The role of need for control and self-reliance in gender and age differences in bowel cancer screening participation

Objective To examine the relationships between need for control and self-reliance and barriers to bowel cancer screening to better understand the reasons for lower bowel cancer screening adherence in males and younger individuals. Methods Participants (n = 506) aged between 54 and 75 years old completed an online survey measuring demographic information, the four-factor Barriers to Home Bowel Cancer Screening Scale (BB-CanS) and a measure of Need for Control and Self-Reliance (NCSR). Model fit statistics were compared for seven path models testing the relationships between NCSR and BB-CanS factors and the moderating and mediating effects of age and gender. Results Models where age and gender were included as moderators showed the best fit. When compared to females and those under 60 years of age, stronger positive associations between NCSR and BB-CanS factors were evident among males (beta(avoidance) = 0.539, p < 0.001); beta(disgust) = 0.558, p 0.001; beta(difficulty) = 0.489, p 0.001; beta(autonomy) = 0.619, p = 0.002) and those over 60 years of age (beta(avoidance) = 0.400, p < 0.001); beta(disgust) = 0.462, p 0.001; beta(difficulty) = 0.447, p 0.001; beta(autonomy) = 0.378, p < 0.001. Conclusions When encouraging males and people aged 60 years and over to participate in bowel cancer screening, public health messages may benefit from conveying preventative health behaviour and cancer screening participation as actions that reflect self-control and self-reliance.

Automated summary

This study aims to examine the relationships between need for control and self-reliance and barriers to bowel cancer screening, in order to better understand the reasons for lower adherence to screening among males and younger individuals. The findings show that stronger positive associations between need for control and self-reliance and barriers to screening were evident among males and those over 60 years of age. Therefore, when encouraging males and individuals over 60 to participate in bowel cancer screening, public health messages may benefit from emphasizing the importance of self-control and self-reliance in preventive health behavior and screening participation.