Is an opportunistic primary care-based intervention for non-responders to bowel screening feasible and acceptable?: A mixed-methods feasibility study in Scotland

Natalia Calanzani; Debbie Cavers; Gabriele Vojt; Sheina  Orbell; Robert J. C. Steele; Linda A. Brownlee; Steve Smith; Julietta  Patnick; David Weller; Christine Campbell

doi:10.1136/bmjopen-2017-016307

Is an opportunistic primary care-based intervention for non-responders to bowel screening feasible and acceptable? A mixed-methods feasibility study in Scotland

Natalia Calanzani (Lead / Corresponding author), Debbie Cavers, Gabriele Vojt, Sheina Orbell, Robert J. C. Steele, Linda A. Brownlee, Steve Smith, Julietta Patnick, David Weller, Christine Campbell

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Abstract

Objectives: We aimed to test whether a brief, opportunistic intervention in general practice was a feasible and acceptable way to engage with bowel screening non-responders.

Design: This was a feasibility study testing an intervention which comprised a brief conversation during routine consultation, provision of a patient leaflet and instructions to request a replacement faecal occult blood test kit. A mixed-methods approach to evaluation was adopted. Data were collected from proformas completed after each intervention, from the Bowel Screening Centre database and from questionnaires. Semi-structured interviews were carried out. We used descriptive statistics, content and framework analysis to determine intervention feasibility and acceptability.

Participants: Bowel screening non-responders (as defined by the Scottish Bowel Screening Centre) and primary care professionals working in five general practices in Lothian, Scotland.

Primary and secondary outcome measures: Several predefined feasibility parameters were assessed, including numbers of patients engaging in conversation, requesting a replacement kit and returning it, and willingness of primary care professionals to deliver the intervention.

Results: The intervention was offered to 258 patients in five general practices: 220 (87.0%) engaged with the intervention, 60 (23.3%) requested a new kit, 22 (8.5%) kits were completed and returned. Interviews and questionnaires suggest that the intervention was feasible, acceptable and consistent with an existing health prevention agenda. Reported challenges referred to work-related pressures, time constraints and practice priorities.

Conclusions: This intervention was acceptable and resulted in a modest increase in non-responders participating in bowel screening, although outlined challenges may affect sustained implementation. The strategy is also aligned with the increasing role of primary care in promoting bowel screening.

Original language	English
Article number	e016307
Pages (from-to)	1-12
Number of pages	12
Journal	BMJ Open
Volume	7
Issue number	10
DOIs	https://doi.org/10.1136/bmjopen-2017-016307
Publication status	Published - 1 Oct 2017

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Calanzani, N., Cavers, D., Vojt, G., Orbell, S., Steele, R. J. C., Brownlee, L. A., Smith, S., Patnick, J., Weller, D., & Campbell, C. (2017). Is an opportunistic primary care-based intervention for non-responders to bowel screening feasible and acceptable? A mixed-methods feasibility study in Scotland. BMJ Open, 7(10), 1-12. Article e016307. https://doi.org/10.1136/bmjopen-2017-016307

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title = "Is an opportunistic primary care-based intervention for non-responders to bowel screening feasible and acceptable?: A mixed-methods feasibility study in Scotland",

abstract = "Objectives: We aimed to test whether a brief, opportunistic intervention in general practice was a feasible and acceptable way to engage with bowel screening non-responders.Design: This was a feasibility study testing an intervention which comprised a brief conversation during routine consultation, provision of a patient leaflet and instructions to request a replacement faecal occult blood test kit. A mixed-methods approach to evaluation was adopted. Data were collected from proformas completed after each intervention, from the Bowel Screening Centre database and from questionnaires. Semi-structured interviews were carried out. We used descriptive statistics, content and framework analysis to determine intervention feasibility and acceptability.Participants: Bowel screening non-responders (as defined by the Scottish Bowel Screening Centre) and primary care professionals working in five general practices in Lothian, Scotland.Primary and secondary outcome measures: Several predefined feasibility parameters were assessed, including numbers of patients engaging in conversation, requesting a replacement kit and returning it, and willingness of primary care professionals to deliver the intervention.Results: The intervention was offered to 258 patients in five general practices: 220 (87.0%) engaged with the intervention, 60 (23.3%) requested a new kit, 22 (8.5%) kits were completed and returned. Interviews and questionnaires suggest that the intervention was feasible, acceptable and consistent with an existing health prevention agenda. Reported challenges referred to work-related pressures, time constraints and practice priorities.Conclusions: This intervention was acceptable and resulted in a modest increase in non-responders participating in bowel screening, although outlined challenges may affect sustained implementation. The strategy is also aligned with the increasing role of primary care in promoting bowel screening.",

author = "Natalia Calanzani and Debbie Cavers and Gabriele Vojt and Sheina Orbell and Steele, {Robert J. C.} and Brownlee, {Linda A.} and Steve Smith and Julietta Patnick and David Weller and Christine Campbell",

note = "This work was supported by Cancer Research UK (grant reference number C12357/A13965) through the National Awareness and Early Diagnosis Initiative (NAEDI-2). The funder had no role in the design, collection, analysis, and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication.",

