General practice perspectives on a bowel cancer screening quality improvement intervention using the Consolidated...

Area of Science:

• Implementation science
• Primary care research
• Health services research

Background:

• Colorectal cancer (CRC) screening participation remains low.
• Understanding contextual factors is crucial for effective interventions.
• Quality improvement (QI) interventions aim to increase CRC screening in general practice.

Purpose of the Study:

• To explore contextual facilitators and barriers to implementing a novel CRC screening quality improvement intervention.
• To identify strategies for flexible implementation across diverse general practices.

Main Methods:

• Qualitative study using focus groups with 18 general practice staff.
• Utilized the Consolidated Framework for Implementation Research (CFIR) for guidance.
• Employed deductive thematic analysis to align findings with the CFIR model.

Main Results:

• Identified facilitators and barriers across CFIR domains and CRC-specific constructs.
• Five key themes emerged: priority setting/incentives, IT, patient barriers, clinical practice, and the National Bowel Cancer Screening Program (NBCSP).
• Incentive payments and NBCSP policy changes were proposed to drive organizational change and intervention implementation.

Conclusions:

• General practice engagement in CRC screening can be enhanced through external support mechanisms.
• Improvements to the National Cancer Screening Register and Practice Incentives Program (PIP) are recommended.
• Policy adjustments can support clinical practice and increase CRC screening rates without altering the NBCSP design.