July 15, 2025

The effects of nursing interventions on colorectal cancer health belief perceptions and Fecal Occult Blood Test (FOBT) screening behaviors of low-income individuals

Key Points

Nurse-led educational interventions significantly improved colorectal cancer knowledge among low-income participants.
FOBT completion rates increased from 54.7% in controls to 87.5% in the intervention group after the program.
Participants in the intervention group showed enhanced health belief perceptions related to colorectal cancer screening.
Implementing nursing strategies can help reduce health disparities in underserved populations by increasing screening participation.

Abstract

Abstract Background: Colorectal cancer (CRC) is a leading cause of cancer-related morbidity and mortality worldwide. Despite the availability of free national screening programs, participation rates—especially among low-income populations—remain low. This study aimed to assess the effectiveness of a nurse-led educational intervention in improving CRC-related knowledge, health belief perceptions, and Fecal Occult Blood Test (FOBT) uptake among low-income individuals in Turkey. Methods: A quasi-experimental, pre-test/post-test control group design was employed. The study included 128 low-income adults aged 50–70 years, registered at a Family Health Center in Zonguldak, Turkey. Participants were randomly assigned to intervention (n = 64) and control (n = 64) groups. The intervention group received a two-stage, face-to-face educational program based on the Health Belief Model (HBM), including visual materials and FOBT kits. The control group received standard Ministry of Health CRC screening information. Data were collected using the Colorectal Cancer Knowledge Form and the CRC Health Belief Model Scale. FOBT completion was assessed after six weeks. Results: Post-intervention, the intervention group demonstrated significantly higher CRC knowledge scores and improved HBM sub-dimensions (severity, health motivation, confidence-benefit perception) compared to controls (p < 0.05). FOBT completion was also significantly higher in the intervention group (87.5%) than in the control group (54.7%) (χ²=16.765, p < 0.001). Conclusions: The nurse-led educational intervention significantly improved CRC knowledge, health belief perceptions, and FOBT screening behaviors among low-income individuals. Incorporating structured nursing interventions within primary care settings may enhance the effectiveness of national CRC screening programs and reduce health disparities in underserved populations.

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