# Co-designing a general practice-led intervention and implementation strategy to increase bowel cancer screening through general practice: a qualitative study

## TL;DR

This study explores how general practice stakeholders in Australia can better support bowel cancer screening programs and identifies ways to improve their involvement.

## Contribution

The study co-designs a general practice-led intervention and implementation strategy to increase bowel cancer screening participation.

## Key findings

- Proactive GP involvement in the NBCSP is hindered by clinical information system limitations and time constraints.
- A multi-component intervention involving risk assessment and electronic reminders is seen as feasible if implementation challenges are addressed.
- Stakeholders are willing to support CRC screening but do not prioritize the NBCSP as the main method.

## Abstract

Regular screening can reduce the burden of colorectal cancer (CRC) and general practice involvement has been demonstrated to improve screening uptake and CRC outcomes. Our study explores Australian general practice stakeholders’ current involvement in supporting organised CRC screening through the National Bowel Cancer Screening Program (NBCSP) and their views of the feasibility and applicability of evidence-based intervention components.

A qualitative study was undertaken using focus groups (n = 12) with 45 participants that included General Practitioners (GPs), practice nurses, practice staff and program support staff from across Australia. The Consolidated Framework for Implementation Research (CFIR) was used as a guiding framework for deductive thematic content analysis.

The findings indicated that proactive GP involvement in the NBCSP is challenged by clinical information system limitations, time constraints, and competing priorities. Participants expressed a willingness to support CRC screening activities, understood the effectiveness of screening, but placed little focus on using the NBCSP as the primary method of CRC screening. An intervention to increase NBCSP participation involving a risk assessment tool, electronic reminder prompt, clinical information system and workflow enhancement, and education was viewed as feasible and applicable to practice if identified implementation challenges in the inner setting and individuals CFIR domains were addressed.

General practice stakeholders acknowledge their potential for a more enhanced role in supporting the NBCSP and contributing to reducing the impact of CRC. A multi-component general practice-led intervention to promote an enhanced role was perceived as acceptable. To improve feasibility and applicability, the intervention needs to be integrated, straightforward, time-efficient, and supported by incentives and a whole-of-practice approach.

The online version contains supplementary material available at 10.1186/s12875-025-03016-4.