Is an opportunistic primary care-based intervention for non-responders to bowel screening feasible and acceptable? A mixed-methods feasibility study in Scotland

Natalia Calanzani*, Debbie Cavers, Gabriele Vojt, Sheina Orbell, Robert J. C. Steele, Linda Brownlee, Steve Smith, Julietta Patnick, David Weller , Christine Campbell

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)
30 Downloads (Pure)


Objectives: We aimed to test whether a brief, opportunistic intervention in general practice was a feasible and acceptable way to engage with bowel screening non-responders.
Design: This was a feasibility study testing an intervention which comprised a brief conversation during routine consultation, provision of a patient leaflet and instructions to request a replacement faecal occult blood test kit. A mixed-methods approach to evaluation was adopted. Data were collected from proformas completed after each intervention, from the Bowel Screening Centre database and from questionnaires. Semi-structured interviews were carried out. We used descriptive statistics, content and framework analysis to determine intervention feasibility and acceptability.
Participants: Bowel screening non-responders (as defined by the Scottish Bowel Screening Centre) and primary care professionals working in five general practices in Lothian, Scotland.
Primary and secondary outcome measures: Several predefined feasibility parameters were assessed, including numbers of patients engaging in conversation, requesting a replacement kit and returning it, and willingness of primary care professionals to deliver the intervention.
Results: The intervention was offered to 258 patients in five general practices: 220 (87.0%) engaged with the intervention, 60 (23.3%) requested a new kit, 22 (8.5%) kits were completed and returned. Interviews and questionnaires suggest that the intervention was feasible, acceptable and consistent with an existing health prevention agenda. Reported challenges referred to work-related pressures, time constraints and practice priorities.
Conclusions: This intervention was acceptable and resulted in a modest increase in non-responders participating in bowel screening, although outlined challenges may affect sustained implementation. The strategy is also aligned with the increasing role of primary care in promoting bowel screening.
Original languageEnglish
Number of pages11
JournalBMJ Open
Issue number10
Early online date1 Oct 2017
Publication statusPublished - 11 Oct 2017


  • bowel screening
  • feasibility studies
  • general practice
  • neoplasms
  • Humans
  • Middle Aged
  • Reagent Kits, Diagnostic/statistics & numerical data
  • Male
  • Scotland
  • Health Knowledge, Attitudes, Practice
  • Feasibility Studies
  • Colorectal Neoplasms/diagnosis
  • Mass Screening/psychology
  • Female
  • Surveys and Questionnaires
  • Aged
  • Occult Blood
  • Patient Compliance/statistics & numerical data
  • Primary Health Care/methods
  • Qualitative Research


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