Objectives/Purpose
Participation in the National Bowel Cancer Screening Program (NBCSP) remains significantly lower among culturally and linguistically diverse (CALD) populations than among English-speaking Australians. This study explored the feasibility and acceptability of the Alternative Access Model (AAM), a general practice–based strategy to improve participation through General Practitioner (GP) endorsement. A secondary aim was to identify barriers and enablers to implementing the model in routine care.
Sample and Setting
Six general practices from socioeconomically diverse areas were selected based on large Mandarin-speaking patient populations, with one additional site serving Vietnamese speakers. A total of 23 healthcare providers participated, including GPs (n=6), practice nurses (n=10), and practice managers (n=7), several of whom were Mandarin speakers.
Procedures
Semi-structured interviews were conducted to assess providers’ awareness of, and attitudes toward, the AAM. Interviews also explored how the model could be integrated into current screening workflows and coordination with the NBCSP.
Results
Most participants were unfamiliar with the AAM, with only one Vietnamese-speaking practice having implemented it. Once explained, the model was considered feasible and acceptable if introduced with minimal disruption. Barriers included time constraints, challenges with IT systems (e.g., PRODA, National Cancer Screening Register), and patient-level issues such as cultural beliefs and preference for colonoscopy or overseas care. The presence of a clinical “champion” was identified as a key enabler of adoption.
Conclusion and Clinical Implications
Embedding culturally responsive strategies in general practice is a promising approach to improve bowel screening participation among CALD populations. Structural supports—such as multilingual materials, streamlined IT integration, and training—are essential. Enabling clinical champions and aligning policy to support equity-driven initiatives can facilitate broader implementation and help address disparities in cancer prevention outcomes across diverse Australian communities.