Acceptability of a standalone written leaflet for the National Health Service for England (NHSE) Targeted Lung Health Check Programme: a concurrent, think-aloud study

Jallow, M. et al. (2022) Acceptability of a standalone written leaflet for the National Health Service for England (NHSE) Targeted Lung Health Check Programme: a concurrent, think-aloud study. Health Expectations, 25(4), pp. 1776-1788. (doi: 10.1111/hex.13520) (PMID:35475542) (PMCID:PMC9327842)

Abstract

Background: Many countries are introducing low-dose computed tomography screening programmes for people at high risk of lung cancer. Effective communication strategies that convey risks and benefits, including unfamiliar concepts and outcome probabilities based on population risk are critical to achieving informed choice and mitigating inequalities in uptake. Methods: This study investigated the acceptability of an aspect of NHS England's communication strategy in the form of a leaflet that was used to invite and inform eligible adults about the Targeted Lung Health Check (TLHC) programme. Acceptability was assessed in terms of how individuals engaged with, comprehended, and responded to the leaflet. Semi-structured, ‘think aloud’ interviews were conducted remotely with 40 UK screening-naïve current and former smokers (aged 55-73). The verbatim transcripts were analysed thematically using a coding framework based on the Dual Process Theory of cognition. Results: The leaflet helped participants understand the principles and procedures of screening and fostered cautiously favourable intentions. Three themes captured the main results of the data analysis: (1) Response – participants experienced anxiety about screening results and further investigations, but the involvement of specialist healthcare professionals was reassuring; (2) Engagement – participants were rapidly drawn to information about lung cancer prevalence, and benefits of screening, but deliberated slowly about early diagnosis, risks of screening and less familiar symptoms of lung cancer; (3) Comprehension – participants understood the main principles of the TLHC programme, but some were confused by its rationale and eligibility criteria. Radiation risks, abnormal screening results and numerical probabilities of screening outcomes were hard to understand. Conclusion: The TLHC information leaflet appeared to be acceptable to the target population. There is scope to improve aspects of comprehension and engagement in ways that would support informed choice as a distributed process in lung cancer screening.

• Item Type: Articles
• Additional Information: This study was funded by a grant from Cancer Research UK (C50664/A30770]. SLQ is supported by a Cancer Research UK fellowship (C50664/A24460) and Barts Charity (MRC&U0036). KB and GM are supported by Welsh Government funding via the Health and Care Research Wales’ Primary and Emergency Care Research Centre and Wales Cancer Research Centre. GB is supported by the Health Foundation’s grant to the University of Cambridge for The Healthcare Improvement Studies Institute.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Robb, Professor Katie and Kurtidu, Clara

Creator Roles

Kurtidu, C.: Methodology, Writing – review and editing
Robb, K.: Conceptualization, Methodology, Writing – review and editing, Funding acquisition

• Authors: Jallow, M., Black, G., van Os, S., Baldwin, D. R., Brain, K. E., Donnelly, M., Janes, S. M., Kurtidu, C., McCutchan, G., Robb, K. A., Ruparel, M., and Quaife, S. L.
• College/School: College of Medical Veterinary and Life Sciences; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
• Journal Name: Health Expectations
• Publisher: Wiley
• ISSN: 1369-6513
• ISSN (Online): 1369-7625
• Published Online: 27 April 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in Health Expectations 25(4): 1776-1788
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher