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Qualitative Interviews to Add Patient Perspectives in Colorectal Cancer Screening: Improvements in a Learning Health

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Understanding patient perspectives is key to improving colorectal cancer (CRC) screening. Local insights reveal barriers like ambivalence and facilitators such as social support, guiding future screening strategies.

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Area of Science:

  • Public Health
  • Health Services Research
  • Qualitative Research

Background:

  • Colorectal cancer (CRC) is a leading cause of preventable cancer death, prompting health systems to enhance screening rates.
  • Learning health systems utilize data, including qualitative local perspectives, to continuously improve patient care and education.
  • Understanding patient viewpoints is crucial for developing effective CRC screening strategies within integrated health systems.

Purpose of the Study:

  • To explore local perspectives on colorectal cancer (CRC) screening among health insurance members.
  • To identify barriers and facilitators influencing CRC screening uptake.
  • To inform the development of targeted outreach and education strategies to increase CRC screening rates.

Main Methods:

  • Semi-structured phone interviews were conducted with health insurance plan members eligible for CRC screening.
  • A qualitative content analysis using an inductive approach was applied to interview data.
  • Forty member interviews were completed and analyzed to identify key themes.

Main Results:

  • Identified barriers to CRC screening included ambivalence towards screening options, negative prior experiences, and competing life priorities.
  • Facilitators for CRC screening comprised a positive general health attitude, social support, perceived CRC risk, and positive prior screening experiences.
  • Ambivalence regarding screening options, such as preferring home fecal tests over colonoscopies due to skepticism, was a significant barrier.

Conclusions:

  • Local perspectives on CRC screening are essential for designing effective interventions.
  • Addressing patient ambivalence about screening modalities and leveraging positive attitudes are key to increasing screening rates.
  • Findings directly informed health system leaders in selecting and refining CRC screening outreach and education strategies for future testing.