Co-production of a novel intervention targeting obesity-related barriers to mammographic screening participation

Introduction: Women with obesity are less likely to participate in mammographic screening and more likely to develop post-menopausal breast cancer. We describe the co-production of a novel training intervention for breast screening staff, targeting obesity-related barriers to participating in a population-based mammographic screening.

Methods: A Stakeholder Consultant Group (SCG) was established to guide the co-production process. A narrative review of the literature was conducted, as well as first person interviews of women with lived experience of obesity, to identify/inform themes for service delivery staff training.

Results: Three themes from the narrative review emerged: (i) enhanced staff-client communication, (ii) promoting compassionate connections during client interactions (iii) tailored mammography positioning for women with obesity. Iterative co-design and consultation with the SCG resulted in six key sessions delivered within an in-service training day: determinants of obesity, weight stigma and healthcare, screening challenges for women living with obesity, empathy 'mapping', front-line training for reception staff, and screening challenges for radiographers when screening women with obesity. Subsequent practical workshops for radiographers provided hands-on positioning training using a real-life model and a 'mammo vest'. Feedback showed that 74 % of staff rated the training as "very good" or "excellent".

Conclusion: Training to improve staff interactions with women with obesity appears to be acceptable.

Implications for practice: The intervention has been successfully implemented in a population-based breast screening program to improve the mammography experience for both clients and staff. Improving the mammogram experience will improve the likelihood of clients returning to screening when next due. Given the prevalence of obesity and body image issues, targeted interventions that optimize client interactions could significantly reduce breast cancer mortality through early detection.