Perceptions Towards the Adoption of Multi-Risk Factors Cancer Prevention Educational Tool Among European Union Citizens: A Multi-Country Qualitative Study Protocol

Abstract

Background: Cancer is a major public health problem. Four million new cancer cases are diagnosed annually in Europe, of which around 40% could be prevented. The European Code Against Cancer (ECAC) is a health education tool to raise awareness about risk factors and evidence-based measures to prevent cancer. The ECAC 4th edition consists of 12 recommendations to reduce individuals’ cancer risk and related deaths. This study explores perceived barriers to adopting the cancer prevention actions recommended by the ECAC fourth edition in the European Union (EU). Methods: The COM-B model of behaviour change will be used as a framework for the design and analysis of the study since it identifies factors (capability, opportunity, motivation) that need to be present for any behaviour change to occur. A qualitative study using an exploratory research methodology was designed to obtain information from adults with no previous cancer diagnosis by employing in-depth semi-structured interviews. Participants are selected using a quota sampling strategy according to sex, age, and education level (18 profiles/country). Interviews will be conducted in participants’ native language by trained researchers. Afterward, a thematic content analysis will be conducted to identify common topics, followed by a critical analysis of their discourse. Discussion: This study will contribute to informing the fifth edition of the ECAC –currently under development; by providing insights on how EU citizens perceive the cancer prevention recommendations of the fourth edition and whether they can motivate them to change unhealthy behaviours. Additionally, the study will help to identify the main facilitators and barriers (perceived or already confronted) to adopt these cancer prevention recommendations so that this knowledge will contribute to updating the recommendations of the fifth edition of the ECAC.