Table 6.

Patients’ Qualitative Perspectives Related to CRC Screening Barriers, Benefits, Cues to Action, and Self-efficacy (n = 60)

Specific Theory of Planned Behavior Constructs	Representative Patient Quotes
Perceived barriers to CRC screening
Cost/Insurance	“I’ve got crappy insurance. And, if they don’t find if they do it and don’t find. If they do the test and don’t find nothing, its free. But if they go in there and find more polyps, you’re charged so you know.” – Male, age 55-60 “We do live, what I consider these days a third world country we’re, we’re backwoods, so the cost based on the insurances that I’m able to get. I know that it affects me on how often if the doctor does not prescribe it. I won’t volunteer because of the cost.” – Male, age 60-65 “The only thing that stops me on a lot of stuff right now is insurance. I don’t have Medical insurance as of yet. I am disabled and no medical insurance so I have to search around for places that will get me help. That would be the only thing to slow me up.” – Male, age 55-60
Transportation	“Right now I have, there’s four of us living in the house. We normally have two vehicles; we’ve had one broken down since January. Two of the four of us work and vehicles aren’t around when you need it. … I have my two grandsons living here and that’s a tough deal when neither of them have the vehicle. We’re trying to get them to have jobs.” – Female, age 65-70
Not necessary if there aren’t symptoms	“Because if there are no symptoms and no problems of any type, I can’t see just searching in there to have stuff done.” – Female, age 55-60
Fear of diagnosis	“Well you know, sometimes you get it in your head that you don’t really want to know, then you want to know. and you know…you figure that if you know you’re going to be scared to death. Especially if you had a bunch in your family that passed away. I believe that there is a cure out there for cancer but you’ve got to have a whole lot of money to get it.” – Male, age 65-70
Fears and beliefs about the procedure	“Yeah I was scared the first time. Some say they hurt. Some say they didn’t. Fear of the unknown.” – Female, age 55-60 “My brother in law He had one [colonoscopy] and they found some polyps and took i guess a scrape or whatever they did and he got an infection. So that was a pretty big deal for him. It was serious.” – Male, age 65-70 “I’ve got friends that have had colonoscopies that have ended up in ICU because their colon or stomach was damaged during the procedure, and that’s another reason I won’t do it.” – Female, age 65-70
Perceived benefits to CRC screening
Peace of mind because can know or catch early	“The peace of my mind means a lot to me, and the raising of my children. I want to be here for them. As long as I can, and my wife.” – Male, age 60-65 “Because a lot of it is curable, if you catch it in time.” – Male, age 60-64
Cues to action for CRC screening
Trust/respect their provider	“You know I really, really like [provider’s name]. And you know whatever she tells me I try to do it.” – Female, age 60-65
Guidance from provider	“Well I mean as far as actually get the test done I believe that all I would really need to do is get in touch with my doctor and she would make the arrangements and everything for me. I would like to think that. That’s why I said a five.” – Female, age 60-65
If have symptoms	“Well I’ll tell you if I told him I was having any symptoms and he recommended one I would certainly do it.” – Female, age 70-75
Self-efficacy to get a regular CRC screening test
FIT test is simple (high efficacy)	“I didn’t use to like to do that [stool based screening] and then they showed me how easy it was it wasn’t like what I thought it was going to be.” – Female, age 60-65 “It [stool based screening] seems a lot easier with no preparation. No drinking that stuff and having to go to the hospital and having to have a driver. So it would be a lot simpler.” – Female, age 55-60
Self-efficacy to prevent getting CRC
Lack of knowledge (low efficacy)	“I think it’s very serious for anyone to look at especially for someone who doesn’t and understand the causes. Right. I don’t know. I have no clue what would cause colorectal cancer so I wouldn’t have any idea how to you know take general preventative measures.” – Female, age 65-70
Not all factors are in their control (low efficacy)	“I mean nobody is going to prevent something they don’t know is going to happen. What’s going to happen. I mean you know the week after I got back from the gastroenterologist I could’ve got it.” – Male, age 55-60 “Well, I don’t know at this point in my life if I can prevent myself from getting it, you know, I’m 62.” – Female, age 60-65 “Because I for one thing I feel that genetics, genetics have a lot to do with things. And I think screenings alone don’t prevent those things.” – Female, age 65-70