153 Perceptions and beliefs of GPs on the CSPs in qualitative studies.31 Future (qualitative) studies are thus needed to clarify the above issues, which could also analyse possible differences in GP-specific characteristics related to outcomes. Lastly, as we conducted our study with GPs in (highly urbanised areas of) the Netherlands, our conclusions are primarily valid for Dutch GPs. GP involvement in the CSPs is however, not unique for the Netherlands,15-18, 22, 24, 30, 32, 33 therefore we believe that interested readers (e.g., healthcare professionals and policymakers) from other (European) countries could also benefit from the insights gained from this study. Based on the results of this study, we are confident that the future role of GPs can be optimised. One of the most cited concepts in the interviews was the idea of an ‘add-on methodology’ to increase current screening uptake, which might be particular suited for the more deprived neighbourhoods. This is in line with a more proactive, population/ neighbourhood/community-oriented primary care approach and fits into the description of structured Population Health Management.34 Such an ‘add-on methodology’ can be organised as a proactive tool, aiming to prevent adverse health events resulting from missing early screening opportunities in populations specifically at risk. A tool like this also responds to the concept of ‘trust’ in primary care and pays attention to people as individuals. Moreover, positive endorsement can be promoted by a GP practice. Another important, and recurring issue in the interviews was the currently increasing workload of GPs.35 In our view, the prospect of getting even busier hinders potential innovations in primary care. This phenomenon is not desirable given all the challenges in the current healthcare landscape. We would therefore advocate that new innovations to optimise current CSPs should be implemented only in close consultation with GPs. For the nearby future, we would like to challenge the national screening organisation, together with GP-practices, to determine whether such an ‘add-on methodology’ can be rolled out in several neighbourhoods, and to evaluate whether this approach is indeed effective for increasing current attendance rates among screening-eligible people, ideally for those at highest cancer risks. Considering the results of this study, it would be logical to establish a pilot study in the greater city of The Hague. The hope is that if GPs are more involved in the CSPs, they can especially educate and motivate people with potentially higher pre-existing risks of developing cancer to get screened. In this regard, attention must also be given to communication from GPs to potential participants, as it is known that the way of communicating influences perceptions on the CSP.36 In this context, consideration can also be given to shared decision-making tools, where thought should be given to what can help involve individuals who are currently not participating in the CSPs. Recent research suggests that shared decision-making tools appear to be particularly useful for people belonging to socially disadvantaged groups. A prerequisite hereby is that there is sufficient time available for the consultation.37 Ultimately, it is most 6
RkJQdWJsaXNoZXIy MTk4NDMw