Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Quantitative evaluation of an information leaflet to increase prompt help-seeking for gynaecological cancer symptoms

Authors: Melanie Morris, Claire Friedemann Smith, Emily Boxell, Jane Wardle, Alice Simon, Jo Waller

Published in: BMC Public Health | Issue 1/2016

Login to get access

Abstract

Background

Provision of written information may improve awareness of cancer symptoms and encourage timely presentation in primary care. This study assessed changes in symptom knowledge, perceived barriers to help-seeking, anxiety and intention to seek help, following exposure to a leaflet to raise awareness of gynaecological cancer symptoms.

Methods

Women (N = 484) completed questionnaires before and after reading the leaflet. The primary outcome was change in anticipated time to help-seeking for 12 symptoms. Changes in symptom knowledge, barriers and anxiety, and their association with prompt help-seeking were evaluated using Wilcoxon signed rank tests and logistic regression analyses.

Results

After reading the leaflet, symptom knowledge increased (p < 0.001), and perceived barriers (p < 0.001) and anxiety (p = 0.008) decreased. The number of symptoms for which women anticipated seeking help promptly increased (p < 0.001). Changes in knowledge (OR 4.21, 95 % CI 1.95-9.13) and perceived barriers (OR 4.60, 95 % CI 1.91-11.04) were independently associated with increased help-seeking.

