@article {Stanciubjgpopen18X101595, author = {Marian Andrei Stanciu and Rebecca-Jane Law and Sadia Nafees and Maggie Hendry and Seow Tien Yeo and Julia Hiscock and Ruth Lewis and Rhiannon T Edwards and Nefyn H Williams and Katherine Brain and Paul Brocklehurst and Andrew Carson-Stevens and Sunil Dolwani and Jon Emery and William Hamilton and Zoe Hoare and Georgios Lyratzopoulos and Greg Rubin and Stephanie Smits and Peter Vedsted and Fiona Walter and Clare Wilkinson and Richard D Neal and The WICKED Team on behalf of}, title = {Development of an intervention to expedite cancer diagnosis through primary care: a protocol}, elocation-id = {bjgpopen18X101595}, year = {2018}, doi = {10.3399/bjgpopen18X101595}, publisher = {Royal College of General Practitioners}, abstract = {Background GPs can play an important role in achieving earlier cancer diagnosis to improve patient outcomes, for example through prompt use of the urgent suspected cancer referral pathway. Barriers to early diagnosis include individual practitioner variation in knowledge, attitudes, beliefs, professional expectations, and norms.Aim This programme of work (Wales Interventions and Cancer Knowledge about Early Diagnosis [WICKED]) will develop a behaviour change intervention to expedite diagnosis through primary care and contribute to improved cancer outcomes.Design \& setting Non-experimental mixed-method study with GPs and primary care practice teams from Wales.Method Four work packages will inform the development of the behaviour change intervention. Work package 1 will identify relevant evidence-based interventions (systematic review of reviews) and will determine why interventions do or do not work, for whom, and in what circumstances (realist review). Work package 2 will assess cancer knowledge, attitudes, and behaviour of GPs, as well as primary care teams{\textquoteright} perspectives on cancer referral and investigation (GP survey, discrete choice experiment [DCE], interviews, and focus groups). Work package 3 will synthesise findings from earlier work packages using the behaviour change wheel as an overarching theoretical framework to guide intervention development. Work package 4 will test the feasibility and acceptability of the intervention, and determine methods for measuring costs and effects of subsequent behaviour change in a randomised feasibility trial.Results The findings will inform the design of a future effectiveness trial, with concurrent economic evaluation, aimed at earlier diagnosis.Conclusion This comprehensive, evidence-based programme will develop a complex GP behaviour change intervention to expedite the diagnosis of symptomatic cancer, and may be applicable to countries with similar healthcare systems.}, URL = {https://bjgpopen.org/content/early/2018/09/03/bjgpopen18X101595}, eprint = {https://bjgpopen.org/content/early/2018/09/03/bjgpopen18X101595.full.pdf}, journal = {BJGP Open} }