School of Health and Society, University of Wollongong, Australia.
School of Health and Society, University of Wollongong, Australia.
Public Health. 2023 Jun;219:67-72. doi: 10.1016/j.puhe.2023.03.022. Epub 2023 Apr 28.
This review aims to provide a comprehensive overview of the literature examining factors influencing participation in organised faecal occult blood test (FOBT) screening programmes in culturally and linguistically diverse populations. This article addresses gaps in the literature by providing a mixed methods review of the multilevel influences on FOBT screening in culturally and linguistically diverse (CALD) populations. This review was guided by the question "What are the factors influencing participation in organised FOBT screening programs in CALD populations?"
Scoping review.
A scoping review methodology was used to summarise the available evidence. A thematic analysis of the included studies was undertaken to identify factors influencing organised FOBT screening participation in CALD populations from the literature.
FOBT screening participation was lower by ethnicity, religion, birthplace and language spoken. Barriers to screening included, faecal aversion, fatalism, fear of cancer, language and literacy barriers, difficulty accessing translated materials and low colorectal screening knowledge and awareness. CALD populations also had lower perceived benefits, susceptibility and cues to action, higher perceived barriers and greater perceived external health locus control than non-CALD populations. Facilitators of screening included positive attitudes to screening, general practitioner recommendations and social support. Group education sessions and narrative-based screening information were found to increase screening participation.
This review highlights the range of interrelated factors influencing participation in organised FOBT screening programmes in CALD populations and proposes multicomponent interventions to address low screening uptake. Features of successful community-level interventions should be explored further. Narratives show promise for engaging CALD populations. Accessibility of screening information should be addressed at the system level. Leveraging the general practitioner relationship in promoting FOBT screening programmes may also be an effective strategy to target 'hard-to-reach' populations.
本综述旨在全面概述研究文化和语言多样化人群中影响参与组织粪便潜血试验（FOBT）筛查计划因素的文献。本文通过对文化和语言多样化（CALD）人群中 FOBT 筛查的多层次影响进行混合方法综述，解决了文献中的空白。本综述的问题是“影响 CALD 人群参与组织性 FOBT 筛查计划的因素有哪些？”
范围综述。
采用范围综述方法总结现有证据。对纳入研究进行主题分析，以确定文献中影响 CALD 人群参与组织性 FOBT 筛查的因素。
FOBT 筛查的参与率因种族、宗教、出生地和语言而异。筛查的障碍包括粪便厌恶、宿命论、对癌症的恐惧、语言和文化障碍、获取翻译材料的困难以及结直肠筛查知识和意识水平低。与非 CALD 人群相比，CALD 人群对筛查的感知益处、易感性和行动线索较低，感知障碍、外部健康定位控制较高。筛查的促进因素包括对筛查的积极态度、全科医生的建议和社会支持。小组教育课程和基于叙述的筛查信息被发现可以提高筛查的参与率。
本综述强调了影响文化和语言多样化人群参与组织性 FOBT 筛查计划的一系列相互关联的因素，并提出了多组分干预措施来解决低筛查参与率的问题。应进一步探讨成功的社区层面干预措施的特点。叙述有潜力吸引 CALD 人群。应在系统层面解决筛查信息的可及性问题。利用全科医生的关系来推广 FOBT 筛查计划也可能是针对“难以接触”人群的有效策略。
