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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

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
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
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.
1471-2407
255-[23pp]
Dowswell, George
ddfd8393-d0d7-4dab-bd12-76ff859a67c6
Ryan, Angela
f84ed37a-c93d-4cfa-9534-0468cc9dc33e
Taylor, Aliki
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Daley, Amanda
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Freemantle, Nick
8182a4ad-e20e-4aea-b5f7-62b170845d1e
Brookes, Matthew
4c16eac1-b4d3-48a7-8fbe-61c57357d5e5
Jones, Janet
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Haslop, Richard
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Grimmett, Chloe
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Cheng, Kk
49fa270c-60e3-4fbb-be4e-1c4e0f9b3bec
Wilson, Sue
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Dowswell, George
ddfd8393-d0d7-4dab-bd12-76ff859a67c6
Ryan, Angela
f84ed37a-c93d-4cfa-9534-0468cc9dc33e
Taylor, Aliki
250708c9-a401-4ff0-a9d3-37f9fdb550da
Daley, Amanda
b4db8784-bff5-45d7-8c28-67503a40389a
Freemantle, Nick
8182a4ad-e20e-4aea-b5f7-62b170845d1e
Brookes, Matthew
4c16eac1-b4d3-48a7-8fbe-61c57357d5e5
Jones, Janet
153b6e4e-5263-4acd-bd07-46079c5136fd
Haslop, Richard
c49986b7-3c4d-4fa7-a300-e2b5be9cb4bf
Grimmett, Chloe
7f27e85b-2850-481d-a7dd-2835e1a925cd
Cheng, Kk
49fa270c-60e3-4fbb-be4e-1c4e0f9b3bec
Wilson, Sue
6fd6c8e9-2e06-4eff-a081-feecf4d173ae

Dowswell, George, Ryan, Angela, Taylor, Aliki, Daley, Amanda, Freemantle, Nick, Brookes, Matthew, Jones, Janet, Haslop, Richard, Grimmett, Chloe, Cheng, Kk and Wilson, Sue (2012) 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. BMC cancer, 12 (1), 255-[23pp]. (doi:10.1186/1471-2407-12-255). (PMID:22708848)

Record type: Article

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.

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Published date: 18 June 2012
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 342061
URI: http://eprints.soton.ac.uk/id/eprint/342061
ISSN: 1471-2407
PURE UUID: c2b2af20-edcc-4743-8d3b-9a3ec2450e3d
ORCID for Chloe Grimmett: ORCID iD orcid.org/0000-0002-7540-7206

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Date deposited: 10 Aug 2012 15:02
Last modified: 15 Mar 2024 03:43

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Contributors

Author: George Dowswell
Author: Angela Ryan
Author: Aliki Taylor
Author: Amanda Daley
Author: Nick Freemantle
Author: Matthew Brookes
Author: Janet Jones
Author: Richard Haslop
Author: Chloe Grimmett ORCID iD
Author: Kk Cheng
Author: Sue Wilson

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