Lofti-Jam Kerryann L, O'Reilly Clare L, Feng Charissa S, Wakefield Melanie A, Durkin Sarah, Broun Kate H
Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Australia,
Prevention Division, Cancer Council Victoria, Melbourne, Australia.
Public Health Res Pract. 2019 Jul 31;29(2):2921916. doi: 10.17061/phrp2921916.
Participation in the Australian National Bowel Cancer Screening Program (NBCSP) is suboptimal. Given the program's enormous potential to save lives, Cancer Council Victoria has prioritised increased screening participation as part of its strategic plan. This paper describes the implementation, and evaluation where available, of Cancer Council Victoria programs to increase participation, supported by a mix of own organisation and Victorian state health department funding. Type of programs: At the population level, Cancer Council Victoria has delivered television-led mass media campaigns to motivate age-eligible individuals to complete and return their NBCSP kit. It has also delivered targeted awareness and education programs for underscreened populations including Aboriginal and Torres Strait Islander people, people from culturally and linguistically diverse communities, and groups experiencing social disadvantage. Programs involving general practice have also been trialled to improve the knowledge and confidence of general practitioners (GPs) to discuss bowel screening with their patients, and to implement identification, reminder and follow-up systems to improve bowel screening participation.
There is strong evidence to support the use of mass media public health campaigns, which have resulted in significant increases in screening kit return rates. Targeted education sessions with underscreened communities have led to increases in knowledge about bowel cancer screening, confidence to do the test and intention to participate in the NBCSP in communities where these sessions have been trialled. Early findings suggest that GP endorsement strategies are welcomed by patients and are an effective way to encourage NBCSP participation. System changes using patient information systems may be more challenging, given the inconsistent entry of NBCSP data.
Our work to date demonstrates that there is a strong case for regular, widespread mass media strategies to increase NBCSP participation. There is also evidence to support more tailored, complementary approaches with dedicated education programs for underscreened groups, and active and sustained engagement with underscreened communities and primary care providers to overcome personal, cultural and systems barriers to screening. Improved data capture capabilities are needed to better implement and evaluate the impact of future strategies to improve NBCSP participation.
参与澳大利亚国家肠癌筛查计划（NBCSP）的情况并不理想。鉴于该计划在挽救生命方面具有巨大潜力，维多利亚癌症理事会已将提高筛查参与率作为其战略计划的优先事项。本文介绍了维多利亚癌症理事会提高参与率计划的实施情况，并在可行的情况下进行了评估，这些计划由该组织自身和维多利亚州卫生部的资金混合支持。计划类型：在人群层面，维多利亚癌症理事会开展了以电视为主的大众媒体宣传活动，以激励符合年龄条件的个人完成并返还他们的NBCSP试剂盒。它还为筛查不足的人群开展了有针对性的宣传和教育计划，包括原住民和托雷斯海峡岛民、来自文化和语言多元社区的人群以及面临社会不利处境的群体。还对涉及全科医疗的计划进行了试验，以提高全科医生（GP）与患者讨论肠道筛查的知识和信心，并实施识别、提醒和随访系统，以提高肠道筛查参与率。
有强有力的证据支持使用大众媒体公共卫生宣传活动，这些活动使筛查试剂盒返还率显著提高。与筛查不足的社区进行的有针对性的教育课程，在进行过这些课程试验的社区中，提高了对肠癌筛查的认识、进行检测的信心以及参与NBCSP的意愿。早期研究结果表明，全科医生认可策略受到患者欢迎，是鼓励参与NBCSP的有效方式。鉴于NBCSP数据录入不一致，利用患者信息系统进行系统变革可能更具挑战性。
我们迄今为止的工作表明，有充分理由采用定期、广泛的大众媒体策略来提高NBCSP参与率。也有证据支持采用更具针对性、互补性的方法，为筛查不足的群体制定专门的教育计划，并与筛查不足的社区和初级保健提供者进行积极和持续的接触，以克服筛查的个人障碍、文化障碍和系统障碍。需要改进数据收集能力，以便更好地实施和评估未来提高NBCSP参与率策略的影响。
