Experience-based co-design of an active case finding service for colorectal cancer in community pharmacies: findings from a focused ethnography

Abstract Background Colorectal cancer (CRC) is the fourth most common cancer and second leading cause of cancer deaths in the UK. Socioeconomic deprivation is associated with delayed diagnoses and poorer CRC outcomes. Community pharmacies, highly accessible in underserved areas, present an opportuni...

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Main Authors: Naseeb Ezaydi, Daniel Hind, Atique Arif, Ian Kellar, Rachel Matthews, Dana Marbu, Claire Thomas, Matthew Kurien, DETECT-CRC Co-design group
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Research Involvement and Engagement
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Online Access:https://doi.org/10.1186/s40900-025-00740-0
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author Naseeb Ezaydi
Daniel Hind
Atique Arif
Ian Kellar
Rachel Matthews
Dana Marbu
Claire Thomas
Matthew Kurien
DETECT-CRC Co-design group
author_facet Naseeb Ezaydi
Daniel Hind
Atique Arif
Ian Kellar
Rachel Matthews
Dana Marbu
Claire Thomas
Matthew Kurien
DETECT-CRC Co-design group
author_sort Naseeb Ezaydi
collection DOAJ
description Abstract Background Colorectal cancer (CRC) is the fourth most common cancer and second leading cause of cancer deaths in the UK. Socioeconomic deprivation is associated with delayed diagnoses and poorer CRC outcomes. Community pharmacies, highly accessible in underserved areas, present an opportunity to address these health inequalities. This DETECT-CRC study aimed to develop a pharmacy-based active case-finding (ACF) service for CRC in underserved communities of Yorkshire, UK. Methods We used a modified Experience-Based Co-Design (EBCD) approach to develop the ACF service. Four co-design workshops were conducted over five months, bringing together pharmacists, general practitioners (GP), patients and community members. A focused ethnography was embedded within the EBCD process, consisting of interviews and observation of workshops. Field notes were analysed thematically to identify key considerations shaping the service design. Results Three overarching themes emerged: 1) Amplifying community pharmacy assets, emphasising accessibility and trust-building; 2) Strengthening inclusive practice, highlighting privacy, cultural considerations, health literacy, and emotional factors; and 3) Enabling service integration and quality, stressing collaboration between pharmacies and GPs, and pharmacy training needs. These insights informed the development of a comprehensive ACF service model, including multilingual patient-facing materials, a training package for pharmacy staff, and protocols for GP communication. The co-design process ensured the resulting service was grounded in community needs and perspectives. Conclusion This study provides a co-designed model for pharmacy-based ACF of CRC in underserved areas. The model shows promise in addressing health inequalities and improving early cancer detection. It demonstrates how community pharmacies can play a pivotal role in cancer detection, contributing to the NHS Long Term Plan’s ambition of diagnosing 75% of cancers at stage 1 or 2 by 2028. While further research is needed to evaluate its effectiveness, this approach holds potential for improving CRC outcomes in underserved communities and could be adapted for other health conditions and settings.
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spelling doaj-art-cd44b472e9cd434aa5da128cba0f9e272025-08-20T02:39:44ZengBMCResearch Involvement and Engagement2056-75292025-06-0111111910.1186/s40900-025-00740-0Experience-based co-design of an active case finding service for colorectal cancer in community pharmacies: findings from a focused ethnographyNaseeb Ezaydi0Daniel Hind1Atique Arif2Ian Kellar3Rachel Matthews4Dana Marbu5Claire Thomas6Matthew Kurien7DETECT-CRC Co-design groupSchool of Medicine and Population Health, Sheffield Centre for Health and Related Research, University of SheffieldSenior Research Fellow (Social Care Research and Development), School of Healthcare, University of LeedsRotherham Doncaster and South Humber NHS Foundation Trust (RDaSH)Department of Psychology, The University of SheffieldFreelance Certified Professional Co-Active Coach and National Voices Associate, Rachel Matthews Coaching and ConsultancySchool of Medicine and Population Health, Sheffield Centre for Health and Related Research, University of SheffieldCommunity Pharmacy South YorkshireDivision of Clinical Medicine, School of Medicine and Population Health, The University of SheffieldAbstract Background Colorectal cancer (CRC) is the fourth most common cancer and second leading cause of cancer deaths in the UK. Socioeconomic deprivation is associated with delayed diagnoses and poorer CRC outcomes. Community pharmacies, highly accessible in underserved areas, present an opportunity to address these health inequalities. This DETECT-CRC study aimed to develop a pharmacy-based active case-finding (ACF) service for CRC in underserved communities of Yorkshire, UK. Methods We used a modified Experience-Based Co-Design (EBCD) approach to develop the ACF service. Four co-design workshops were conducted over five months, bringing together pharmacists, general practitioners (GP), patients and community members. A focused ethnography was embedded within the EBCD process, consisting of interviews and observation of workshops. Field notes were analysed thematically to identify key considerations shaping the service design. Results Three overarching themes emerged: 1) Amplifying community pharmacy assets, emphasising accessibility and trust-building; 2) Strengthening inclusive practice, highlighting privacy, cultural considerations, health literacy, and emotional factors; and 3) Enabling service integration and quality, stressing collaboration between pharmacies and GPs, and pharmacy training needs. These insights informed the development of a comprehensive ACF service model, including multilingual patient-facing materials, a training package for pharmacy staff, and protocols for GP communication. The co-design process ensured the resulting service was grounded in community needs and perspectives. Conclusion This study provides a co-designed model for pharmacy-based ACF of CRC in underserved areas. The model shows promise in addressing health inequalities and improving early cancer detection. It demonstrates how community pharmacies can play a pivotal role in cancer detection, contributing to the NHS Long Term Plan’s ambition of diagnosing 75% of cancers at stage 1 or 2 by 2028. While further research is needed to evaluate its effectiveness, this approach holds potential for improving CRC outcomes in underserved communities and could be adapted for other health conditions and settings.https://doi.org/10.1186/s40900-025-00740-0Patient and public involvementCo-designEarly diagnosisCancer detectionPharmacy
spellingShingle Naseeb Ezaydi
Daniel Hind
Atique Arif
Ian Kellar
Rachel Matthews
Dana Marbu
Claire Thomas
Matthew Kurien
DETECT-CRC Co-design group
Experience-based co-design of an active case finding service for colorectal cancer in community pharmacies: findings from a focused ethnography
Research Involvement and Engagement
Patient and public involvement
Co-design
Early diagnosis
Cancer detection
Pharmacy
title Experience-based co-design of an active case finding service for colorectal cancer in community pharmacies: findings from a focused ethnography
title_full Experience-based co-design of an active case finding service for colorectal cancer in community pharmacies: findings from a focused ethnography
title_fullStr Experience-based co-design of an active case finding service for colorectal cancer in community pharmacies: findings from a focused ethnography
title_full_unstemmed Experience-based co-design of an active case finding service for colorectal cancer in community pharmacies: findings from a focused ethnography
title_short Experience-based co-design of an active case finding service for colorectal cancer in community pharmacies: findings from a focused ethnography
title_sort experience based co design of an active case finding service for colorectal cancer in community pharmacies findings from a focused ethnography
topic Patient and public involvement
Co-design
Early diagnosis
Cancer detection
Pharmacy
url https://doi.org/10.1186/s40900-025-00740-0
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