title: Developing a complex intervention to reduce time to presentation with symptoms of lung cancer.
abstract: BACKGROUND
  Lung cancer is the commonest cause of cancer in Scotland and is usually advanced at diagnosis. Median time between symptom onset and consultation is 14 weeks, so an intervention to prompt earlier presentation could support earlier diagnosis and enable curative  treatment in more cases.
  
  
  OBJECTIVE
  To develop and optimise an intervention to reduce the time between onset and first consultation with symptoms that might indicate lung cancer.
  
  
  METHODS
  Iterative development of complex healthcare intervention according  to the MRC Framework conducted in Northeast Scotland.
  
  
  METHODS
  The study produced a complex intervention to promote early presentation of lung cancer symptoms. An expert multidisciplinary group developed the first draft of the intervention based on theory and existing evidence.  This was refined following focus groups with health professionals and high-risk patients.
  
  
  RESULTS
  First draft intervention components included: information communicated persuasively, demonstrations of early consultation and its benefits, behaviour change techniques, and  involvement of spouses/partners. Focus groups identified patient engagement, achieving behavioural change, and conflict at the patient-general practice interface as challenges and measures were incorporated to tackle these. Final intervention delivery included a detailed self-help manual  and extended consultation with a trained research nurse at which specific action plans were devised.
  
  
  CONCLUSIONS
  The study has developed an intervention that appeals to patients and health professionals and has theoretical potential for benefit. Now it requires evaluation.
authors.affiliation: Centre of Academic Primary Care, University of Aberdeen, Aberdeen Health Centre, Aberdeen.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Smith
authors.forename: Peter
authors.initials: P
authors.lastname: Murchie
authors.forename: Graham
authors.initials: G
authors.lastname: Devereux
authors.forename: Marie
authors.initials: M
authors.lastname: Johnston
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Lee
authors.forename: Una
authors.initials: U
authors.lastname: Macleod
authors.forename: Marianne C
authors.initials: MC
authors.lastname: Nicolson
authors.forename: Rachael
authors.initials: R
authors.lastname: Powell
authors.forename: Lewis D
authors.initials: LD
authors.lastname: Ritchie
authors.forename: Sally
authors.initials: S
authors.lastname: Wyke
authors.forename: Neil C
authors.initials: NC
authors.lastname: Campbell
mesh_terms: D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D058006:General Practice / Q000458:organization & administration; D015438:Health Behavior; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D008297:Male; D010348:Patient Care Team / Q000458:organization & administration; D010817:Physician-Patient Relations; D012606:Scotland; D061665:Time-to-Treatment / Q000458:organization & administration*