Annual progress reports

SMARTERscreen: A randomised controlled trial of patient SMS messaging in general practice to increase participation in the National Bowel Cancer Screening Program (2014703)

  • Professor Mark Jenkins (Chief Investigator A)
  • University of Melbourne
  • Budget: $1,595,838.95
  • Funding period: 2022 to 2025

Project Synopsis

Screening participation in the National Bowel Cancer Screening Program (NBCSP) is low, especially in the youngest eligible age group of 50–59-year-olds of which only 34% of invitees return a home test kit in any round.

GP advice to screen for bowel cancer is potentially one of the most effective methods for increasing participation, however, there is currently no opportunity for the GP to influence the decision-making process of the invitee. Primary care is not involved in kit delivery when the decision is made on whether to participate—the kit is sent directly in the mail by the Program to the home of the invitee. In addition to GP advice, there is evidence that participation can be improved by increasing awareness of bowel cancer, decreasing fear and anxiety, increasing beliefs about the screening efficacy, and bridging language, cognition and health literacy of the invitees.

The effect of these potential improvements combined, to increase screening participation in the NBCSP has never been systematically tested. We will test whether an information bundle sent by SMS by the invitee’s GP directly to their patients’ phones, prior to the patient receiving their kit, can increase participation.

Our pilot study has demonstrated efficacy and feasibility; the difference in kit-return between people who received an SMS from their GP and people who did not was 16.5%. SMARTERscreen will trial the difference between sending an SMS alone, an SMS bundle and not sending an SMS (the control group).

The SMS bundle will contain multiple components designed to increase screening by addressing known barriers to participation:

  • a recommendation from the invitee’s GP to participate in the screening program
  • a narrative video encouraging screening
  • an instructional video on how to complete the kit
  • information on the importance of bowel cancer, delivered in multiple languages in an easy-to-understand format.

We will test the effectiveness of this SMS via a randomised controlled GP cluster trial directly alongside the current screening program. We will evaluate effect of the SMS on screening participation in terms of the implementation of the process, and cost-effectiveness.

Progress report as of 30 April 2024

To-date the SMARTERscreen trial is on track.

We have developed a protocol, co-designed the intervention with an expert panel and greater than 200 consumers, obtained ethics approval, registered the trial (ANZCTR: ACTRN12623000036617), and secured an agreement with the National Cancer Screening Register to collect data to measure the outcome.

All relevant data to conduct the trial has been obtained and provided to the 63 general practices recruited in Victoria and Queensland. Since recruitment, 4 practices have withdrawn.

The trial intervention period began in May 2024.

Publications, Conference abstracts and other resources

McIntosh, J., Emery, J., Wood, A., Chondros, P., Goodwin, B., Meyers, L., Wilson, C., Ait Ouakrim, D., Flander, L., Macrae, F., Huang, J., Campbell, T., & Jenkins, M. (2023). SMARTscreen to SMARTERscreen: developing and trialling a combination SMS to prompt people to participate in the Australian National Bowel Cancer Screening Program. Society for Academic Primary Care, South-West Chapter, Birmingham, UK.

McIntosh, J., Emery, J., Wood, A., Chondros, P., Goodwin, B., Meyers, L., Wilson, C., Ait Ouakrim, D., Flander, L., Macrae, F., Huang, J., Campbell, T., & Jenkins, M. (2023). SMARTscreen to SMARTERscreen: developing and trialling a combination SMS to prompt people to participate in the Australian National Bowel Cancer Screening Program. Cancer in Primary Care International Research Group Conference, Oxford, UK.

McIntosh, J., Emery, J., Wood, A., Chondros, P., Goodwin, B., Meyers, L., Wilson, C., Ait Ouakrim, D., Flander, L., Macrae, F., Huang, J., Campbell, T., & Jenkins, M. (2023). SMARTscreen to SMARTERscreen: developing and trialling a combination SMS to prompt people to participate in the Australian National Bowel Cancer Screening Program. University of Glasgow, School of Health and Wellbeing Research Group, Glasgow, UK.

McIntosh, J., Emery, J., Wood, A., Chondros, P., Goodwin, B., Meyers, L., Wilson, C., Ait Ouakrim, D., Flander, L., Macrae, F., Huang, J., Campbell, T., & Jenkins, M. (2023). SMARTscreen to SMARTERscreen: developing and trialling a combination SMS to prompt people to participate in the Australian National Bowel Cancer Screening Program. International Cancer Screening Network (ICSN) Conference, Turin, Italy.

