What goes up, must come down?
By Sam G Smith, on 8 September 2011
Plans to complete a Bowel Cancer Screening test reduce after exposure to the nitty gritty of the test
We all make plans to do things that are good for us, whether it is going for the Sunday morning jog, eating an extra spoonful of greens or saying no to that second (third or fourth!) drink in the pub. The problem is, when the time comes to actually doing whatever it is we’ve been promising ourselves and others to do, all those good intentions seem to disappear as quickly as they arrived. For the runners among you that have woken only to be faced with a dark and drizzly January morning, you will know what it is that I’m talking about.
So why is it that some people are able to overcome hurdles like the miserable weather, the unappealing sight boiled cabbage and the luring temptation of that extra glass of bubbly? Here at the HBRC we are particularly interested in attempting to answer that question by researching how the perception of time influences people’s behaviour. Some people are always looking towards the future and always want to be prepared for what is to come. Others just want to live for the moment and prefer not to think about what could be round the corner. Interestingly, this appears to be a relatively stable personality characteristic and it is linked to how we feel about behaving in certain ways.
We have recently shown how plans to complete a bowel cancer screening test are affected by time perceptions. Completing a bowel cancer screening kit requires overcoming some pretty immediate obstacles (handling faeces being the most obvious to spring to mind). In addition, the benefits of doing the test won’t be experienced for at least one month (when you hopefully receive a reassuring all-clear letter), or worse, in several years’ time (when you have successfully lived for five years after your bowel cancer treatment). The question we wanted to answer was whether the same people that are able to get out of bed on a cold January morning ready for a 5 mile run, are better able to overcome the short term obstacles of a bowel cancer screening test. In other words, is the ability to look towards the future influencing decisions to complete a bowel cancer screening kit?
We presented some snippets of information to over 200 volunteer middle aged adults (i.e. the group approaching screening age) and asked them after each statement to report ‘how likely it is that you would take part in the screening programme’ (see box 1 for the statements we showed people). Our findings showed how certain parts of the screening programme (e.g. completing it at home) were appreciated, and after finding this out the volunteers increased the strength of their plans. However, once participants were gradually informed about the nitty gritty of the test, people started to waiver. Motivation rapidly declined once people realised they had to collect a sample of faeces and hit a second low when they were informed that the test requires this to be done three times.
|Box 1 – Description of the test|
|1. The NHS has introduced a screening test for men and women of a similar age group|
|2. This test can detect colorectal cancer and pre-cancerous signs of colorectal cancer|
|3. This test is self-administered in your own home|
|4. This test provides a simple way for you to collect small samples of your bowel motions|
|5. This test involves you collecting your stools in a plastic tub and sampling them for tiny amounts of blood|
|6. This test involves smearing a sample of faeces onto the test kit using a cardboard stick|
|7. The test involves sampling three separate bowel movements within 14 days|
|8. Pictorial description of the test|
Perhaps most interestingly is that people that prefer to live for the moment were more put off by completing it three times and by some photos explaining how to complete the test kit. This enables us to pinpoint the exact stage at which motivation is reduced the most, allowing us to intervene and help people overcome these obstacles. While this is an exciting finding (even if we do say so ourselves!), it doesn’t explain why those who prefer to stay in the present reduce their motivation faster than others. Is it because they were more put off by the short term obstacles that might affect their short term plans? Or were they just less able to see how beneficial it might be for them in the future? Our analysis seems to suggest that as always, it might be a bit of both. So back to work it is for us, but not before that five mile run I told you about. Anyone?
Von Wagner, C., Good, A., Smith, S. G., Wardle, J. (in press) Responses to procedural information about colorectal screening using Faecal Occult Blood testing: the role of consideration of future consequences. Health Expectations. DOI: 10.1111/j.1369-7625.2011.00675.x