Persuading people to come along for health screening can be tricky, especially when the test you’re offering is not universally understood and involves them doing something slightly squeamish.
This was the situation facing St Mark’s Hospital in North West London, while inviting the over 55s to attend for the bowel scope screening test.
The test involves looking at the bowel with a camera to examine it for polyps and other early signs of cancer. If found the polyps can be easily removed and further treatment offered where needed.
St Mark’s together with University College London (UCL) approached Partners in Creation for help using qualitative research to improve the patient journey, from receiving their first communication to attending for the test. The aim was ultimately to get more people through the doors of the testing centre.
Rob Kerrison, from UCL explained: “We asked Partners in Creation to help us develop a new set of materials. We had worked closely with them in the past on similar projects and were impressed by their enthusiasm to involve the public in developing the materials.”
There were two groups of people to focus on; those who didn’t respond to the screening invitation (DNRs) and those who got as far as booking an appointment but never attended (DNAs).
Using survey data to understand the barriers to uptake we found that, in the case of DNRs, roughly a quarter of people believed the test would be painful, embarrassing and not relevant to them, with slightly fewer believing it could be harmful.
Of those who made an appointment the same concerns were shared but by fewer people. Of this group 15% were also put off by the need to use an enema at home before attending. Says Rob Kerrison: “We were surprised to find that many people seemed to be more worried about doing the enema than the test itself!”
In response we created a new appointment process that primed the audience in advance of receiving an invitation letter. Says Rob Kerrison: “We wanted to develop new materials specifically for these two groups of people who we realised had very different needs in terms of the information they receive compared with people who had already taken part in the programme.”
Testing draft materials on two focus groups helped us develop the tone of the materials and convinced us to use video to explain the process and give a personal perspective.
The final materials included an A5 flyer and letter from the hospital, as primers along with a website designed to demystify the process with straightforward information about what to expect - including more about that enema. Featured on the site are short video testimonials from patients as well as the expert take on the test, what it involves and why it’s important.
St Mark's bowel screening website (with video stories)
St Mark's Hospital website
University College London (UCL) - Department of Epidemiology and Public Health