MacIntosh, J., Fletcher, S., Buchanan, L., Goodwin, B., Sursock, S., Trevena, J., Chondros, P., Wood, A., Emery, J., & Jenkins, M. (2024). Data Collection and Enrichment in General Practice Trials: Obstacles and Potential Solutions. 2Cancer in Primary Care International Research Group conference, Melbourne, Australia.

 

Embedding community driven models to increase cervical screening via HPV self-collection to improve cervical cancer outcomes for Aboriginal and Torres Strait Islander people (2014908)

  • Associate Professor Lisa Whop (Chief Investigator A)
  • Australian National University
  • Budget: $1,579,683.10
  • Funding period: 2022 to 2025

Project Synopsis

Research suggests that HPV self-collection is a safe, effective and acceptable method of cervical screening for Aboriginal and Torres Strait Islander people. Despite being available since 2018, less than 1% of estimated eligible women have been screened using self-collection. It is unknown how many Aboriginal and Torres Strait Islander women this included, or whether specific service level strategies have been successful in implementing self-collection to its maximum potential.

Using an Indigenist research approach, our study aims to co-design, facilitate and test implementation models of self-collection in 12 Aboriginal Community Controlled Health Organisations (ACCHOs) across the NT, NSW and QLD. Formative scoping will first explore what is or isn't currently occurring, and what is working across the ACCHO sector.

Recruited ACCHOs will then work closely with the research team individually and collectively to create tailored implementation 'packages' suited to their services and communities. This may include a suite of participant-focused health promotion, workforce development, and/or community empowerment activities. Service-tailored packages for self-collection will be applied within and across participating ACCHOs.

In-depth evaluation to assess uptake, acceptability, effectiveness, and sustainability from stakeholders’ perspectives will be used to develop a broader scale-up plan. Aboriginal and Torres Strait Islander Steering- and Technical and Clinical- committees will be central to the study’s governance ensuring cultural and clinical safety, alignment of community needs and oversight of all research activities.

By encouraging community-driven innovations of self-collection, we aim to embed these practices in ACCHO service delivery long after the study is completed and provide a way to scale up nationally. This will both honour community voices and maximize cervical screening participation through a mechanism that we know works.

Progress report 30 April 2024

The project is currently in the recruitment phase. Four ACCHOs have signed on to participate in the study – 2 in Queensland and 2 in New South Wales. Two ACCHOs in Northern Territory are considering the proposal.

One site visit has been undertaken to meet with staff and community members in advance of formal co-design workshops. Ethics amendments relating to participating sites and data access for specified team members to support data cleaning activities have been submitted to the relevant ethics bodies.

During this reporting period we have held 3 investigator meetings, one Data Working Group meeting, one Caucus meeting and presented 2 project updates to the Thiitu Tharrmay Reference Group (ANU).

We are currently recruiting an additional Research Fellow to support research activities and outputs.

Publications, Conference abstracts and other resources

Engagements and presentations at conferences about the study include:

  • Screen Your Way: a review of strategies to increase self-collection cervical screening among Indigenous women and people with a cervix, presented by Assoc Professor Lisa Whop and Dr Louise Mitchell at the World Indigenous Cancer Conference, Naarm (Melbourne), 18-20 March 2024
  • Aboriginal and Torres Strait Islander Health Workers and Practitioners and their role in cervical screening and self-collection in Australia: An Indigenist research approach, presented by Claire Zammit (ANU/UOM) and Desiree Leha (NAATSIHWP), World Indigenous Cancer Conference, Naarm (Melbourne), 18-20 March 2024
  • Assoc. Professor Lisa Whop and Dr Louise Mitchell led the Cancer Screening Session, NACCHO Members' Conference, Noongar Boodjar (Perth), 25-26 October 2023
  • Community engagement at the Lowitja International Indigenous Health and Wellbeing Conference, Cairns, 14-17 June 2023
  • Assoc. Professor Lisa Whop presented on the COSA Panel, COSA's 50th Annual Scientific Meeting, Naarm (Melbourne) 1-3 November 2023

 

MAIL, GP, and SCALE: Mobilising nAtIonaL bowel cancer screeninG Program participation through combining individual, health ServiCe, and populAtion Level intervEntions (2014964)

  • Associate Professor Eleonora Feletto (Chief Investigator A)
  • University of Sydney
  • Budget: $1,749,059.70
  • Funding period: 2022 to 2025

Project Synopsis

The Mobilising the National Bowel Cancer Screening Program through combining individual, health service, and population level interventions (MAIL, GP, and SCALE) project will design and evaluate innovative approaches to increasing participation in the National Bowel Cancer Screening Program (NBCSP).

