Centre for Rural Health, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia.
School of Psychological Sciences, University of Tasmania, Launceston, Tasmania, Australia.
Aust J Rural Health. 2024 Oct;32(5):1041-1053. doi: 10.1111/ajr.13181. Epub 2024 Aug 30.
Identify barriers and enablers for remote Tasmanians participating in bowel cancer screening through the National Bowel Cancer Screening Program.
A small remote Tasmanian community.
Tasmanian remote community members aged 50 years and over.
A qualitative study conducted 16 semi-structured interviews. Two researchers conducted in-person and telephone interviews. Questions were directed by an interview guide developed using the Theoretical Domains Framework for behaviour change and Behaviour Change Wheel. Two researchers analysed data using directed content analysis with a flexible inductive approach.
Four themes related to barriers and enablers to completing the National Bowel Cancer Screening Program screening kit in remote Tasmania. Themes included the subject of screening, physical screening kit, the process and outcome of the kit. Several barrier and enabler sub-themes overlapped or were linked, as many enablers mitigated barriers. For example, social influences, awareness level, steps in completing screening, and planning and timing to screen. Social support and discussing screening with others were key enablers, whereas lack of these were barriers. For remote communities, taking the kit to the post office was a barrier from often knowing the post officer. A bowel bus providing screening and information support services may reduce the travel burden of follow-up diagnostic tests and support low-literacy individuals to screen.
Barriers and enablers exist within each stage of the screening process, from what influences an individual decision to screen, through to the outcome. To improve screening rates in rural/remote Tasmania, barriers and enablers to screening must be considered.
通过国家肠癌筛查计划，确定参与肠癌筛查的塔斯马尼亚偏远地区居民的障碍和促进因素。
塔斯马尼亚偏远社区。
50 岁及以上的塔斯马尼亚偏远社区成员。
一项定性研究，进行了 16 次半结构化访谈。两位研究人员进行了面对面和电话访谈。问题是根据行为改变理论框架和行为改变轮制定的访谈指南提出的。两位研究人员使用有弹性的归纳方法对数据进行定向内容分析。
有四个主题与在塔斯马尼亚偏远地区完成国家肠癌筛查计划筛查工具包相关，涉及筛查主题、物理筛查工具包、工具包的过程和结果。几个障碍和促进因素的子主题重叠或相互关联，因为许多促进因素减轻了障碍。例如，社会影响、意识水平、完成筛查的步骤以及筛查的计划和时间。社会支持和与他人讨论筛查是关键的促进因素，而缺乏这些则是障碍。对于偏远社区来说，将工具包送到邮局是一个障碍，因为通常不认识邮局工作人员。肠道巴士提供筛查和信息支持服务，可能会减轻后续诊断测试的旅行负担，并支持低识字能力的人进行筛查。
在筛查过程的每个阶段都存在障碍和促进因素，从影响个人筛查决定的因素到结果。为了提高塔斯马尼亚农村/偏远地区的筛查率，必须考虑筛查的障碍和促进因素。
