Newcastle Cancer Control Collaborative (New-3C), NSW


Improving self-management of health risks among general practice patients

Background
Preventative health guidelines highlight the important role of general practitioners in identifying and managing cancer risk factors. However, general practitioners have reported several barriers to implementing such guidelines into practice, including lack of time and competing demands within the consultation. Patient self-management may offer a solution to overcome such barriers, by empowering the patient to manage their own healthcare via lifestyle changes and encouraging them to seek support from their doctor when needed.

Aims
Members of New-3C are undertaking a study to test the impact of a low intensity intervention to increase patient self-management of cancer risk factors and screening needs. The study examines whether providing general practice patients with brief information about their health risk factors and cancer screening tests that may be appropriate for them, has an impact on the self-management strategies used to manage their health. For the purpose of this study we have focussed on selected cancer risk factors – smoking, and risky alcohol consumption – as well as screening for breast, bowel and cervical cancer. We are also assessing depressive symptoms, and for those with elevated depression scores, providing brief information on self-management and sources of professional help. While depression is not a cancer risk factor; it may co-occur with risk factors such as smoking and risky alcohol intake. Where depression co-occurs it may impede self-management efforts to reduce preventable risk factors, and therefore, it is important that information on depression is obtained and addressed.

Methods
Eligible general practice patients are asked to complete a brief touchscreen computer survey in the waiting room prior to their appointment. The survey includes questions about their cancer health risk factors (e.g. smoking) and their participation in cancer screening. Upon survey completion, participants in the intervention condition receive tailored printed feedback about their health risk factors and recommended cancer screening tests. All participants are followed up with a 15 minute telephone interview one month after their initial survey. The telephone interview asks about any self-management steps and cancer screening tests which they may have undertaken since the initial survey. This allows us to test whether providing this brief feedback to patients at their primary care appointment results in actions to improve health. (Protocol paper is published here: Carey C, Sanson-Fisher R, Oldmeadow C, Mansfield M and Walsh J. (2016). Improving self-management of cancer risk factors, underscreening for cancer and depression among general practice patients: study protocol of a randomised controlled trial. BMJ Open, 6: e014782).

Progress
Data collection is underway at two general practices in the Hunter region, with plans to expand recruitment to a third general practice in 2017. To date 130 participants have been recruited across two practices and follow-up interviews have been completed with 80% of participants.

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