Designing an intervention to help people with colorectal adenomas reduce their intake of red and processed meat and increase their levels of physical activity : a qualitative study

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Designing an intervention to help people with colorectal adenomas reduce their intake of red and processed meat and increase their levels of physical activity : a qualitative study. / Dowswell, George; Ryan, Angela; Taylor, Aliki; Daley, Amanda; Freemantle, Nick; Brookes, Matthew; Jones, Janet; Haslop, Richard; Grimmett, Chloe; Cheng, Kk; Wilson, Sue.

In: BMC Cancer, Vol. 12, No. 1, 255, 18.06.2012.

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@article{82149667c0954f6aab01a3cb89701b4a,
title = "Designing an intervention to help people with colorectal adenomas reduce their intake of red and processed meat and increase their levels of physical activity : a qualitative study",
abstract = "ABSTRACT: BACKGROUND: Most cases of colorectal cancer (CRC) arise from adenomatous polyps and malignant potential is greatest in high risk adenomas. There is convincing observational evidence that red and processed meat increase the risk of CRC and that higher levels of physical activity reduce the risk. However, no definitive randomised trial has demonstrated the benefit of behaviour change on reducing polyp recurrence and no consistent advice is currently offered to minimise patient risk. This qualitative study aimed to assess patients' preferences for dietary and physical activity interventions and ensure their appropriate and acceptable delivery to inform a feasibility trial. METHODS: Patients aged 60-74 included in the National Health Service Bowel Cancer Screening Programme (NHSBCSP) were selected from a patient tracking database. After a positive faecal occult blood test (FOBt), all had been diagnosed with an intermediate or high risk adenoma (I/HRA) at colonoscopy between April 2008 and April 2010. Interested patients and their partners were invited to attend a focus group or interview in July 2010. A topic guide, informed by the objectives of the study, was used. A thematic analysis was conducted in which transcripts were examined to ensure that all occurrences of each theme had been accounted for and compared. RESULTS: Two main themes emerged from the focus groups: a) experiences of having polyps and b) changing behaviour. Participants had not associated polyp removal with colorectal cancer and most did not remember being given any information or advice relating to this at the time. Heterogeneity of existing diet and physical activity levels was noted. There was a lack of readiness to change behaviour in many people in the target population. CONCLUSION: This study has demonstrated the difficulties involved in developing interventions to change dietary and physical activity behaviour in this population. The need to tailor the intervention to individuals, the lack of knowledge about the aetiology of colon cancer and the lack of motivation to change behaviour are critical factors.",
keywords = "Adenomatous polyps, Feasibility studies, Prevention & control, Health behaviour, Attitude to health, Qualitative research, Colorectal neoplasms",
author = "George Dowswell and Angela Ryan and Aliki Taylor and Amanda Daley and Nick Freemantle and Matthew Brookes and Janet Jones and Richard Haslop and Chloe Grimmett and Kk Cheng and Sue Wilson",
year = "2012",
month = jun,
day = "18",
doi = "10.1186/1471-2407-12-255",
language = "English",
volume = "12",
journal = "BMC Cancer",
issn = "1471-2407",
publisher = "Springer",
number = "1",

}

RIS

TY - JOUR

T1 - Designing an intervention to help people with colorectal adenomas reduce their intake of red and processed meat and increase their levels of physical activity : a qualitative study

AU - Dowswell, George

AU - Ryan, Angela

AU - Taylor, Aliki

AU - Daley, Amanda

AU - Freemantle, Nick

AU - Brookes, Matthew

AU - Jones, Janet

AU - Haslop, Richard

AU - Grimmett, Chloe

AU - Cheng, Kk

AU - Wilson, Sue

PY - 2012/6/18

Y1 - 2012/6/18

N2 - ABSTRACT: BACKGROUND: Most cases of colorectal cancer (CRC) arise from adenomatous polyps and malignant potential is greatest in high risk adenomas. There is convincing observational evidence that red and processed meat increase the risk of CRC and that higher levels of physical activity reduce the risk. However, no definitive randomised trial has demonstrated the benefit of behaviour change on reducing polyp recurrence and no consistent advice is currently offered to minimise patient risk. This qualitative study aimed to assess patients' preferences for dietary and physical activity interventions and ensure their appropriate and acceptable delivery to inform a feasibility trial. METHODS: Patients aged 60-74 included in the National Health Service Bowel Cancer Screening Programme (NHSBCSP) were selected from a patient tracking database. After a positive faecal occult blood test (FOBt), all had been diagnosed with an intermediate or high risk adenoma (I/HRA) at colonoscopy between April 2008 and April 2010. Interested patients and their partners were invited to attend a focus group or interview in July 2010. A topic guide, informed by the objectives of the study, was used. A thematic analysis was conducted in which transcripts were examined to ensure that all occurrences of each theme had been accounted for and compared. RESULTS: Two main themes emerged from the focus groups: a) experiences of having polyps and b) changing behaviour. Participants had not associated polyp removal with colorectal cancer and most did not remember being given any information or advice relating to this at the time. Heterogeneity of existing diet and physical activity levels was noted. There was a lack of readiness to change behaviour in many people in the target population. CONCLUSION: This study has demonstrated the difficulties involved in developing interventions to change dietary and physical activity behaviour in this population. The need to tailor the intervention to individuals, the lack of knowledge about the aetiology of colon cancer and the lack of motivation to change behaviour are critical factors.

AB - ABSTRACT: BACKGROUND: Most cases of colorectal cancer (CRC) arise from adenomatous polyps and malignant potential is greatest in high risk adenomas. There is convincing observational evidence that red and processed meat increase the risk of CRC and that higher levels of physical activity reduce the risk. However, no definitive randomised trial has demonstrated the benefit of behaviour change on reducing polyp recurrence and no consistent advice is currently offered to minimise patient risk. This qualitative study aimed to assess patients' preferences for dietary and physical activity interventions and ensure their appropriate and acceptable delivery to inform a feasibility trial. METHODS: Patients aged 60-74 included in the National Health Service Bowel Cancer Screening Programme (NHSBCSP) were selected from a patient tracking database. After a positive faecal occult blood test (FOBt), all had been diagnosed with an intermediate or high risk adenoma (I/HRA) at colonoscopy between April 2008 and April 2010. Interested patients and their partners were invited to attend a focus group or interview in July 2010. A topic guide, informed by the objectives of the study, was used. A thematic analysis was conducted in which transcripts were examined to ensure that all occurrences of each theme had been accounted for and compared. RESULTS: Two main themes emerged from the focus groups: a) experiences of having polyps and b) changing behaviour. Participants had not associated polyp removal with colorectal cancer and most did not remember being given any information or advice relating to this at the time. Heterogeneity of existing diet and physical activity levels was noted. There was a lack of readiness to change behaviour in many people in the target population. CONCLUSION: This study has demonstrated the difficulties involved in developing interventions to change dietary and physical activity behaviour in this population. The need to tailor the intervention to individuals, the lack of knowledge about the aetiology of colon cancer and the lack of motivation to change behaviour are critical factors.

KW - Adenomatous polyps

KW - Feasibility studies

KW - Prevention & control

KW - Health behaviour

KW - Attitude to health

KW - Qualitative research

KW - Colorectal neoplasms

U2 - 10.1186/1471-2407-12-255

DO - 10.1186/1471-2407-12-255

M3 - Article

C2 - 22708848

VL - 12

JO - BMC Cancer

JF - BMC Cancer

SN - 1471-2407

IS - 1

M1 - 255

ER -