BackgroundThe aim of this study was to assess the extent of knowledge of primary health care (PHC) patients about colorectal cancer (CRC), their attitudes toward population-based screening for this disease and gender differences in these respects.MethodsA questionnaire-based survey of PHC patients in the Balearic Islands and some districts of the metropolitan area of Barcelona was conducted. Individuals between 50 and 69 years of age with no history of CRC were interviewed at their PHC centers.ResultsWe analyzed the results of 625 questionnaires, 58% of which were completed by women. Most patients believed that cancer diagnosis before symptom onset improved the chance of survival. More women than men knew the main symptoms of CRC. A total of 88.8% of patients reported that they would perform the fecal occult blood test (FOBT) for CRC screening if so requested by PHC doctors or nurses. If the FOBT was positive and a colonoscopy was offered, 84.9% of participants indicated that they would undergo the procedure, and no significant difference by gender was apparent. Fear of having cancer was the main reason for performance of an FOBT, and also for not performing the FOBT, especially in women. Fear of pain was the main reason for not wishing to undergo colonoscopy. Factors associated with reluctance to perform the FOBT were: (i) the idea that that many forms of cancer can be prevented by exercise and, (ii) a reluctance to undergo colonoscopy if an FOBT was positive. Factors associated with reluctance to undergo colonoscopy were: (i) residence in Barcelona, (ii) ignorance of the fact that early diagnosis of CRC is associated with better prognosis, (iii) no previous history of colonoscopy, and (iv) no intention to perform the FOBT for CRC screening.ConclusionWe identified gaps in knowledge about CRC and prevention thereof in PHC patients from the Balearic Islands and the Barcelona region of Spain. If fears about CRC screening, and CRC per se, are addressed, and if it is emphasized that CRC is preventable, participation in CRC screening programs may improve.

Within the context of promoting the “healthy routes” program, the aim of this study was to validate the urban walkability perception questionnaire (UWPQ) in the Balearic Islands to determine the characteristics of the urban environment that promote walking among the population. The UWPQ measures pedestrian facilities, infrastructures of the environment, perception of safety and a participant’s general opinion. This process was performed in 12 routes predefined by a community participation program and set around the primary health centers. Degree of correlation between the items was calculated. The final internal consistency was 0.8 in all blocks according to the Cronbach's alpha test (p < 0.01). Goodman and Kruskal–gamma correlation coefficient (γ) between the item measuring the general opinion and the rest of the items was significant. The items from the perception of safety and pedestrian facilities blocks were the ones that most affected the final assessment. Those regarding the pedestrianonly pavements, clearly marked pavements, noise, traffic density and parks condition obtained the lowest coefficients. To conclude, the results showed that the UWPQ is a suitable instrument to assess the degree of adequacy of the urban environment for walking. It could contribute to create healthy environments as well as to improve public policies.

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