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Calanzani, N, Cavers, D, Vojt, G, Orbell, S, Steele, RJC, Brownlee, LA, Smith, S, Patnick, J, Weller, D & Campbell, C 2017, 'Is an opportunistic primary care-based intervention for non-responders to bowel screening feasible and acceptable? A mixed-methods feasibility study in Scotland', BMJ Open, vol. 7, no. 10, e016307, pp. 1-12. https://doi.org/10.1136/bmjopen-2017-016307

Is an opportunistic primary care-based intervention for non-responders to bowel screening feasible and acceptable? A mixed-methods feasibility study in Scotland. / Calanzani, Natalia (Lead / Corresponding author); Cavers, Debbie; Vojt, Gabriele et al.
In: BMJ Open, Vol. 7, No. 10, e016307, 01.10.2017, p. 1-12.

Research output: Contribution to journal › Article › peer-review

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T2 - A mixed-methods feasibility study in Scotland

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AU - Cavers, Debbie

AU - Vojt, Gabriele

AU - Orbell, Sheina

AU - Steele, Robert J. C.

AU - Brownlee, Linda A.

AU - Smith, Steve

AU - Patnick, Julietta

AU - Weller, David

AU - Campbell, Christine

N1 - This work was supported by Cancer Research UK (grant reference number C12357/A13965) through the National Awareness and Early Diagnosis Initiative (NAEDI-2). The funder had no role in the design, collection, analysis, and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication.

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Y1 - 2017/10/1

N2 - Objectives: We aimed to test whether a brief, opportunistic intervention in general practice was a feasible and acceptable way to engage with bowel screening non-responders.Design: This was a feasibility study testing an intervention which comprised a brief conversation during routine consultation, provision of a patient leaflet and instructions to request a replacement faecal occult blood test kit. A mixed-methods approach to evaluation was adopted. Data were collected from proformas completed after each intervention, from the Bowel Screening Centre database and from questionnaires. Semi-structured interviews were carried out. We used descriptive statistics, content and framework analysis to determine intervention feasibility and acceptability.Participants: Bowel screening non-responders (as defined by the Scottish Bowel Screening Centre) and primary care professionals working in five general practices in Lothian, Scotland.Primary and secondary outcome measures: Several predefined feasibility parameters were assessed, including numbers of patients engaging in conversation, requesting a replacement kit and returning it, and willingness of primary care professionals to deliver the intervention.Results: The intervention was offered to 258 patients in five general practices: 220 (87.0%) engaged with the intervention, 60 (23.3%) requested a new kit, 22 (8.5%) kits were completed and returned. Interviews and questionnaires suggest that the intervention was feasible, acceptable and consistent with an existing health prevention agenda. Reported challenges referred to work-related pressures, time constraints and practice priorities.Conclusions: This intervention was acceptable and resulted in a modest increase in non-responders participating in bowel screening, although outlined challenges may affect sustained implementation. The strategy is also aligned with the increasing role of primary care in promoting bowel screening.

AB - Objectives: We aimed to test whether a brief, opportunistic intervention in general practice was a feasible and acceptable way to engage with bowel screening non-responders.Design: This was a feasibility study testing an intervention which comprised a brief conversation during routine consultation, provision of a patient leaflet and instructions to request a replacement faecal occult blood test kit. A mixed-methods approach to evaluation was adopted. Data were collected from proformas completed after each intervention, from the Bowel Screening Centre database and from questionnaires. Semi-structured interviews were carried out. We used descriptive statistics, content and framework analysis to determine intervention feasibility and acceptability.Participants: Bowel screening non-responders (as defined by the Scottish Bowel Screening Centre) and primary care professionals working in five general practices in Lothian, Scotland.Primary and secondary outcome measures: Several predefined feasibility parameters were assessed, including numbers of patients engaging in conversation, requesting a replacement kit and returning it, and willingness of primary care professionals to deliver the intervention.Results: The intervention was offered to 258 patients in five general practices: 220 (87.0%) engaged with the intervention, 60 (23.3%) requested a new kit, 22 (8.5%) kits were completed and returned. Interviews and questionnaires suggest that the intervention was feasible, acceptable and consistent with an existing health prevention agenda. Reported challenges referred to work-related pressures, time constraints and practice priorities.Conclusions: This intervention was acceptable and resulted in a modest increase in non-responders participating in bowel screening, although outlined challenges may affect sustained implementation. The strategy is also aligned with the increasing role of primary care in promoting bowel screening.

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DO - 10.1136/bmjopen-2017-016307

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JO - BMJ Open

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ER -

Is an opportunistic primary care-based intervention for non-responders to bowel screening feasible and acceptable? A mixed-methods feasibility study in Scotland

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