TY - JOUR T1 - Development of an intervention to expedite cancer diagnosis through primary care: a protocol JF - BJGP Open JO - BJGP Open DO - 10.3399/bjgpopen18X101595 VL - 2 IS - 3 SP - bjgpopen18X101595 AU - Marian Andrei Stanciu AU - Rebecca-Jane Law AU - Sadia Nafees AU - Maggie Hendry AU - Seow Tien Yeo AU - Julia Hiscock AU - Ruth Lewis AU - Rhiannon T Edwards AU - Nefyn H Williams AU - Katherine Brain AU - Paul Brocklehurst AU - Andrew Carson-Stevens AU - Sunil Dolwani AU - Jon Emery AU - William Hamilton AU - Zoe Hoare AU - Georgios Lyratzopoulos AU - Greg Rubin AU - Stephanie Smits AU - Peter Vedsted AU - Fiona Walter AU - Clare Wilkinson AU - Richard D Neal AU - The WICKED Team on behalf of Y1 - 2018/10/01 UR - http://bjgpopen.org/content/2/3/bjgpopen18X101595.abstract N2 - 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’ 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. ER -