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Title: Understanding the influences on cancer symptom presentation behaviour in the context of socioeconomic deprivation : development of a targeted cancer awareness intervention
Author: McCutchan, Grace
ISNI:       0000 0004 5989 4627
Awarding Body: Cardiff University
Current Institution: Cardiff University
Date of Award: 2016
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Inequalities in cancer survival outcomes can partly be explained by prolonged cancer symptom presentation among socioeconomically deprived groups. This PhD aimed to (1) understand the barriers to cancer symptom presentation among low socioeconomic groups and (2) develop a targeted cancer awareness intervention to promote timely symptom presentation. The COM-B (Capability, Opportunity, Motivation-Behaviour) model was selected to guide understanding of the influences on cancer symptom presentation behaviour. Systematic review and qualitative methods (30 in-depth interviews and six focus groups) were employed to identify the factors influencing symptom presentation. Findings from these studies and a scoping review of cancer awareness interventions were used to inform intervention development, guided by the Behaviour Change Wheel. The intervention was tested for acceptability with two groups of potential users. The combination of poor cancer symptom knowledge, fearful and fatalistic beliefs about cancer, and barriers such as problems associated with obtaining and accessing a primary care appointment prolonged cancer symptom presentation among low socioeconomic groups. In addition, the wider social and environmental opportunities available to people from low socioeconomic groups including economic hardship and negative experiences of cancer were identified as key influences on behaviour. An intensive community group based educational session was developed targeted at current or former smokers and family members of smokers, aged 40 years or over from socioeconomically deprived communities. Content was developed to increase cancer symptom knowledge, modify beliefs and enable timely symptom presentation by utilising strong social networks in the community. Findings from user testing confirmed that group education was an acceptable mode of intervention delivery. Understanding the complex interaction between individual psychological characteristics and the wider environment in which people from low socioeconomic groups live in is essential for modifying cancer symptom presentation behaviour. Community education could be used as a strategy to engage low socioeconomic groups in early cancer detection and warrants further feasibility and pilot testing.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: RC0254 Neoplasms. Tumors. Oncology (including Cancer)