The NBCSP has now been fully rolled out, but national participation remains at less than 45%. Research shows that the NBCSP has the potential to save 84,000 lives by 2040 if participation could reach and be sustained at 60%.

The project will explore the application of proven evidence-based interventions in Australia, particularly for under-screened or inappropriately screened people. Primary care, especially through general practitioners (GPs), play a critical role in advocating for cancer screening. The project will leverage our experience, growing knowledge and stakeholder consultation to design and evaluate an innovative primary care based 'advocate' intervention alongside a planned mass-media campaign and emerging interventions to determine the optimal combination of interventions to increase NBCSP participation.

The 5 aims are to:

  1. Provide an up-to-date profile of CRC screening in Australia, including non-NBCSP screening, to determine the existing gaps and highlight screening inequities
  2. Characterise emerging and existing evidence on the effectiveness of interventions in mobilising primary care and changing screening behaviours
  3. Co-design, pilot and evaluate an innovative primary care 'advocate intervention to increase NBCSP participation by supporting guideline-appropriate CRC screening and addressing screening inequities
  4. Evaluate the effectiveness and cost-effectiveness of CRC screening interventions to determine the optimal combination of interventions to increase NBCSP participation equitably
  5. Design an NBCSP Interventions Scale-up Plan to leverage existing interventions and implement adaptations to improve equity of CRC screening.

Progress report 30 April 2024

Aim 1: Data analysis is underway to determine the up-to-date CRC screening rates. Preliminary results have been discussed and a publication is in draft.

Aim 2: An evidence review on CRC screening interventions and implementation strategies was updated to Oct 2023. The updated findings showed consistency with the previous results. A publication is in draft.

Aim 3: The co-design component was completed in April 2023 (12 focus groups, 45 participants). Data analysis is complete, and publication is under internal review. The findings have informed the trial intervention. Ethics approvals have been obtained and include conducting the trial implementation strategy development and a process evaluation.

We have undertaken extensive consultation and planning to ensure appropriate trial sites, data collection and intervention design for a seamless trial commencement (Australian and New Zealand Clinical Trials Registry ACTRN12623000355673).

Trial agreements with the 4 trial sites are being finalised and the trial is due to commence in September 2024.

We have designed an implementation process for the trial which will ensure the intervention is supported during the delivery and identify possible barriers. This will be valuable for the trial evaluation and final project stage to design an interventions Scale-Up Plan in Aim 5.

Aims 4 and 5: Planning has started for the modelling evaluations to be conducted in Aim 4 and the scale up plan to be developed for Aim 5. These will be conducted in 2025.

Over the last year we have had important project achievements including 2 University of Sydney Doctor of Medicine students undertaking their 3-month research projects as part of the study and contributed to analysis of the co-design (May 2023).

Publications, Conference abstracts and other resources

Eleonora Feletto, Stephanie Walker, Kelera Levu, Melissa Tran, Corey Henshaw, Karen Canfell, Jie Bin Lew, Lyndal Trevena, Sarah Durkin, Emily He, Belinda Goodwin, Mark Jenkins, Jane Young, Kate Broun, Katina D’Onise, Christopher Horn, Melissa Treby, Tanya Buchanan, Anita Dessaix, Jeff Cuff, Claire Nightingale, Glenn Austin, Paul Grogan, Natalie Taylor. Co-designing with General Practice to support National Bowel Cancer Screening Program participation. NSW Cancer Conference. Poster Presentation. September 2023.

Eleonora Feletto, Stephanie Walker, Kelera Levu, Melissa Tran, Corey Henshaw, Karen Canfell, Jie Bin Lew, Lyndal Trevena, Sarah Durkin, Emily He, Belinda Goodwin, Mark Jenkins, Jane Young, Kate Broun, Katina D’Onise, Christopher Horn, Melissa Treby, Tanya Buchanan, Anita Dessaix, Jeff Cuff, Claire Nightingale, Glenn Austin, Paul Grogan, Natalie Taylor. Combining effective interventions to increase bowel cancer screening equitably. NSW Cancer Conference. Poster Presentation. September 2023.