Conclusion

Increased symptom knowledge and lowered perceived barriers were related to increased prompt anticipated help-seeking. This occurred without an increase in anxiety. This intervention is effective in altering knowledge, beliefs and help-seeking intentions for gynaecological cancer symptoms, at least in the short-term, and should be trialled in primary care.
Appendix
Available only for authorised users
Footnotes
Literature
1.
Office for National Statistics. Cancer Incidence and Mortality in the United Kingdom, 2008–2010. Newport: ONS; 2012.
2.
Modesitt SC, van Nagell JRJ. The impact of obesity on the incidence and treatment of gynecologic cancers: a review. Obstet Gynecol Surv. 2005;60:683–92.CrossRefPubMed
3.
Hamilton W, Peters TJ, Bankhead C, Sharp D. Risk of ovarian cancer in women with symptoms in primary care: population based case–control study. Brit Med J. 2009;339:b2998.
4.
Stapley S, Hamilton W. Gynaecological symptoms reported by young women: examining the potential for earlier diagnosis of cervical cancer. Fam Pract. 2011;28:592–8.CrossRefPubMed
5.
Rossing MA, Wicklund KG, Cushing-Haugen KL, Weiss NS. Predictive value of symptoms for early detection of ovarian cancer. J Natl Cancer I. 2010;102:222–9.CrossRef
6.
Kirwan JM, Tincello DG, Herod JJ, Frost O, Kingston RE. Effect of delays in primary care referral on survival of women with epithelial ovarian cancer: retrospective audit. Brit Med J. 2002;324:148–51.CrossRefPubMedPubMedCentral
7.
NICE. Suspected cancer: recognition and referral. London: National Institute for Health and Care Excellence; 2015.
8.
Weller D, Vedsted P, Rubin G, Walter FM, Emery J, Scott S, et al. The Aarhus statement: improving design and reporting of studies on early cancer diagnosis. Brit J Cancer. 2012;106:1262–7.CrossRefPubMedPubMedCentral
9.
10.
Thomson CS, Forman D. Cancer survival in England and the influence of early diagnosis: what can we learn from recent EUROCARE results? Brit J Cancer. 2009;3:6605399.
11.
Low EL, Simon AE, Lyons J, Romney-Alexander D, Waller J. What do British women know about cervical cancer symptoms and risk factors? Eur J Cancer. 2012;48:3001–8.CrossRefPubMed
12.
Low EL, Waller J, Menon U, Jones A, Reid F, Simon AE. Ovarian cancer symptom awareness and anticipated time to help-seeking for symptoms among UK women. J Fam Plann Reprod Health Care. 2013;39:163–71.CrossRefPubMed
13.
Cooper CP, Polonec L, Stewart SL, Gelb CA. Gynaecologic cancer symptom awareness, concern and care seeking among US women: a multi-site qualitative study. Fam Pract. 2013;30:96–104.CrossRefPubMed
14.
Low EL, Whitaker KL, Simon AE, Sekhon M, Waller J. Women’s interpretation of and responses to potential gynaecological cancer symptoms: a qualitative interview study. BMJ Open. 2015;5:e008082.CrossRefPubMedPubMedCentral
15.
Quaife SL, Forbes LJL, Ramirez AJ, Brain KE, Donnelly C, Simon AE, et al. Recognition of cancer warning signs and anticipated delay in help-seeking in a population sample of adults in the UK. Brit J Cancer. 2014;110:12–8.CrossRefPubMed
16.
Robb K, Stubbings S, Ramirez A, Macleod U, Austoker J, Waller J, et al. Public awareness of cancer in Britain: a population-based survey of adults. Brit J Cancer. 2009;101:S18–23.CrossRefPubMedPubMedCentral
17.
Evans RE, Morris M, Sekhon M, Buszewicz M, Walter FM, Waller J, et al. Increasing awareness of gynaecological cancer symptoms: a GP perspective. Brit J Gen Pract. 2014;64:e372–80.CrossRef
18.
Whitaker KL, Macleod U, Winstanley K, Scott SE, Wardle J. Help seeking for cancer ‘alarm’ symptoms: a qualitative interview study of primary care patients in the UK. Brit J Gen Pract. 2015;65:e96–e105.CrossRef
19.
Austoker J, Bankhead C, Forbes LJ, Atkins L, Martin F, Robb K, et al. Interventions to promote cancer awareness and early presentation: systematic review. Br J Cancer. 2009;101 Suppl 2:S31–9.CrossRefPubMedPubMedCentral
20.
Robb KA, Miles A, Campbell J, Evans P, Wardle J. Can cancer risk information raise awareness without increasing anxiety? A randomized trial. Prev Med. 2006;43:187–90.CrossRefPubMed
21.
John H, Hale ED, Treharne GJ, Korontzis K, Obrenovic K, Carroll D, et al. Patient evaluation of a novel patient education leaflet about heart disease risk among people with rheumatoid arthritis. Musculoskeletal Care. 2011;9:194–9.CrossRefPubMed
22.
Heesen C, Schaffler N, Kasper J, Muhlhauser I, Kopke S. Suspected multiple sclerosis - what to do? Evaluation of a patient information leaflet. Mult Scler. 2009;15:1103–12.CrossRefPubMed
23.
Olamijulo JA, Duncan ID. Patient-based evaluation of a colposcopy information leaflet. J Obstet Gynaecol. 1997;17:394–8.CrossRefPubMed
