Factors contributing to low readiness and capacity of culturally diverse participants to use the Australian national bowel screening kit

Abstract

Objectives: Bowel screening is an effective way to promote early detection of bowel cancer. Culturally and linguistically diverse (CALD) people face considerable barriers to screening. This qualitative study explored perceptions towards, and usability of, Australia's national bowel screening kit with members of two migrant communities. Methods: Thirty-three people (aged 50-79 years) from Serbian and Macedonian communities in the Illawarra region in New South Wales, Australia, participated in one of five interactive focus group sessions. Sessions used innovative 'customer journey' techniques to understand participants' experience of each step of the faecal occult blood test process. Participants discussed knowledge of bowel cancer and attitudes to screening, and participated in a collective mock use of a test kit. Sessions were audio recorded, transcribed and thematically analysed by two researchers in collaboration with bicultural health workers. Results: Multiple factors contributed to low readiness and capacity to use the kit, including limited promotion of the program in community languages, complicated and poorly sequenced kit instructions, and confusion around the order and labelling of kit components. Participants suggested several ways to improve kits to improve uptake by CALD communities. Conclusion: Simplified and targeted promotion of bowel screening programs in community languages, and improved kit design, may support participation of CALD populations in screening programs.

Novel Toilet Paper–Based Point-Of-Care Test for the Rapid Detection of Fecal Occult Blood: Instrument Validation Study

“…Troublesome operation of stool specimen collection is considered one of the obstacles affecting participation in colorectal cancer screening [ 13 , 32 , 34 , 36 , 37 , 39 ]. In a typical fecal occult blood test, fecal immunochemical-based test, or other stool-based occult blood tests, stool specimen collection is difficult.…”

“…Moreover, current fecal occult blood tests generally require the user to collect fecal specimens using sticks to scoop stool after defecation. This unpleasant process could affect the widespread utilization of fecal occult blood tests for colorectal cancer screening [ 32 - 39 ].…”

Equity across the cancer care continuum for culturally and linguistically diverse migrants living in Australia: a scoping review

“…The detection phase of the cancer care continuum was measured through screening services and reported in twenty-two studies [ 29 – 50 ]. Six studies reported on the barriers and/or facilitators to screening services for cervical, breast and colorectal cancer [ 30 – 32 , 39 – 41 ]. Common barriers identified were lack of screening knowledge, feelings of embarrassment, fear over the gender of health provider, privacy concerns, religious and cultural beliefs, language barriers, fatalistic views of cancer, screening not being promoted in community languages and location of services [ 30 – 32 , 39 , 40 ].…”

Novel Toilet Paper–Based Point-Of-Care Test for the Rapid Detection of Fecal Occult Blood: Instrument Validation Study (Preprint)

“…Troublesome operation of stool specimen collection is considered one of the obstacles affecting participation in colorectal cancer screening [13,32,34,36,37,39]. In a typical fecal occult blood test, fecal immunochemical-based test, or other stool-based occult blood tests, stool specimen collection is difficult.…”

“…Moreover, current fecal occult blood tests generally require the user to collect fecal specimens using sticks to scoop stool after defecation. This unpleasant process could affect the widespread utilization of fecal occult blood tests for colorectal cancer screening [32][33][34][35][36][37][38][39].…”