What are common barriers and helpful solutions to colorectal cancer screening? A cross-sectional survey to develop intervention content for a planning support tool

Kotzur, M. , MacDonald, S. , O'Carroll, R. E., O'Connor, R. C. , Irvine, A., Steele, R. J. C. and Robb, K. A. (2022) What are common barriers and helpful solutions to colorectal cancer screening? A cross-sectional survey to develop intervention content for a planning support tool. BMJ Open, 12(9), e062738. (doi: 10.1136/bmjopen-2022-062738) (PMID:36691140) (PMCID:PMC9445780)

Abstract

Objective: Colorectal screening using faecal immunochemical tests (FITs) can save lives if the people invited participate. In Scotland, most people intend to complete a FIT but this is not reflected in uptake rates. Planning interventions can bridge this intention-behaviour gap. To develop a tool supporting people willing to do colorectal screening with planning to complete a FIT, this study aimed to identify frequently experienced barriers and solutions to these barriers. Design: This is a cross-sectional study. Setting: Participants were recruited through the Scottish Bowel Screening Programme to complete a mailed questionnaire. Participants: The study included 2387 participants who had completed a FIT (mean age 65 years, 40% female) and 359 participants who had not completed a FIT but were inclined to do so (mean age 63 years, 39% female). Outcome measures: The questionnaire assessed frequency of endorsement of colorectal screening barriers and solutions. Results: Participants who had not completed a FIT endorsed significantly more barriers than those who had completed a FIT, when demographic, health and behavioural covariates were held constant (F(1,2053)=13.40, p<0.001, partial η2=0.01). Participants who completed a FIT endorsed significantly more solutions than those who did not (U=301 585.50, z=−3.21, p<0.001, r=0.06). This difference became insignificant when covariates were controlled. Participants agreed on the most common barriers and solutions regardless of screening history. Barriers included procrastination, forgetting, fear of the test result, screening anxiety, disgust and low self-efficacy. Solutions included hand-washing, doing the FIT in private, reading the FIT instructions, benefit of early detection, feelings of responsibility, high self-efficacy and seeing oneself as a person who looks after one’s health. Conclusion: This survey identified six barriers and seven solutions as key content to include in the development of a planning tool for colorectal screening using the FIT. Participatory research is required to codesign an engaging and accessible planning tool.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: O'Connor, Professor Rory and O'Carroll, Prof Ronan and Robb, Professor Katie and Macdonald, Professor Sara and Kotzur, Dr Marie
• Authors: Kotzur, M., MacDonald, S., O'Carroll, R. E., O'Connor, R. C., Irvine, A., Steele, R. J. C., and Robb, K. A.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
• Journal Name: BMJ Open
• Publisher: BMJ Publishing Group
• ISSN: 2044-6055
• ISSN (Online): 2044-6055
• Published Online: 05 September 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in BMJ Open 12(9): e062738
• Publisher Policy: Reproduced under a Creative Commons License

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
300434		Increasing Uptake Of Bowel Cancer Screening: Development And Trial Of A FIT Planning Support Tool	Kathryn Robb	Office of the Chief Scientific Adviser (CSO)	HIPS/17/23	HW - General Practice and Primary Care