114 Chapter 4 (frequency question), nor how the perspectives are associated with the characteristics of respondents, or why specific respondents with the same perspective present different screening behaviour.61 Such ‘frequency-questions’ could be examined with surveys,62 whereas future ‘how and why-questions’ can be answered by performing additional interviews and focus groups.63 Second, respondents were recruited from an existing research panel of an external agency. On the one hand this allowed us to conduct the study remotely and thereby guaranteeing full anonymity, whereby respondents did not feel any social pressure during the ranking exercise. On the other hand, it introduced a selection and led to several specific drawbacks. Our sample predominantly contained women, aged between 50 and 69 years, living with a partner, and were higher educated (Table 1). From literature it is known that people with these characteristics are more prone to participate in the CSPs.16 When taking the general demographics of the screening eligible inhabitants of The Hague into account, one would expect to included: more men, more people living alone, lesser people with children, more people with vocational education or lower, and more people who adhere to a religion.40 It is possible that additional perspectives would have been identified if more respondents with these more general characteristics had been included in this study. Therefore, we recommend future studies with a similar aim to use a face-to-face sampling approach. Furthermore, the switch to the online data approach may have affected the number of exclusions as issues with the software tool that were not addressed in the explanation materials could not been solved. And, lastly, it was not possible to obtain an interview with the two respondents most strongly associated with each factor directly after they had finished their ranking of the statements, as they could only be invited for this interview after all data was collected and the analysis was finalized. Third, statement categorization by the I-Change model was challenging, especially since the relationship between the components is not always clearly defined.27, 32 Respondents are not familiar with the subdivision of the I-Change model and could therefore classified some statements differently. However, since we upfront tested our statement set and none of the initial potential respondents, nor the actual respondents, reported to mis significant statements important to their perspective, we believe the I-Change model to be suitable in order to create a comprehensive set of statements. This Q-methodology study shows that beliefs and motivations towards CSPs are not only different between attenders and non-attenders but can also differ between subgroups of people holding different perspectives. In order to increase awareness and knowledge regarding the CSPs, we therefore suggest tailoring communications to the perspectives of potential participants. This implies that for perspective 1 more attention needs to be paid to providing informing about the CSPs and follow-up medical testing procedures, that for perspective 2 more attention needs to pe paid to the potential disadvantages of
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