Social Cognitive Theory

Applying Social Cognitive Theory to Colorectal Cancer Screening

A clinician can use social cognitive theory to promote CRC screening in several ways.

To help encourage positive outcome expectations, you can:

• Explain the purpose of screening in plain language.  Emphasize the fact that screening and follow-up can prevent colon cancer or reduce mortality if cancer is found.
• Give information about what to expect before, during, and after a screening procedure.
• Encourage questions.

To help promote a patient's feelings of self-efficacy, you can:

• Make sure the patient knows when to obtain screening. 
• Provide information on how to make a screening appointment or schedule the appointment directly from your office. 
• Educate the patient about how to do a home test (e.g., a fecal occult blood test) or how to prepare for an in-office screening (e.g., colonoscopy).
• Discuss obstacles such as transportation and insurance coverage, and provide options to help minimize these obstacles when possible.

To take advantage of observational learning and modeling, you can:

• Let your patient know that screening is a standard part of your practice and a common procedure.
• Offer informational materials which relate others’ experiences.  The American Cancer Society (www.cancer.org) has comments on colonoscopy from patients who have experienced it.  Many people are also encouraged by celebrity Katie Couric’s story.  After her husband died from colon cancer, she broadcast her own colonoscopy experience on national television and continues to advocate for screening.

Finally, to provide reinforcement, you can:

• Review the screening results with your patient, making it clear that you value the information obtained.
• Offer praise for making and keeping a screening appointment.  This both provides reinforcement and makes it clear that you consider CRC screening to be an important part of preventive care.