Validation of an instrument to assess barriers to care-seeking for accidental bowel leakage in women: the BCABL questionnaire

Brown, Heidi W.; Wise, Meg; Westenberg, Danielle; Schmuhl, Nicholas B.; Brezoczky, K. L.; Rogers, Rebecca G.; Constantine, Melissa L.

doi:10.1007/s00192-016-3261-8

Cited by 5 publications

(8 citation statements)

References 18 publications

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“…This suggestion of broad potential reach, especially among women who already use the Internet for health information and among women with a higher BMI, is especially important because obesity is a barrier to care seeking for incontinence. 18 Given that stigma is a known barrier to seeking medical health care for bowel 19,20 and bladder incontinence, 21,22 it is not surprising that the desire for privacy drove women's preference for the online format. Respondents offered suggestions to improve accountability and skill building and to incorporate an interactive forum option to overcome some of the disadvantages of an online program.…”

Section: Discussionmentioning

confidence: 99%

Reasons Behind Preferences for Community-Based Continence Promotion

Brown

Wise

LeCaire³

et al. 2020

Female Pelvic Med Reconstr Surg

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Objectives-This study aimed to understand the potential reach of continence promotion intervention formats among incontinent women. Methods-The Survey of the Health of Wisconsin conducts household interviews on a population-based sample. In 2016, 399 adult women were asked about incontinence and likelihood of participation in continence promotion via 3 formats: single lecture, interactive 3-session workshop, or online. Descriptive analyses compared women likely versus unlikely to participate in continence promotion. To understand format preferences, modified grounded theory was used to conduct and analyze telephone interviews. Results-One hundred eighty-seven (76%) of 246 incontinent women reported being likely to attend continence promotion: 111 (45%) for a single lecture, 43 (17%) for an interactive 3-session workshop, and 156 (64%) for an online program. Obesity, older age, nonwhite race, prior health program participation, and Internet use for health information were associated with reported continence promotion participation. Cited advantages of a single lecture included convenience and ability to ask questions. A workshop offered accountability, hands-on learning, and opportunity to learn from others; online format offered privacy, convenience, and self-directed learning.

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Section: Discussionmentioning

confidence: 99%

Reasons Behind Preferences for Community-Based Continence Promotion

Brown

Wise

LeCaire³

et al. 2020

Female Pelvic Med Reconstr Surg

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“…To understand care-seeking during the study period and intention moving forward, the 4 months questionnaire asked, “Have you talked to a health care provider (like a doctor or nurse practitioner) about accidental urine leakage in the last 4 months?” and “Do you plan to talk to a health care provider about accidental urine leakage in the next 6 months?” with similar language for bowel leakage. Participants completed the Barriers to Care seeking for Accidental Bowel Leakage Questionnaire 22 and the Barriers to Incontinence Care seeking Questionnaire 23 on the baseline and 4 months questionnaires. The Geriatric Self-Efficacy for Urinary Incontinence 24 assessed self-efficacy to control urinary symptoms and the Patient Health Questionnaire assessed depression 25 at baseline and 4 months.…”

Section: Methodsmentioning

confidence: 99%

“…with similar language for bowel leakage. Participants completed the Barriers to Care seeking for Accidental Bowel Leakage Questionnaire 22 and © 2019 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc.…”

Section: Methodsmentioning

confidence: 99%

Small-Group, Community-Member Intervention for Urinary and Bowel Incontinence

Brown

Braun

Wise

et al. 2019

Obstetrics &Amp; Gynecology

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OBJECTIVE: To evaluate the effects of Mind Over Matter: Healthy Bowels, Healthy Bladder, a small-group intervention, on urinary and bowel incontinence symptoms among older women with incontinence. METHODS: In this individually randomized group treatment trial, women aged 50 years and older with urinary, bowel incontinence, or both, were randomly allocated at baseline to participate in Mind Over Matter: Healthy Bowels, Healthy Bladder immediately (treatment group) or after final data collection (waitlist control group). The primary outcome was urinary incontinence (UI) improvement on the Patient Global Impression of Improvement at 4 months. Validated instruments assessed incontinence, self-efficacy, depression, and barriers to care-seeking. Intent-to-treat analyses compared differences between groups. Target sample size, based on an anticipated improvement rate of 45% in treated women vs 11% in the control group, 90% power, type I error of 0.05, with anticipated attrition of 25%, was 110. RESULTS: Among 121 women randomized (62 treatment group; 59 control group), 116 (95%) completed the 4-month assessment. Most participants were non-Hispanic white (97%), with a mean age of 75 years (SD 9.2, range 51–98); 66% had attended some college. There were no significant between-group differences at baseline. At 4 months, 71% of treated women vs 23% of women in the control group reported improved UI on Patient Global Impression of Improvement (P<.001); 39% vs 5% were much improved (P<.001). Regarding bowel incontinence, 55% of treated women vs 27% of women in the control group improved on Patient Global Impression of Improvement (P<.005), with 35% vs 11% reporting much improvement (P<.005). Treated women improved significantly more than women in the control group on all validated instruments of incontinence severity, quality of life, and self-efficacy. Care-seeking rates were similar between groups. CONCLUSION: Participation in a small-group intervention improves symptoms of both urinary and bowel incontinence in older women. Mind Over Matter is a feasible model with potential to bring effective behavioral solutions to the community. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, .

