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Canadian Journal of Gastroenterology
Volume 25, Issue 5, Pages 248-252
http://dx.doi.org/10.1155/2011/397302
Original Article

Reactions to a Targeted Intervention to Increase Fecal Occult Blood Testing among Average-Risk Adults Waiting for Screening Colonoscopy

S Elizabeth McGregor,1,2,3 Paul Ritvo,4,5,6,7 Jill Tinmouth,8,9,10 Ashley Kornblum,4 Ronald Myers,11 Robert J Hilsden,2,12 Lawrence F Paszat,6,9,10 and Linda Rabeneck8,9,10

1Alberta Health Services – Cancer Care, Canada
2Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
3Division of Preventive Oncology, Department of Oncology, University of Calgary, Calgary, Alberta, Canada
4School of Kinesiology and Health Science, York University, Canada
5Population Studies and Surveillance, Cancer Care Ontario, Canada
6Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, Canada
7Ontario Cancer Institute, University Health Network, Canada
8Department of Medicine, Faculty of Medicine, University of Toronto, Canada
9Sunnybrook Health Sciences Centre, Canada
10Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
11Division of Population Science, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
12Department of Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada

Received 10 May 2010; Accepted 18 October 2010

Copyright © 2011 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

BACKGROUND: Increasing demand combined with limited capacity has resulted in long wait times for average-risk adults referred for screening colonoscopy for colorectal cancer. Management of patients on these growing wait lists is an emerging clinical issue.

OBJECTIVE: To inform the content and design of a mailed targeted invitation for patients to undergo annual fecal occult blood testing (FOBT) while awaiting colonoscopy.

METHODS: Focus groups (FGs) with average-risk patients on a wait list for screening colonoscopy at a high-throughput academic outpatient colonoscopy facility were conducted. During each FG session, feedback regarding a range of materials under consideration for the planned intervention was elicited using a semistructured facilitator guide. The FG sessions were recorded and transcribed verbatim, and analyzed using the constant comparative method to identify key themes.

RESULTS: Findings from the three FGs (n=28) suggested that average-risk patients on a wait list for screening colonoscopy would be receptive to a targeted intervention recommending they undergo FOBT while waiting. Participants indicated that the invitation to undergo FOBT was an important acknowledgement that they were on an actively managed list, and that a mechanism to ensure that they were correctly triaged while waiting was in place. Several specific suggestions to improve the design of the targeted intervention were obtained.

CONCLUSIONS: Results of the present study provide useful information for developing effective strategies to manage average-risk individuals facing long wait times for screening colonoscopy.