Eleonora Feletto, Stephanie Walker, Kelera Levu, Melissa Tran, Corey Henshaw, Karen Canfell, Jie Bin Lew, Lyndal Trevena, Sarah Durkin, Emily He, Belinda Goodwin, Mark Jenkins, Jane Young, Kate Broun, Katina D’Onise, Christopher Horn, Melissa Treby, Tanya Buchanan, Anita Dessaix, Jeff Cuff, Claire Nightingale, Glenn Austin, Paul Grogan, Natalie Taylor. Enhancing General Practice involvement in the National Bowel Cancer Screening Program (NBCSP) Public Health Association of Australia Annual Conference. Virtual Presentation. September 2023.

 

'It’s a gamechanger' – using HPV self-collection to improve equity and participation in Australia's National Cervical Screening Program (2015178)

  • Dr Claire Nightingale (Chief Investigator A)
  • University of Melbourne
  • Budget: $1,408,759.50
  • Funding period: 2022 to 2025

Project Synopsis

Cervical cancer can be prevented. The World Health Organization (WHO) has called for its elimination as a public health problem. In Australia, the key to achieving this quickly and equitably is improving participation in cervical screening. There is substantial evidence that HPV screening on a self-collected sample (self-collection) can increase participation among people that are under-screened (including never-screened).

A policy change in mid-2022 to provide all women and people with a cervix with the option to use self-collection has game-changing potential to increase participation and redress longstanding inequity in cervical cancer. On its own, a policy change, with self-collection offered in usual practice is not enough. Innovative solutions are needed to scale-up self-collection across a range of services and models of care in efficient, acceptable and equitable ways to eliminate cervical cancer among ALL groups of women and people with a cervix in Australia. Our work will generate the evidence needed to support this and will be achieved through four research components:

  • Component 1: To develop and test an implementation tool kit that supports the efficient integration of self-collection into existing clinical services.
  • Component 2: To develop and evaluate decision support tools for under-screened participants to increase knowledge and aid decision making for cervical screening.
  • Component 3: To measure awareness and acceptability of self-collection in the general population, among people with a cervix and providers.
  • Component 4: To explore possible models of offering self-collection outside of mainstream medical settings in order to increase reach.

Progress report 30 April 2024

We have conducted interviews with clinicians working in sexual health, and service providers for people with physical disability, refugee and asylum seekers and LGBTQ+ people and pathology providers.

We have found that awareness and adoption of self-collection was highest among clinicians working in sexual health and LGBTQ+ services. They perceived high acceptability in their communities and reported increased participation.

Despite high acceptability amongst refugee and asylum seeker services, concerns about client knowledge, communication, and missed opportunities for comprehensive care existed.

People working in disability services reported high acceptability, but adoption was limited by a need for clarification on process, roles and responsibilities, scope of practice for nurses and support workers, and a need to increase knowledge and awareness among both clients and staff.

 

Overcoming Inequity: Increasing Cervical Screening Participation for People with Intellectual Disability (ScreenEQUAL) (2015215)

  • Professor Deborah Bateson (Chief Investigator A)
  • The Daffodil Centre, a joint venture between the Cancer Council NSW and The University of Sydney
  • Budget: $1,433,806.71
  • Funding period: 2022 to 2025

Project Synopsis

The project aims to identify facilitators which could increase engagement in the National Cervical Screening Program (NCSP) among people with intellectual disability. Using a single-arm trial design we will test the effectiveness of a co-produced suite of information resources and training materials, in supporting informed decision-making, about cervical screening and improving access to and uptake of screening by people with intellectual disability.

The 3-year project will be undertaken via collaboration between state-based Family Planning and Peak Disability Organisations, and Universities. In Stage 1, an advisory group consisting of people with intellectual disability, their support people, and key health and disability sector stakeholders has been convened. Through a qualitative process and with input from the advisory group, screening barriers as well as facilitators that increase access and uptake of screening have been explored. The advisory group is supporting the development of a co-produced accessible information resource for people with intellectual disability and training materials for families and support people and General Practitioners (GPs) and nurses to support informed decision-making and screening participation.

