access processes to CRS public service, particularly in Campania.