Dr Foster Intelligence | Case studies

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Success stories

Researching the needs of the local community helped design better services.

Using local knowledge to save local lives

When four PCTs in North East London realised they had a much higher than average rate of did-not-attend appointments for breast cancer screening, they knew they needed to understand why. Supported by the Department of Health, City and Hackney, Newham, Tower Hamlets and Waltham Forest PCTs embarked on a series of research forums and analyses with Dr Foster Intelligence's Social Marketing team.

The team had pioneered the use of commercial marketing techniques in the health and social care sectors. Their work is effective and engaging, understanding what drives the communities and shaping campaigns and plans to reflect those interests.

Health needs mapping

The first step in understanding a community is to identify who is at risk for a disease and where they live.

The project team used Experian's data mapping expertise to show the levels of risk for breast cancer in each PCT. Taken together, the PCTs cover a large area with a lot of younger women in residence.

Unsurprisingly, the risk map showed that overall, the women in the PCTs were generally only at average risk for getting breast cancer.

More info: Dr Foster Intelligence uses ©Experian Ltd population mapping expertise to visually understand where groups of at-risk populations are clustered.

Data analysis

The project team then examined the PCTs' breast cancer screening data in order to try to identify patterns in the lists of women invited for a screening but not attending.

The diversity in the area studied is greater than London as a whole, making it more difficult for patterns of attendance to be identified.

What the research did show was that the largest group not attending screenings had a name of English origin. Geography and lifestyle did not appear to be a significant factor in influencing screening attendance, although minority groups did appear more likely to never have been screened.

Focus groups and lifestyle analyses

In order to control for differences in attendance due to backgrounds and beliefs, the project team used focus groups to gain a more nuanced understanding of the women's decision not to attend screening appointments.

The focus groups were divided into four groups by ethnicity (Bangladeshi, African, Afro-Caribbean and White) and were asked to explore their perceptions and myths around breast cancer.

Fear of the unknown was the main theme to emerge from the groups. Many women would prefer to avoid addressing the possibility of having the disease by not attending screening appointments. The one thing that they said would help them overcome that fear would be a closer relationship with their nurse or GP.

The focus groups also told the project team that the rigid opening and closing times of screening centres were simply too difficult to fit into their daily routines.

Solution

After understanding who was at what level of risk for breast cancer, and learning what the women thought about the disease, the project team put together its recommendations for improving attendance at screenings.

Using the knowledge of the importance of a trusting relationship with a healthcare professional, the project team suggested to the PCTs and Department of Health that mobile testing units be used rather than hospitals.

Hospitals were viewed by the women in the focus groups as places where people went when they were ill, not a place to go when they were healthy. The mobile testing units allowed GPs and nurses to work directly with their patient population, and if the communication around the testing focused on the overall well-being and benefits, rather than doomsday scare tactics, the women felt more comfortable about addressing breast cancer and thus attending screening appointments.

Outcome

Work is already underway by the four PCTs in redesigning the method of delivering breast cancer screening. Communication campaigns have been intensified and also redesigned. With every invitation sent out inviting women to attend a screening, a leaflet is included that gives general information about breast cancer and highlights the reasons and benefits of early detection and screening.