In Stage 2, a single-arm trial will be used to test the effectiveness of the co-produced accessible resource for people with intellectual disability. Single-arm sub-studies will, respectively, test the effectiveness of accompanying supporting materials for families and support people and trauma-informed training materials for GPs and nurses. Forty-eight people with intellectual disability aged 25-74 who are due for cervical screening will be invited to participate in the trial to see if there is a change in informed decision-making about cervical screening before and after they receive the co-produced resource at accessible workshops supported by trained support people. Forty-eight family members and support people and over 400 GPs and nurses will be invited to participate in the sub-studies, and over 4-months will receive the tailored supporting resources and training materials. Changes in knowledge, attitudes, confidence and preparedness to support cervical screening for people with intellectual disability will be measured over the intervention period.

In Stage 2 we will also measure the uptake of cervical screening, including making a choice to have self-collection, in the 9-months after the accessible workshops (intervention). We will conduct in-depth interviews with participants, and a process evaluation, to obtain a better understanding of how the multi-faceted intervention worked and for whom. All resources and training materials developed will be made available on a co-produced ScreenEQUAL website, and findings disseminated to inform policy/procedure/practice at the state and national level.

Progress report 30 April 2024

Achieved data saturation for Stage 1 participant groups – families and support people (n=13), health professionals (n=21) and disability stakeholders (n=20).  

Commenced co-analysis of Stage 1 qualitative data with people with intellectual disability at an Advisory Group Meeting (13/03/2024). Key outcomes:

  • complex trauma is common highlighting the importance of trauma-informed care
  • a lack of accessible health information, limiting awareness and understanding of cervical screening
  • misassumptions about screening eligibility and benefits of self-collection
  • systems-based barriers to access.

Completed a comprehensive environmental scan of existing cervical screening resources/campaigns tailored for people with intellectual disability.

Commenced co-production of accessible resources and training materials and workshop planning in Sydney, Newcastle and Wagga Wagga supported by Family Planning Australia.

Publications, Conference abstracts and other resources

We have submitted 2 scientific publications to the Special Issue ‘Break the Stigma: People with Intellectual Disability’ in ‘Frontiers in Public Health’. These include a study protocol paper (accepted) and a systematic review and meta-analysis (currently under review) of barriers, facilitators and uptake of cervical screening uptake among people with intellectual disability.

Novel screening participation data from the meta-analysis was presented at the 35th International Papillomavirus Conference - IPVC 2023 held in Washington DC.

The study protocol was awarded an oral presentation at the 2023 Australasian Sexual and Reproductive Health Conference and primary care Stage 1 qualitative data was awarded an oral presentation at the 2024 Primary Care Collaborative Cancer Clinical Trials Group Conference’ funded by Cancer Australia.

Publications:

  • Bateson D, Ussher J, Strnadová I, Loblinzk J, David M, Chang E-L, Carter A, Sweeney S, Winkler L, Power R, Basckin C, Kennedy E and Jolly H. (2024). Working together with people with intellectual disability to make a difference: a protocol for a mixed-method co-production study to address inequities in cervical screening participation. Frontiers in Public Health 12:1360447. doi: 10.3389/fpubh.2024.1360447
  • Rosalie Power, Michael David, Iva Strnadová, Lauren Winkler, Caroline Basckin, Julie Loblinzk, Heather Jolly, Elizabeth Kennedy, Jane Ussher, Sally Sweeney, EeLin Chang, Allison Carter and Deborah Bateson*. (2024). Cervical screening participation and access facilitators and barriers for people with intellectual disability: A systematic review and meta-analysis. Manuscript under review in Frontiers in Public Health

Conferences and other presentations:

  • Bateson, D. Self-collection within the within the NCSP and screening for people with Intellectual Disability, Australian Centre for Prevention of Cervical Cancer ECHO (virtual). Invited oral presentation. November 17, 2022
  • Bateson, D. Ensuring equity in screening for people with disability. National Elimination of Cervical Cancer Conference (ECC) (hybrid). Invited oral presentation. November 17, 2023.
  • Bateson, D. Enhancing equity: cervical screening for people with disability. Public Health Association Australia (PHAA) Conference Melbourne. Invited oral presentation.  September 26-28, 2023.
  • Power, R., Winkler, L., David, M., Ussher, J., Strnadová, I., Loblinzk, J., ChangE., Carter A., Sweeney S., Kennedy E., Bahwichband Y. & Bateson D. A systematic review of cervical screening uptake and facilitators and barriers that affect participation for people with intellectual disability. (Poster). International Papilloma Virus Conference (IPVC) April 17-21, 2023.
  • Winkler, L., on behalf of the ScreenEQUAL team. An innovative protocol to address inequities in cervical screening for people with intellectual disability. Cancer Innovations Conference (Poster). August 1, 2023.
  • Winkler, L., on behalf of the ScreenEQUAL team. A protocol for an innovative disability-inclusive study to address inequities in cervical screening participation for people with intellectual disability. Australasian Sexual and Reproductive Health Conference. Oral presentation. September 18-20, 2023
  • Bateson, D. Addressing inequity in cervical cancer prevention: self-collection in your practice. WONCA World Conference GP23 Sydney Convention Centre. Oral presentation. October 26-29, 2023

