Change in public awareness of colorectal cancer symptoms following the Be Cancer Alert Campaign in the multi-ethnic population of Malaysia

Schliemann, Desiree and Paramasivam, Darishiani and Dahlui, Maznah and Cardwell, Christopher R. and Somasundaram, Saunthari and Tamin, Nor Saleha Binti Ibrahim and Donnelly, Conan and Su, Tin Tin and Donnelly, Michael (2020) Change in public awareness of colorectal cancer symptoms following the Be Cancer Alert Campaign in the multi-ethnic population of Malaysia. BMC Cancer, 20 (1). ISSN 1471-2407, DOI https://doi.org/10.1186/s12885-020-06742-3.

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Abstract

Colorectal cancer (CRC) cases are detected late in Malaysia similar to most Asian countries. The Be Cancer Alert Campaign (BCAC) was a culturally adapted mass media campaign designed to improve CRC awareness and reduce late detection in Malaysia. The evaluation of the BCAC-CRC aimed to assess campaign reach, campaign impact and health service use. Methods Participants aged >= 40 years (n = 730) from randomly selected households in Selangor State Malaysia, completed interview-based assessments. Campaign reach was assessed in terms of responses to an adapted questionnaire that was used in evaluations in other countries. The impact of the campaign was assessed in terms of awareness, confidence to detect symptoms and self-efficacy to discuss symptoms with a doctor as captured by the Cancer Awareness Measure (CAM). CAM was administered before-and-after campaign implementation and responses by BCAC recognisers (i.e. participants who recognised one or more of the BCAC television, radio or print advertisements when prompted) and non-recognisers (i.e. participants who did not recognise any of the BCAC advertisements) were compared analytically. Logistic regression analysed comparative differences in cancer awareness by socio-demographic characteristics and recognition of the BCAC materials. Results Over 65% of participants (n = 484) recognised the BCAC-CRC. Campaign-recognisers were significantly more likely to be aware of each CRC symptom at follow-up and were more confident about noticing symptoms (46.9% vs 34.9%, p = 0.018) compared to non-recognisers. There was no difference between groups in terms of self-efficacy to see a doctor about symptoms. Improved symptoms awareness at follow-up was lower for Indians compared to Malays (adjusted odds ratio (OR) 0.53, 95% Confidence Interval (CI): 0.34, 0.83, p = 0.005). Health service use data did not indicate an increase in screening activity during or immediately after the campaign months. Conclusion Overall, the findings of the evaluation indicated that the culturally adapted, evidence-based mass media intervention improved CRC symptom awareness among the Malaysian population; and that impact is more likely when a campaign operates a differentiated approach that matches modes of communication to the ethnic and social diversity in a population.

Item Type: Article
Funders: UK MRC-Newton Ungku Omar Funding, UK Research & Innovation (UKRI) Medical Research Council UK (MRC) [MR/P013910/1]
Uncontrolled Keywords: Colorectal cancer; Bowel cancer; Awareness; Mass media; Social media; Campaign; TV; Radio; Colonoscopy; iFOBT; Recognition; Effectiveness; Reach; Health promotion; Malaysia
Subjects: R Medicine
Divisions: Faculty of Medicine
Depositing User: Ms Zaharah Ramly
Date Deposited: 04 Oct 2023 07:21
Last Modified: 04 Oct 2023 07:21
URI: http://eprints.um.edu.my/id/eprint/36808

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