Early cancer detection: Evaluation of the ‘Get to know cancer’ pop-up shop initiative
Jo Armes describes how to encourage people to talk about cancer in a non-clinical environment located in the community.
More than 250,000 people in England are diagnosed with cancer every year and around 130,000 die from the disease (ONS, 2012). Despite improvements in survival in recent decades, cancer survival rates in England are lower when compared with the best outcomes in Europe (Coleman et al, 2011; Department of Health, 2011). It is generally accepted that diagnosis of cancer at a later stage is the most important reason for lower survival rates in England (Department of Health, 2011) therefore early diagnosis is now a national priority.
Research suggests a combination of public education about symptoms and empowerment to seek medical advice, as well as support at the primary care level, could enhance early presentation and improve cancer outcomes (Robb et al, 2009). Thus a ‘Get to know cancer’ campaign was set up by the London Health Improvement Board. This included a ‘pop-up’ shop in North London which aimed to promote early diagnosis by profiling cancer survivorship, raising awareness of cancer symptoms and encouraging people to see their General Practitioner if appropriate.
The 'Get to know cancer' pop-up shop
The ‘Get to know cancer’ pop-up shop was located in unused shop space in a local shopping centre and was selected on the basis of higher local cancer mortality rates and lower life expectancy. The pop-up shop aimed to provide a convenient environment where people felt comfortable talking and learning about cancer. The shop was open for a short time (1 February – 3 March 2013) and was staffed by two nurses who offered advice, cancer information and general health information. One nurse was a cancer nurse specialist and the other was trained in cancer awareness and was experienced in health promotion. Provision was made in the shop space for a more private area so nurses could consult with visitors who had particular questions or concerns about cancer. Volunteers, known as ‘cancer activists’, were also present in the shop, welcoming visitors and signposting them to relevant information.
The shop offered a programme of information sessions/events, in partnership with cancer charities and local organisations as well as calculating visitors’ Body Mass Index (BMI). The shop was advertised in local newspapers. Posters were put in the majority of local GP practices, as well as in local settings. Social care suppliers and pharmacists were also informed of the initiative and retailers in the area were asked to promote the shop.
Drawing people in
Over 31 days, 4,000 people were approached by volunteers and 8,000 leaflets on healthy living and cancer signs/symptoms were distributed. Of 1,079 people who visited the shop, 322 had a consultation with a nurse. Just under half of the consultations were with people who were classified overweight and smokers made up only a fifth of the sample. During the consultations, nurses discussed a range of important topics including healthy living advice and signs and symptoms of cancer. A fifth mentioned symptoms that could be indicative of cancer and most were advised by the nurse to see their GP or a specialist.
Visitors to the 'Get to know cancer' pop-up shop
We evaluated how the shop operated and its impact on visitors using a number of different approaches. We:
- spent time observing what happened in the shop
- audited health service signposting and uptake
- undertook a visitor survey.
Questionnaires from 98 visitors revealed an overwhelmingly positive response to the pop-up shop: 93% said they would recommend it to others and over half said they planned to visit their GP as a result. No one said they would definitely not recommend the shop. The campaign aimed to make people more aware of the signs and symptoms of cancer so that early diagnosis was possible. There was some evidence of uplifts in knowledge for visitors to the shop whose knowledge was low to begin with. Other important issues which seemed to attract people’s attention and help them interact with the shop were healthy eating and exercise. This would appear to be an effective method of engaging people into discussion about health more generally, and opens a pathway into talking about cancer.
The shop can also be considered a success in terms of helping people to access further help and advice. A quarter of those who had a nurse consultation were advised to visit their GP, 19 visitors were referred on to discuss smoking cessation and 16% were advised to look into weight loss services. Some of those advised to see their GP had already been before coming to the shop, but needed to be empowered to go back again. Feedback from staff working in the pop-up shop suggested some visitors acted on the advice given as they came back to the shop to let staff know that they had been to see their GP.
This was a well-received, innovative initiative that encouraged people to talk about cancer in a non-clinical environment conveniently located in the community. Community cancer awareness initiatives exist in the UK but very few are based in shop-space for an extended period. More needs to be done to raise awareness of signs/symptoms of common cancers and, when delivered at a local level, success can be maximised by tailoring messages so they are appropriate to the population.
Jo Armes and Emma Scott, Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, London, UK,
Laura Boyd UCL Partners, London, UK,
Emma Ream School of Health Sciences, University of Surrey, Guildford, UK.