Predictors of intention translation in flexible sigmoidoscopy screening for colorectal cancer

Objective: This prospective study aimed to identify predictors of intention and subsequent attendance of flexible sigmoidoscopy screening using constructs derived from the Health Belief Model (HBM). Method: A total of 4,330 people aged 54 years and registered at 1 of 83 participating English general practices were sent a preinvitation questionnaire to assess sociodemographics, HBM variables including perceived benefits, barriers, seriousness, health motivation, and external cues to action as well a range of other constructs and personal characteristics known to relate to cancer screening. Results: Of the 1,578 respondents (36.4%), 1,555 (98.5%) answered the intention question: 52.9% stated definitely yes, 38.1% probably yes, 6.8% probably not, and 2.2% definitely not. Intentions were positively associated with a higher score on a scale of benefits (odds ratio [OR] = 4.62; 95% confidence intervals [CI; 3.24, 6.59]) and health motivation, that is, interest in other ways of preventing colorectal cancer (OR = 2.61; 95% CI [1.62, 4.22]), while a higher score on perceived barriers (OR = 0.19; 95% CI [0.12, 0.31]) and currently following recommended healthy lifestyle behaviors (OR = 0.31; 95% CI [0.16, 0.59]) were negatively associated. Attendance was verified for 922 intenders (65.2%) of whom 737 (79.9%) attended. Attendance was predicted by health motivation (OR = 1.75; 95% CI [1.07, 2.86]), perceived benefits (OR = 1.82; 95% CI [1.37, 2.43]), perceived barriers (OR = 0.47; 95% CI [0.32, 0.69]), individual-level deprivation (OR = 0.26; 95% CI [0.14, 0.50]), and having diabetes (OR = 0.48; 95% CI [0.25, 0.94]). Conclusion: This study supported the usefulness of the HBM in predicting cancer screening and was further enhanced by adding non-HBM variables such as individual socioeconomic deprivation and comorbidities

Barriers to bowel scope (flexible sigmoidoscopy) screening: a comparison of non-responders, active decliners and non-attenders

Background Participation in bowel scope screening (BSS) is low (43%), limiting its potential to reduce colorectal cancer (CRC) incidence and mortality. This study aimed to quantify the prevalence of barriers to BSS and examine the extent to which these barriers differed according to non-participant profiles: non-responders to the BSS invitation, active decliners of the invitation, and non-attenders of confirmed appointments. Methods Individuals invited for BSS between March 2013 and December 2015, across 28 General Practices in England, were sent a questionnaire. Questions measured initial interest in BSS, engagement with the information booklet, BSS participation, and, where applicable, reasons for BSS non-attendance. Chi-square tests of independence were performed to examine the relationship between barriers, non-participant groups and socio-demographic variables. Results 1478 (45.8%) questionnaires were returned for analysis: 1230 (83.2%) attended screening, 114 (7.7%) were non-responders to the BSS invitation, 100 (6.8%) were active decliners, and 34 (2.3%) were non-attenders. Non-responders were less likely to have read the whole information booklet than active decliners (x2 (2, N = 157) = 7.00, p = 0.008) and non-attenders (x2 (2, N = 101) = 8.07, p = 0.005). Non-responders also had lower initial interest in having BSS than either active decliners (x2 (2, N = 213) = 6.07, p = 0.014) or non-attenders (x2 (2, N = 146) = 32.93, p

Uptake of Bowel Scope (Flexible Sigmoidoscopy) Screening in the English National Programme: the first 14 months

Objective To examine uptake in the first six pilot centres of the English Bowel Scope Screening (BSS) programme, which began in early 2013 and invites adults aged 55 for a one off Flexible Sigmoidoscopy. Methods Between March 2013 and May 2014 the six pilot centres sent 21,187 invitations. Using multivariate logistic regression analysis, we examined variation in uptake by gender, socioeconomic deprivation (using the Index of Multiple Deprivation), area-based ethnic diversity (proportion of non-white residents), screening centre, and appointment time (routine: daytime vs out-of-hours: evening/weekend). Results Uptake was 43.1%. Men were more likely to attend than women (45% vs 42%; OR 1.136, 95% CI 1.076, 1.199, p

RF25 The role of social networks in weight management interventions during pregnancy and postpartum for women who are overweight and obese: a systematic review

Background: Maternal obesity is a growing public health issue. It is associated with pregnancy and birth complications and increased risk for childhood and long-term obesity. Interventions focusing on individual behaviour change have had a modest impact on clinical outcomes. There is increasing evidence that social networks are an important driver of obesityrelated behaviours. The aim of this systematic review is to explore the effectiveness of lifestyle interventions that use social networks for weight management and to explore participants’ experiences, and the process outcomes of these interventions. Methods: MEDLINE, PsychINFO, EMBASE, Cochrane, CENTRAL and CINAHL databases were searched as well as reference lists of included studies. Eligibility criteria included: intervention studies with a comparator group and qualitative studies/process evaluations of the included intervention studies; pregnant or postnatal women (<2 years) with BMI >25 kg/m2 ; a lifestyle intervention with a social network component; and a gestational or postpartum weight outcome. Protocol papers were included to aid extraction of intervention components and behaviour change techniques (BCTs). Articles were screened by two independent reviewers. Data extraction is ongoing and studies will be assessed for quality and risk of bias. BCTs and social network functions are also being coded by two reviewers and will be summarised in tables. We will assess heterogeneity and, if possible, a random-effects meta-analysis and a priori specified subgroup analyses will be conducted. We will carry out a narrative synthesis. Results: A total of 10 211 records were identified from databases with 73 full-text articles and another 25 identified from references screened. 30 articles (15 studies) were included. 8 potentially relevant studies are ongoing or results have not yet been published. Searches will be rerun before the final analyses. Preliminary findings are that the interventions are heterogeneous but most were group-based and delivered face-to-face. Interventions often advised on obtaining social support from existing social network (e.g. family), arranged support through created social networks (e.g. group of mothers) and a few directly involved the participants’ partner in the intervention. None used social network data to accelerate behaviour change among participants. Conclusion: Interventions often include social support from existing or created social networks as a BCT. There is a lack of interventions that purposefully utilise social network data. More qualitative research with participants and process evaluations are required. The findings of this review will be used to inform the development of a weight management intervention that mobilises social networks for behaviour change

Additional file 2: of Using a hypothetical scenario to assess public preferences for colorectal surveillance following screening-detected, intermediate-risk adenomas: annual home-based stool test vs. triennial colonoscopy

Questionnaire items relating to surveillance. (DOCX 1099 kb