 

BreastScreenPlus: A novel intervention targeting obesity-related barriers to mammographic screening (2015286)

  • Associate Professor Jennifer Stone (Chief Investigator A)
  • University of Western Australia
  • Budget: $819,444.70
  • Funding period: 2023 to 2026

Project Synopsis

Eight breast cancer deaths are prevented for every 1,000 women aged 50-74 years who undergo biennial mammographic screening. However, despite the demonstrated benefits of (free) screening, fewer than half of women attending BreastScreen Western Australia for the first time fail to return for screening when next due. Hence, there is an urgent need for evidence-based interventions to retain women in the program.

It is well established that women with obesity are at increased risk of non-participation in screening. Our group has demonstrated that body image disturbances play a critical role in deterring women from mammographic screening, and that negative screening experiences by women with obesity drive their reluctance to rescreen.

For service delivery staff (radiographers and receptionists), both practical problems with screening women with obesity and varying mindfulness towards body image disturbances appear to exacerbate the issues. As obesity is linked to poorer prognoses and lower breast cancer survival rates, improving rescreening rates within women with obesity is vital.

This proposal aims to evaluate a novel intervention to improve the screening experience for both women with obesity and radiographers and thereby, increase rescreening participation in women with obesity and others impacted by body image disturbances. We aim to:

  1. Co-design an intervention with 2 components:
    1. Practical and empathy training for BreastScreen service delivery staff to optimise their management of women with obesity
    2. Information for BreastScreen clients about mammography including visual images to normalize body shapes and sizes
  2. Evaluate the efficacy of the intervention by comparing both rescreening rates and survey responses (from clients and service delivery staff) assessing satisfaction of the mammogram experience.

This world-first investigation will assess the efficacy of an obesity-related intervention within a population-based mammographic screening program.

Progress report 30 April 2024

Women with obesity are less likely to participate in mammographic screening and are more likely to develop post-menopausal breast cancer. As part of the BreastScreenPlus project, we have co-produced a novel intervention to improve the mammogram experience for both women with obesity and screening service staff, with the aim of improving screening participation within the BreastScreen WA screening program.

The intervention has 2 components – a staff component involving in-service training and practical workshops to optimise their management of women living with obesity and, a client component (video) involving promotional material about what to expect at mammography which also normalises body shapes and sizes.

The intervention has been implemented within BreastScreen WA and has the potential to reduce breast cancer mortality through early detection in women who, otherwise, may not routinely rescreen due to issues relating to obesity and/or body image. The next step is to evaluate the efficacy of the intervention on rescreening rates and on client/staff satisfaction.

Publications, Conference abstracts and other resources

Our first manuscript describing the 'Co-design of an intervention to optimize mammographic screening participation in women with obesity and/or physical disabilities' has just been published in the journal Radiography. The corresponding abstract was recently presented at the BreastScreen Australia Conference (Canberra, March 2024) and won Best Oral Presentation.

McBride, K. A., O'Fee, A., Hogan, S., Stewart, E., Madeley, C., Wilkes, J., Wylie, E., White, A., Hickey, M., Stone, J. (2024). Co-design of an intervention to optimize mammographic screening participation in women with obesity and/or physical disabilities. Radiography (London, England. 1995), 30(3), 951-963. https://doi.org/10.1016/j.radi.2024.04.011

McBride, K. A., O'Fee, A., Hogan, S., Stewart, E., Madeley, C., Wilkes, J., Wylie, E., White, A., Hickey, M., Stone, J. Co-design of an intervention to optimize mammographic screening participation in women with obesity and/or physical disabilities. BreastScreen Australia Conference. March 2024. Canberra, Australia

 

A preference-informed model to improve access and equity in bowel screening for Australia’s First Nations people through home care services (2015290)

  • Professor Gail Garvey (Chief Investigator A)
  • The University of Queensland
  • Budget: $994,552.30
  • Funding period: 2022 to 2025

Project Synopsis

Bowel cancer is the third-most common cancer affecting First Nations Australians. Aboriginal and Torres Strait Islander Australians diagnosed with bowel cancer are less likely to survive 5 years compared with non-Indigenous Australians (58% versus 67% respectively).

