Mail‐out bowel cancer screening: Identifying the behavioural stumbling blocks

Abstract

Objective: To describe the actions taken by recipients of mail-out faecal occult blood test (FOBT) kits and to identify the points at which progress towards kit completion typically stops. Differences according to gender, age, and screening intention were also examined.Methods: 1599 people completed an online survey identifying the actions they took upon receiving an FOBT kit. Latent class analysis was conducted to identify latent subgroups of participants that reported similar actions. Differences between gender, age, and intention status were assessed using non-invariance testing.Results: Four latent subgroups of FOBT invitees were identified: those who complete and return their FOBT kit ('completers'); those who bring the kit into their house but go no further ('ignorers'); those who open the package and read the bowel cancer information materials but go no further ('readers'); and those who read the instructions but do not place the kit near the toilet and do not complete their FOBT kit ('leavers'). Non-completers who intended to use the kit were most likely to be in the 'leavers' class, while those who had no intention were most likely to be in the 'readers' class.Conclusions: Distinct subgroups of non-responders exist among bowel cancer screening invitees, suggesting different behaviour change interventions are needed to facilitate participation. Some invitees, especially those with high participatory intention, are likely to benefit from prompts to take the kit into the toilet, while others, with little participatory intention, often read the invitation materials presenting an opportunity to intervene with health messages.

Psychological distress and bowel cancer screening participation

“…21 Participants responded on a five-point scale ranging from 1 = "none of the time" to 5 = "all of the time". Responses were summed to create a total score and categorized as low (scores of 10-15), moderate, [16][17][18][19][20][21] high, [22][23][24][25][26][27][28][29] or very high distress (30-50).…”

“…This study formed part of a larger research project whereby one survey link was distributed to potential participants directing them to an online survey with multiple components. 25,26 Recruitment and attrition for this study are outlined in Supplementary File 1. The final sample consisted of 479 adults between the ages of 50 and 74 years (M = 61.85, SD = 6.91).…”

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

“…This explanation seems particularly likely for colorectal screening which, unlike other screening tests, is self-completed at home 10 : in a recent Australian survey 64% reported intentions to do the FIT. 11 Systematic reviews demonstrate that interventions supporting people to plan how to enact a behaviour can change the behaviour of inclined abstainers. 12 Planning support interventions have been shown to be more effective than other approaches, such as self-monitoring, 13 and have high adherence rates.…”

“…This explanation seems particularly likely for colorectal screening which, unlike other screening tests, is self-completed at home 10 : in a recent Australian survey 64% reported intentions to do the FIT. 11 …”

“…A major reason may be that people are ‘not getting round to it’8 which is consistent with previous work on ‘inclined abstainers,’9 showing that a proportion of people intending to do screening fail to do it. This explanation seems particularly likely for colorectal screening which, unlike other screening tests, is self-completed at home10: in a recent Australian survey 64% reported intentions to do the FIT 11…”