TY - JOUR

T1 - Development of an intervention to expedite cancer diagnosis through primary care

T2 - a protocol

AU - Stanciu, Marian Andrei

AU - Law, Rebecca-Jane

AU - Nafees, Sadia

AU - Hendry, Margaret

AU - Yeo, Seow Tien

AU - Hiscock, Julia

AU - Lewis, Ruth

AU - Edwards, Rhiannon

AU - Williams, Nefyn

AU - Brain, Katherine

AU - Brocklehurst, Paul

AU - Carson-Stevens, Andrew

AU - Dolwani, Sunil

AU - Emery, Jon

AU - Hamilton, William

AU - Hoare, Zoe

AU - Lyratzopoulos, Georgios

AU - Rubin, Greg

AU - Smits, Stephanie

AU - Vedsted, Peter

AU - Walter, Fiona

AU - Wilkinson, Clare

AU - Neal, Richard

PY - 2018/10

Y1 - 2018/10

N2 - Background GPs can play an important role in achieving earlier cancer diagnosis to improve patient outcomes, for example through prompt use of the urgent suspected cancer referral pathway. Barriers to early diagnosis include individual practitioner variation in knowledge, attitudes, beliefs, professional expectations, and norms. Aim This programme of work (Wales Interventions and Cancer Knowledge about Early Diagnosis [WICKED]) will develop a behaviour change intervention to expedite diagnosis through primary care and contribute to improved cancer outcomes. Design & setting Non-experimental mixed-method study with GPs and primary care practice teams from Wales. Method Four work packages will inform the development of the behaviour change intervention. Work package 1 will identify relevant evidence-based interventions (systematic review of reviews) and will determine why interventions do or do not work, for whom, and in what circumstances (realist review). Work package 2 will assess cancer knowledge, attitudes, and behaviour of GPs, as well as primary care teams’ perspectives on cancer referral and investigation (GP survey, discrete choice experiment [DCE], interviews, and focus groups). Work package 3 will synthesise findings from earlier work packages using the behaviour change wheel as an overarching theoretical framework to guide intervention development. Work package 4 will test the feasibility and acceptability of the intervention, and determine methods for measuring costs and effects of subsequent behaviour change in a randomised feasibility trial. Results The findings will inform the design of a future effectiveness trial, with concurrent economic evaluation, aimed at earlier diagnosis. Conclusion This comprehensive, evidence-based programme will develop a complex GP behaviour change intervention to expedite the diagnosis of symptomatic cancer, and may be applicable to countries with similar healthcare systems.

AB - Background GPs can play an important role in achieving earlier cancer diagnosis to improve patient outcomes, for example through prompt use of the urgent suspected cancer referral pathway. Barriers to early diagnosis include individual practitioner variation in knowledge, attitudes, beliefs, professional expectations, and norms. Aim This programme of work (Wales Interventions and Cancer Knowledge about Early Diagnosis [WICKED]) will develop a behaviour change intervention to expedite diagnosis through primary care and contribute to improved cancer outcomes. Design & setting Non-experimental mixed-method study with GPs and primary care practice teams from Wales. Method Four work packages will inform the development of the behaviour change intervention. Work package 1 will identify relevant evidence-based interventions (systematic review of reviews) and will determine why interventions do or do not work, for whom, and in what circumstances (realist review). Work package 2 will assess cancer knowledge, attitudes, and behaviour of GPs, as well as primary care teams’ perspectives on cancer referral and investigation (GP survey, discrete choice experiment [DCE], interviews, and focus groups). Work package 3 will synthesise findings from earlier work packages using the behaviour change wheel as an overarching theoretical framework to guide intervention development. Work package 4 will test the feasibility and acceptability of the intervention, and determine methods for measuring costs and effects of subsequent behaviour change in a randomised feasibility trial. Results The findings will inform the design of a future effectiveness trial, with concurrent economic evaluation, aimed at earlier diagnosis. Conclusion This comprehensive, evidence-based programme will develop a complex GP behaviour change intervention to expedite the diagnosis of symptomatic cancer, and may be applicable to countries with similar healthcare systems.

U2 - 10.3399/bjgpopen18X101595

DO - 10.3399/bjgpopen18X101595

M3 - Article

VL - 2

JO - British Journal of General Practice

JF - British Journal of General Practice

SN - 0960-1643

IS - 3

M1 - bjgpopen18X101595

ER -