Abstract / Summary
Abstract Background Interventions targeting intention formation and action implementation are expected to further increase colonoscopy uptake amongst the first-degree relatives (FDRs) of patients with colorectal cancer (CRC). To inform the development of precise and efficient interventions, this study aimed to explore the factors influencing the formation of colonoscopy screening intention and the transition from intention to action amongst Chinese FDRs. Methods Guided by the theory of planned behaviour (TPB), a qualitative descriptive study was conducted between May and June 2025. Maximum variation sampling was used; FDRs with different genders, ages, education levels, occupations, places of residence and colonoscopy screening behaviours were selected. Semistructured interviews were conducted in person or via video call, and data were examined using content analysis. Credibility, transferability, dependability and conformability were considered to ensure study rigour. Results Thirty-two FDRs were recruited from a specialised cancer hospital and two comprehensive hospitals in China. Three categories were identified for the factors influencing the formation of intentions for colonoscopy screening: perceived CRC risk, perceived health value of colonoscopy and advice from others. Four categories were identified for the factors influencing the transition from intention to action: priority of colonoscopy (affected by perceived urgency of colonoscopy and conflict with role responsibilities), information preparation (involving information related to screening procedures), psychological preparation (regarding bowel preparation and anaesthesia) and practical conditions (including personal financial capacity, accessibility to caregiving support and organisational support). Conclusions The factors related to the attitude and subjective norm dimensions of the TPB play a decisive role in the formation of colonoscopy screening intentions amongst FDRs. The factors related to the perceived behavioural control dimension can affect the transition from intention to action. Stratified interventions can be implemented according to whether FDRs have formed an intention to undergo colonoscopy screening. Structural support should be further optimised to improve the accessibility and convenience of colonoscopy screening services.