24.
Nicolson D, Knapp P, Raynor DK, Spoor P. Written information about individual medicines for consumers. Cochrane DB Syst Rev. 2009;(2):CD002104.
25.
Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008;337:a1655.
26.
de Nooijer J, Lechner L, Candel M, de Vries H. Short- and long-term effects of tailored information versus general information on determinants and intentions related to early detection of cancer. Prev Med. 2004;38:694–703.CrossRefPubMed
27.
Weiss BD, Mays MZ, Martz W, Castro KM, DeWalt DA, Pignone MP, et al. Quick assessment of literacy in primary care: the newest vital sign. Ann Fam Med. 2005;3:514–22.CrossRefPubMedPubMedCentral
28.
Rowlands G, Khazaezadeh N, Oteng-Ntim E, Seed P, Barr S, Weiss BD. Development and validation of a measure of health literacy in the UK: the newest vital sign. BMC Public Health. 2013;13:1471–2458.CrossRef
29.
Simon AE, Wardle J, Grimmett C, Power E, Corker E, Menon U, et al. Ovarian and cervical cancer awareness: development of two validated measurement tools. J Fam Plann Reprod Health Care. 2012;38:167–74.CrossRefPubMed
30.
Office for National Statistics. 2011 Census questions. Newport: ONS; 2008.
31.
Stubbings S, Robb K, Waller J, Ramirez A, Austoker J, Macleod U, et al. Development of a measurement tool to assess public awareness of cancer. Brit J Cancer. 2009;101:S13–7.CrossRefPubMedPubMedCentral
32.
Marteau TM, Bekker H. The development of a six-item short-form of the state scale of the Spielberger State-Trait Anxiety Inventory (STAI). Br J Clin Psychol. 1992;31:301–6.CrossRefPubMed
33.
Evans RE, Beeken RJ, Steptoe A, Wardle J. Cancer information and anxiety: applying the extended parallel process model. J Health Psychol. 2012;17:579–89.CrossRefPubMed
34.
Marlow LAV, McGregor LM, Nazroo JY, Wardle J. Facilitators and barriers to help-seeking for breast and cervical cancer symptoms: a qualitative study with an ethnically diverse sample in London. Psycho-Oncol. 2014;23:749–57.CrossRef
35.
Smith LK, Pope C, Botha JL. Patients’ help-seeking experiences and delay in cancer presentation: a qualitative synthesis. Lancet. 2005;366:825–31.CrossRefPubMed
36.
Office for National Statistics. Ethnicity and National Identity in England and Wales 2011. Newport: ONS; 2012.
37.
Office for National Statistics. Release: 2011 Census analysis, local area analysis of qualifications across England and Wales. Newport: ONS; 2014.
38.
Korkeila K, Suominen S, Ahvenainen J, Ojanlatva A, Rautava P, Helenius H, et al. Non-response and related factors in a nation-wide health survey. Eur J Epidemiol. 2001;17:991–9.CrossRefPubMed
39.
von Wagner C, Knight K, Steptoe A, Wardle J. Functional health literacy and health-promoting behaviour in a national sample of British adults. J Epidemiol Community Health. 2007;61:1086–90.CrossRef
40.
Harding C, Romanou E, Williams J, Peters M, Winkley J, Burke P, Hamer J, Jeram K, Nelson N, Rainbow B, Bond B and Shay M. Skills for Life Survey: Headline Findings. London, UK: Department for Business Innovations and Skills; 2011.
41.
Balasooriya-Smeekens C, Walter FM, Scott S. The role of emotions in time to presentation for symptoms suggestive of cancer: a systematic literature review of quantitative studies. Psycho-Oncol. 2015;24:1594–604.CrossRef
42.
Sheeran P. Intention–Behavior Relations: A Conceptual and Empirical Review. Eur Rev of Soc Psychol: John Wiley & Sons, Ltd; 2005. p. 1–36.
43.
Metadata
Title
Quantitative evaluation of an information leaflet to increase prompt help-seeking for gynaecological cancer symptoms
Authors
Melanie Morris
Claire Friedemann Smith
Emily Boxell
Jane Wardle
Alice Simon
Jo Waller
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3032-y

Other articles of this Issue 1/2016

BMC Public Health 1/2016 Go to the issue

Research article

Cost and cost-effectiveness analysis of a community mobilisation intervention to reduce intimate partner violence in Kampala, Uganda

Research article

The risk of falling into poverty after developing heart disease: a survival analysis

Research article

The risk of pulmonary tuberculosis in underground copper miners in Zambia exposed to respirable silica: a cross-sectional study

Research article

Non food-related risk factors of campylobacteriosis in Canada: a matched case-control study

Research article

Cross-sectional relations of race and poverty status to cardiovascular risk factors in the Healthy Aging in Neighborhoods of Diversity across the Lifespan (HANDLS) study

Research article

Self-reported acute pesticide intoxications in Ethiopia