Declining the offer of flexible sigmoidoscopy screening for bowel cancer:

The view from two sides: a qualitative study of community and medical perspectives on screening for colorectal cancer using FOBT

“…Participation was motivated by the wish to stay healthy, while non-participants described their current personal well-being and low perceived susceptibility to developing CRC as reasons for not utilising the FOBT. Similar to the findings of McCaffery et al [19], the majority of non-participants considered themselves to be healthy and argued that screening was therefore unnecessary (i.e., screening is only for the sick or unhealthy). This reflects a limited understanding of the intention of screening to detect illness at an asymptomatic stage and the potential benefits of early detection [17 and 36].…”

“…Both those who underwent FOBT screening and those who declined were approached by their GP and asked to participate in this study. The researchers were clearly aligned with the screening program and socially desirable responses can often be a problem in this context [19]. Efforts were made to reassure all people willing to be interviewed that their decision to participate or not in screening was respected.…”

“…Given the potential sensitivity of some of the issues associated with non-participation, it was decided to use telephone interviewing. This approach has been used successfully with older people who had declined flexible sigmoidoscopy [19]. It allowed people to discuss potentially sensitive issues and decision-making while maintaining some level of anonymity.…”

It’s hard to reach the “hard-to-reach”: the challenges of recruiting people who do not access preventative healthcare services into interview studies

“…A number of studies have described identifying non-attendeers from health records held by service providers and contacting the individuals directly by phone or letter to invite them to participate (Hall et al, 2015; McCaffery et al, 2001; Oscarsson, Mijma, & Benzein, 2008). Other studies have described forging links with community leaders to access their networks and approach individuals directly (Quaife, Marlow, McEwen, Janes, & Wardle, 2016) or have offered financial incentives to encourage participation (Ellis et al, 2015).…”

“…The article reports that forty-one interviews were conducted but states that low response rates meant they had to contact additional patients; further reflection on this issue would be useful for other researchers wanting to replicate this approach. Similarly, McCaffery et al (2001) describe recruiting individuals uninterested in attending bowel cancer screening. Potential participants were contacted by telephone and a sample of sixty were recruited.…”