Early diagnosis of bowel cancer greatly improves survival and reduces mortality and morbidity. The National Bowel Cancer Screening Program (NBCSP) aims to reduce death and morbidity from bowel cancer. Participation in the NBCSP by Aboriginal and Torres Strait Islander people is lower than for non-Indigenous Australians (27% and 44% respectively).

To optimise participation in screening, we will use preference-based methods to understand how Aboriginal and Torres Strait Islander people prefer bowel screening to be delivered and maximise the reach of the NBCSP to this under-screened population.

We will work collaboratively with one of Australia’s largest health insurers and providers of Aboriginal Home Care Services to co-develop and implement a bowel cancer screening program that is informed by the preferences and values of Aboriginal and Torres Strait people.

The project aims are to, firstly, demonstrate increased NBCSP participation among the service’s Aboriginal clients; and secondly, to strengthen the evidence base about how to increase access for under-screened populations, particularly in understanding more about the variation in screening preferences within groups.

We have an ideal opportunity to enhance informed choice about participation in the NBCSP, guided by trusted messengers (health professionals) in a culturally safe manner, with the potential for Aboriginal and Torres Strait Islander lives to be saved through early detection.

Progress report 30 April 2024

Phase 1a: The aim of this phase was to establish population level screening status of Industry Partner customers (356 survey completions).

This study phase trained and raised awareness among our industry partner staff about bowel cancer screening and provided baseline screening data.

Phase 1b: The aim is to provide an understanding of the Industry Provider customers’ values and preferences for participation in bowel screening and is in progress. Several activities have been completed:

  • Completion of participant Yarning circles to inform the development of the choice survey questions (n = 27)
  • Drafting and finalising the Choice survey questions.
  • Completion of a pilot of the Choice survey prior to full roll out of the survey (n=8).

Data collection has commenced (316 surveys to date).

Research Training: 2 students have been supported by this project – one Masters of Philosophy student (commenced July 2023) and one PhD candidate (commenced May 2023). Both students are enrolled at the University of Queensland.

Publications, Conference abstracts and other resources

Two abstracts for presentations were submitted and accepted to the World Indigenous Cancer Conference (WICC) held from 18-20 March 2024 in Melbourne:

  • Factors associated with bowel cancer screening participation of First Nations Australians accessing home health care services in New South Wales, Australia. Presented by Tsegaw Amare Baykeda (PhD Candidate). Co-authors: Prof Gail Garvey, Dr Shafkat Jahan, Prof Kirsten Howard, Dr Rakhee Raghunandan, Prof Joan Cunningham, Prof David Currow, Dr Veronica Matthews, Prof Ian Olver, Prof Rebecca Ivers, Prof Gillian Harvey, Dr Tamara Bulter, Dr Nisreen Aouira, Amanda Hunter, Sheree Bennett.
  • Understanding the Bowel Cancer Screening Preferences of First Nations Australian, Presented Dr Rakhee Raghunandan. Co-authors: Dr Tamara Bulter, Prof Gail Garvey, Dr Shafkat Jahan, Prof Joan Cunningham, Prof David Currow, Dr Veronica Matthews, Prof Ian Olver, Prof Rebecca Ivers, Prof Gillian Harvey, Amanda Hunter, Sheree Bennett, Prof Kirsten Howard.

Nyina Budja Health Equity Conference 2024, 30 - 31st of May, the Sunshine Coast, Queensland:

  • An abstract was submitted and accepted for a presentation by Dr Nisreen Aouira on the topic of 'Co-Designing an Intervention to Enhance First Nations Australians’ Participation in Bowel Screening'. Co-authors: Prof Kirsten Howard, Dr Tamara Butler, Dr Rakhee Raghunandran, Dr Shafkat Jahan, Prof Gail Garvey.