The effect of a simple phone call intervention on FIT-positive individuals: an exploratory study
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The effect of a simple phone call intervention on FIT-positive individuals: an exploratory study Gretel Jianlin Wong 1
&
Jerrald Lau 1,2 & Ker-Kan Tan 2
Accepted: 8 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Colorectal cancer (CRC) screening has been shown to improve patient outcomes. A widely utilised preliminary screening tool is the faecal immunochemical test (FIT). However, follow-up rates after a positive FIT result remain suboptimal. Methods In order to improve FIT-positive individuals’ compliance to follow-up consultation and to elucidate barriers to action, a simple 5- to 10-min telephone intervention with a structured script based on the protection motivation theory (PMT) was conducted. Results Ninety-two FIT-positive individuals who had previously rejected follow-up consultation in the National University Hospital, Singapore, were interviewed by the study team. Individuals reported barriers to action such as the denial of a positive FIT result (41.8%) and a lack of knowledge (34.5%). More than 20% of the participants who had yet to schedule follow-up consultation changed their minds after the intervention. Conclusion The results suggest that a simple, structured telephone call can potentially encourage more FIT-positive individuals to pursue follow-up investigation. Keywords Colorectal cancer . Faecal immunochemical test . Screening . Phone intervention . Protection motivation theory
Introduction Colorectal cancer (CRC) is the third most common cancer worldwide [1]. CRC screening has been shown to improve patients’ outcomes through earlier detection and treatment of adenomatous polyps and CRC [2]. Singapore has instituted a national CRC screening programme using the faecal immunochemical test (FIT) kit, which is free-of-charge to all residents aged 50 years and above [3]. FIT uptake remains suboptimal [4], and most efforts have been focused on increasing uptake rates. However, Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00384-020-03742-4) contains supplementary material, which is available to authorized users. * Ker-Kan Tan [email protected] 1
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
2
Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, C/O NUHS Tower Block, Level 8 1E Kent Ridge Road, Singapore 119228, Singapore
what is not often highlighted is that there is a significant proportion of individuals who were tested positive for FIT but chose not to undergo subsequent consultation and colonoscopy [5, 6]. Literature has suggested that interventions are more often successful when underpinned by a health behaviour theory or framework [7]. The protection motivation theory (PMT) states that individuals make decisions to protect themselves (e.g., perform a health behaviour) through an appraisal of threat (e.g., severity of consequences from not performing the behaviour) and an appraisal of copin
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