035 How to improve colorectal cancer screening in underserved areas: a qualitative evaluation of a combined, coproduced health literacy intervention

• Published in: BMJ evidence-based medicine Vol. 29; no. Suppl 1; p. A16
• Main Authors: Cazorla, Géraldine, Boirot, Alix, Lamouroux, Aurore, Redmond, Niamh M, Addamiano, Maria-Claudia, Grami, Raoudha, Couranjou, Françoise, Doukhi, Zineb, Casanova, Clémence, Mancini, Julien, Durand, Marie-Anne
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.07.2024; BMJ Publishing Group LTD
• Subjects: Abstract for Poster Submission; Brochures; Colorectal cancer; Health education; Health literacy; Medical screening; France
• ISSN: 2515-446X; 2515-4478
• DOI: 10.1136/bmjebm-2024-SDC.35

IntroductionColorectal cancer (CRC) is one of the most common causes of cancer burden. In France, it is the second leading cause of cancer mortality. Although systematic uptake of CRC screening improves survival rates, its uptake remains insufficient, especially among people with limited health literacy (HL) and lower socioeconomic position. Our aim was to explore general practitioners’ (GPs) perceptions of the acceptability and implementation potential of a coproduced, combined intervention consisting of 1) e- learning and interactive training for GPs on HL and CRC screening and; 2) a patient-facing pictorial brochure and video.MethodsA qualitative study, nested within a cluster-randomized controlled trial (DECODE, NCT04631692) in four French regions. Semi-structured interviews were conducted (telephone or online) in 2023 to gain insight into the opinions, experiences and recommendations of MGs participating in the intervention arm. Thematic analysis using manual and NVivo coding was conducted.ResultsMost of the 22 GPs interviewed regarded the training as acceptable, informative and offering great flexibility of use. The module on HL was considered more interesting than the one on CRC screening, as addressing HL was new or unfamiliar to many GPs. The patient-facing brochure was seen as redundant alongside the screening kit’s instruction manual. The video, sometimes described as disruptive to the consultation flow, was deemed highly beneficial for patients with low HL and/or difficulties in French. Suggestions for implementing the intervention into routine care while addressing time constraints included using the video with low HL patients and implementing task-sharing.DiscussionThe interactive training sessions, although difficult to organize due to time limitations, were considered critical to discussing the implementation of the intervention in to practice. Keeping the training brief, self-paced and more focused on HL was recommended.ConclusionScaling-up the combined intervention was largely recommended by GPs to maximize screening uptake in France.