Colorectal (bowel) cancer is the second highest cause of cancer death (after lung cancer) and a priority area of the state-wide SA Academic Health Science and Translation Centre. In South Australia (as nationwide), the low participation in the National Bowel Cancer Screening Program (NBCSP) (~44%) constrains the program benefits to be realised in preventing premature death. Primary care plays a vital role in population-based screening programs however, the involvement of GPs in the current NBCSP is limited, despite more than 90% of the eligible patient cohort (50-74 years) visiting a GP in the previous 12 months.
Implementing change in primary care is recognized as challenging. Difficulties in designing, testing and valuating complex interventions in 'real-world' settings influenced by variable contextual factors, partly contributes to the limited evidence-base of effective and sustainable primary care interventions. We propose to use a value co-creation model to design and test the feasibility of a multi-component intervention using evidence-based quality improvement 11 methodology aimed at increasing bowel cancer screening participation at the primary care level. Peer-to-peer review of de-identified, and aggregated, practice data (supplemented with population data) will be used to identify clinical variation and opportunities for improvement and collaboration across practices.
This pilot study will generate an innovative co-created quality improvement model and finalise the experimental design to evaluate the effectiveness of the intervention when it is subsequently applied at scale within primary care settings.