# Understanding patient experiences of a community-based intervention to improve bowel screening uptake: a mixed-method evaluation of Call for a Kit clinics

## TL;DR

This study evaluated a community-based program called Call for a Kit to help people who missed bowel cancer screening appointments, finding that personalized support improved participation and addressed barriers like confusion and discomfort.

## Contribution

The study introduces a novel community-based intervention that uses personalized and culturally sensitive support to increase bowel cancer screening uptake among non-responders.

## Key findings

- Patient experience scores were significantly higher among women than men and linked to increased intention to complete the screening kit.
- Qualitative findings showed that CFAK clinics reduced barriers like low awareness and emotional discomfort through personalized education and support.
- The intervention enhanced psychological capability and motivation for screening through relational and inclusive care.

## Abstract

The study explored patient experiences of the Call for a Kit (CFAK) intervention, a community-based initiative designed to improve bowel cancer screening uptake and examined the mechanisms that may support participation among non-responders.

A convergent parallel mixed-methods design was employed, combining quantitative surveys and qualitative interviews.

The evaluation was conducted in general practices across Lancashire and South Cumbria, Northwest England, where CFAK clinics were delivered by an external health promotion team based within the Community Voluntary Services. These clinics target practices with low screening uptake.

A total of 113 CFAK attendees aged 54 and above, and who had missed their most recent screening invitation, completed a patient experience survey. 12 participants were purposively sampled for follow-up interviews.

Statistical analyses examined associations between patient experience and screening behaviours, including kit ordering and intention to complete the screening kit. Thematic analysis explored barriers and facilitators to participation, as well as experiences of CFAK clinics.

Patient experience scores were significantly higher among women than men and were positively associated with intention to complete the kit, though not with kit ordering. Qualitative findings indicated that CFAK addressed key barriers such as low awareness, confusion and emotional discomfort by providing personalised education, reassurance and culturally sensitive support. Participants particularly valued the relational aspects of the intervention, including the face-to-face delivery and communication in preferred languages.

CFAK clinics appear to enhance psychological capability and motivation for bowel screening by offering tailored, inclusive and supportive care. These findings highlight the value of patient-centred approaches in addressing inequalities in cancer screening and offer insights for the design of future community-based interventions.