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“…Brown et al elegantly review the subject in this issue of the International Urogynecology Journal [8]. The authors discuss the strengths and weaknesses of current methods evaluating barriers to seeking care in women with FI or Baccidental bowl leakage^.…”

mentioning

confidence: 99%

“…The most significant value of the BCABL questionnaire , however, is that it combines in one instrument barriers to seeking care with condition-specific, patient action and care experience factors. This allows the health-care provider to gauge care-seeking patterns in women with FI in relation to disease severity as well as other important variables [8]. Prospective evaluation of respondents over time can assess the effectiveness of public health endeavors to influence health behavior, promote care seeking and enhance health services utilization [5].…”

mentioning

confidence: 99%

Towards a more scientific approach to measuring barriers to seeking health care in women with fecal incontinence: the BCABL questionnaire

Rizk

2017

Int Urogynecol J

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Although barriers to seeking care in women with fecal incontinence (FI) have been identified consistently in the literature [1][2][3][4], research on this topic is inadequate for methodological reasons. Most importantly, there is currently no validated technique for reproducible measurement of these barriers. Furthermore, barriers to seeking incontinence care, whether urinary or fecal, are influenced by confounding anthropological and societal variables including ethnicity, culture, geopolitical orientation, indigenous psychology, personality and the individual's understanding of health, experience of health and illness, and health services utilization [5,6]. Hence, most of the available qualitative research data on care seeking, that is primarily based on thematic or deductive analysis of patient narratives, is not able to demonstrate the full impact of each care barrier with a significant overlap between barriers [4]. Another major problem is the assumption that care seeking is primarily dependent on the severity of FI without further critical evaluation of this observation or factor analysis to determine the contribution of other condition-specific quality of life measures [2]. In fact, mild FI is sometimes a greater problem for affected women than severe incontinence [7]. Finally, survey instruments to assess the epidemiology of FI are limited by differences in definition (incontinence to feces versus incontinence to feces and flatus, or incontinence only versus incontinence and fecal soiling), onset (over the last month or last year), severity (whether or not a social or hygienic problem) and frequency (daily or episodic) [2,7].It is obvious that we lack a validated and structured method to measure factors interfering with care seeking in women with FI and that we need a robust scientific approach to the development of a new research tool. Brown et al. elegantly review the subject in this issue of the International Urogynecology Journal [8]. The authors discuss the strengths and weaknesses of current methods evaluating barriers to seeking care in women with FI or Baccidental bowl leakage^. They test the validity of a questionnaire designed to measure 12 barriers to seeking care for FI identified by the group through previous focus group discussions with 29 women and cognitive interviews with 10 women with FI. A final questionnaire was constructed comprising 42 potential items about condition severity, patient activation (knowledge level, skills and coping), prior care seeking and demographics, and was administered via an electronic survey to a cohort of women with FI who were already enrolled as consumers in a health industry database. Based on an a priori calculation of the study power, a convenience sample of 427 women completed the questionnaire at baseline, and 182 of these women repeated the test after 2 weeks. The psychometric properties were examined using rigorous statistical methodology. Test-retest reliability and criterion validity were excellent for all items with a final questionnaire structure...

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Validation of an instrument to assess barriers to care-seeking for accidental bowel leakage in women: the BCABL questionnaire

Cited by 5 publications

References 18 publications

Reasons Behind Preferences for Community-Based Continence Promotion

Reasons Behind Preferences for Community-Based Continence Promotion

Small-Group, Community-Member Intervention for Urinary and Bowel Incontinence

Towards a more scientific approach to measuring barriers to seeking health care in women with fecal incontinence: the BCABL questionnaire

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