Qualitative study on acceptability of screening

Research team: Alison Heawood (PI, Bristol), Clare Emmett (Qualitative Researcher, Bristol), Niamh Redmond (Trial Coordinator, Bristol), Tim Peters

(Bristol), Liz Lenaghan (UEA) & Lee Shepstone (UEA)

• Qualitative methods are increasingly used within trials to evaluate aspects less accessible to quantitative methods

• Questions are often raised about the costs as well as benefits of screening, for example the psychological impact on patients

• Quantitative studies have produced diverse findings regarding whether screening for osteoporosis contributes to anxiety in women

• Some qualitative studies have examined the psychological impact of screening on patients in other clinical areas (e.g. breast cancer, cervical cancer)

• But there has been little qualitative evaluation of the impact of osteoporosis screening on both women and GPs

Background

Sample

Women:• Purposeful sample of approx. 30 women participating in

SCOOP from two study centres: Bristol and Norwich• Will include women in both the high and low risk groups,

from different general practices and socio-economic backgrounds

GPs:• Purposeful sample of approx. 20 GPs from practices

participating in SCOOP from the same study centres• Will include GPs from a variety of practices (e.g. in terms

of deprivation), with a range of proportions of women identified as at high risk

• Experiences and views of the risk assessment process

• Experiences of the DXA scan (for those who received a scan)

• Understanding of osteoporosis• Perceptions of their risk of future fracture• Feelings about being identified as low risk

Interviews with low risk women

• Experiences and views of the risk assessment process• Experiences of the DXA scan • Understanding of osteoporosis • Reactions to knowing that they are potentially at risk of

a future fracture• Reasons for taking-up or not taking-up the opportunity

to discuss the results with their GP• Experiences of consulting the GP to discuss the result

and future treatment options (where this option has been taken up)

• Thoughts and feelings about using preventative medication

Interviews with high risk women

• Acceptability of the screening process

• Reactions to receiving the screening result (a woman’s risk category) and how they interpret this

• Experiences of discussing the screening results with women (both high risk women who take up this option as part of the trial, and low risk women who independently seek a discussion with their GP as a result of participating in the trial)

• Decision-making about potential preventative treatment options for high risk women

Interviews with GPs