The acceptability and feasibility of lay-health led interventions for the prevention and early detection of cancer

Background: US-based evidence suggests that lay-health worker (LHW) interventions can increase awareness around cancer risk-related lifestyles, symptom recognition and screening programme uptake. The suitability of LHW interventions in the UK and the potential barriers and facilitators for implementation is currently unknown. This study explored the acceptability and feasibility of developing LHW interventions for cancer prevention, screening and early diagnosis. Methods: Purposive sampling recruited five separate lay groups: a) completed cancer treatment; b) friends/family of cancer patients; c) cancer hospital volunteers; d) cancer charity volunteers; and e) members of the public. Audio-recorded focus groups and semi-structured interviews were transcribed for thematic analysis using framework matrices. Results: Forty-one people (66% female, aged 23-84 years) participated. Three main themes are reported: i) scope of LHW roles, with a clear remit embedded within communities or primary care practices, ii) defining LHW tasks, with a focus on supporting people overcome barriers including lack of cancer symptom knowledge and non-attendance at screening and iii) clear boundaries, with LHW training and on-going support from healthcare staff seen as key for intervention success. All groups were uncomfortable about having lifestyle-related risk conversations and potentially inflicting guilt. The post-treatment group expressed less concern about the possible emotional impact of discussing cancer symptoms, compared to the other groups. Conclusions: LHW interventions to promote early diagnosis or screening were generally considered acceptable in a UK context. LHW interventions focussing on reducing cancer risk may be less feasible.