"I'm not doing that." An in-depth examination of nonparticipation in mail-out bowel cancer screening programs
Document Type
Journal Article
Publication Title
Translational Behavioral Medicine
Volume
10
Issue
6
First Page
1515
Last Page
1524
PubMed ID
31228202
Publisher
Oxford University Press
School
Exercise Medicine Research Institute
RAS ID
45041
Funders
University of Southern Queensland Cancer Council Queensland
Abstract
© Society of Behavioral Medicine 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. Despite a clear association between the early detection of bowel cancer and increased survival, participation in mail-out screening programs is poor. Several key barriers to participation have been identified, yet research has failed to examine the specific cognitions, actions, and individual contexts from which barriers emerge. The purpose of the current study was to gain a detailed understanding of the actual experience of kit receipt from the perspective of nonparticipants including their opinion on interventions that may be effective in promoting participation. Demographic differences in reasons for nonparticipation are also examined. Opt-out data from a national program was analyzed to detect demographic differences in reasons for nonparticipation. Qualitative interviews were conducted in a sample of "at risk" nonparticipants. Thematic analysis was conducted using an inductive phenomenological approach. Older, higher SES, male and previously screened participants were more likely to provide a medical reason for opting out of participation. Four key themes emerged from interview data. The first reflected intention; whereby participants were either intenders (i.e., they planned to participate) or refusers. Subsequent themes reflected practicalities, emotional reactions, and necessity. Differences between intenders and refusers within these themes as well as opinions regarding interventions were identified. Interventions involving interactions with health professionals, autonomous decision making, and those which emphasize the positive outcomes of screening may encourage refusers to participate in mail-out bowel cancer screening programs. Messages that reinforce the importance of screening or provide a practical reminder may be more useful for intenders.
DOI
10.1093/tbm/ibz096
Access Rights
subscription content
Comments
Goodwin, B. C., March, S., Crawford-Williams, F., Chambers, S. K., & Dunn, J. (2020). “I’m not doing that.” An in-depth examination of nonparticipation in mail-out bowel cancer screening programs. Translational Behavioral Medicine, 10(6), 1515-1524. https://doi.org/10.1093/tbm/ibz096