Retrospective coding of health care professional cancer screening behaviours and of real-world interventions designed to support them: Identifying recommendations to optimize intervention design

Andria Hanbury*, Anna Sallis, Tim Chadborn, Mick Arber, Alice Sanderson, Caroline Durlik, Hannah Wood

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Screening can detect cancer earlier. Uptake of breast, cervical, and bowel cancer screening in England is below 75%. This study identifies the barriers and facilitators underpinning HCP screening behaviours which can support screening uptake, and reviews the design of real-world interventions targeting these, assessing for congruence between the two. The aim was to provide recommendations to improve the design of interventions. Design and methods: Barriers/facilitators were identified by a literature review and qualitatively coded using the theoretical domains framework (TDF). Interventions were identified by stakeholders and coded using the behaviour change wheel and the taxonomy of behaviour change techniques. Congruence was assessed through comparing the intervention designs with behavioural science experts’ recommendations which link the TDF domains to intervention design. Recommendations targeted missed opportunities. Results: Barriers/facilitators were extracted from 60 papers and most frequently coded to the TDF domains: environmental context and resources, knowledge and beliefs about consequences. Thirty-one interventions were identified, most frequently education, training or enablement functions, delivered via communication/marketing or service provision, and using BCTs designed to shape knowledge or highlight the consequences of or antecedents to screening. Intervention design was largely congruent with recommendations. However, there was less use of persuasion and modelling intervention functions and a reliance on BCTs such as providing instruction when other BCTs could be considered. Conclusions: Recommendations include to consider a broader range of intervention functions and BCTs, particularly for training interventions which should make use of recommended BCTs such as ‘graded tasks’.

Original languageEnglish
Pages (from-to)419-443
Number of pages25
JournalBritish Journal of Health Psychology
Volume26
Issue number2
DOIs
Publication statusPublished - May 2021

Bibliographical note

Funding Information:
The research group would like to thank the steering group for their expertise and input to the report: From PHE, Nick Johnstone-Waddell, Professor Anne Mackie, Joanne Harcombe, and from Cancer Research UK, Kirstie Osborne.

Publisher Copyright:
© 2020 British Psychological Society

Keywords

  • behaviour change techniques
  • behaviour change wheel
  • bowel cancer
  • breast cancer
  • cancer screening
  • cervical cancer
  • health care professionals
  • strategic behavioural analysis
  • theoretical domains framework

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