Implementation Strategies for Interventions Aiming to Increase Participation in Mail-Out Bowel Cancer Screening Programmes: A Realist Review

Myers, Larry and Goodwin, Belinda and Ralph, Nicholas ORCID: and Castro, Oscar and March, Sonja ORCID: (2020) Implementation Strategies for Interventions Aiming to Increase Participation in Mail-Out Bowel Cancer Screening Programmes: A Realist Review. Frontiers in Oncology, 10:543732. pp. 1-14.

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Bowel cancer is the third most commonly diagnosed cancer and the third most common cause of cancer-related death with 1,849,518 new cases of bowel diagnosed, and 880,792 deaths reported globally in 2018 alone. Survival can be improved through early detection via national mail-out bowel cancer screening programs; however, participation remains low in many countries. Behavior change is therefore required to increase participation. This realist review aims to (a) identify the behavior change techniques (BCTs) used in each intervention, (b) understand the mechanisms of action responsible for the BCTs effectiveness, and (c) apply a behavior change model to inform how behavior change techniques and mechanisms of action (MoA) can be combined to increase screening participation.

We systematically reviewed the literature for interventions aiming to increase participation in mail-out bowel cancer screening. We used a four-stage realist synthesis approach whereby; (1) interventions were extracted from each study; (2) BCTs applied in each intervention were identified and coded using the BCT taxonomy-v1; (3) the Theory and Techniques tool was used to link BCT to their mechanisms of action; and (4) BCT and MoA were categorized according to their effectiveness and what Health Action Process Approach (HAPA) stage of change they would affect.

We identified 68 intervention trials using 26 unique BCTs and 13 MoA to increase participation. Sixteen BCTs and 10 MoA were identified within the interventions that successfully increased participation rates. Interventions targeting both stages of the HAPA model had a higher success rate (80%) than those targeting one stage of change (51%). When targeting only one stage, interventions targeting the volitional stage had a higher success rate (71%) than interventions only targeting the motivational stage of change (26%).

Importantly, this review identified a suite of BCTs and MoA that are effective for increasing participation in mail-out bowel cancer screening programs. With increased participation in bowel cancer screening leading to improved survival, our findings are key to informing the improvement of policy and interventions that aim to increase screening using specific strategies at key stages of health decision-making.

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Faculty/School / Institute/Centre: Current - Institute for Resilient Regions - Centre for Health Research (1 Apr 2020 -)
Faculty/School / Institute/Centre: Current - Faculty of Health, Engineering and Sciences - School of Psychology and Counselling (1 Jan 2015 -)
Date Deposited: 07 Oct 2020 01:09
Last Modified: 23 Oct 2020 03:56
Uncontrolled Keywords: bowel cancer screening, Hapa, behavior change techniques (BCTs), Realist review/synthesis, Interventions
Fields of Research (2008): 11 Medical and Health Sciences > 1117 Public Health and Health Services > 111712 Health Promotion
17 Psychology and Cognitive Sciences > 1701 Psychology > 170106 Health, Clinical and Counselling Psychology
Socio-Economic Objectives (2008): C Society > 92 Health > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920102 Cancer and Related Disorders
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