Table 4.
Quotes illustrative of engagement themes
| Themes | Illustrative quotes |
|---|---|
| 1. Enough information to engage attention, support autonomous consideration and initiate shared decision‐making |
F_55_CS: ‘It's in my hands, my decision is up to me, but they're just helping you, to give you the facts, the information to make that decision, but it's still your decision…and that's what I like about the top, how it's saying, helping you make a decision. It's not forcing you to do anything’. F_56_CS: ‘it'd make me want to go forward with it….I think I'd read this and I'd go for the scan. But as far as following anything up with me further, I think this initiates you to go for the scan… I think any further follow up, you would follow up from this, maybe onto the internet’. M_57_CS: ‘the beauty of this is I can take this with me but I can also give this to my nearest and dearest and say this is why I'm doing, this is why I'm going and it's clear enough for everyone to be reading the same information’. |
| 2. Attentional bias towards incidence and early detection messages |
M_71_CS: ‘That's quite impressive actually, isn't it? Yeah. At least one more person for every 250 people will survive lung cancer if they had not been screened… that's good isn't it? That's quite impressive’. F_63_FS: ‘Well I didn't know that lung cancer was the most common types of cancer. That's really shocked me’. M_71_CS: ‘I mean everybody knows, if you find it early you've got a bigger chance, everybody knows that, so. I personally would take one anyway, because everybody knows the earlier the better’. |
| 3. Known risks downplayed, but unfamiliar harms prompted deliberative thinking and concern about the screening reliability |
F_56_CS: ‘Yeah because we all know that there's radiation in anything you're doing and that isn't there, …. they won't perform it if it was, like I said if it outweighed the odds of it being no good for you’. F_62_FS: ‘So if there's no cancer found then why do they done the operation? So that's no good because they make sure, they have to make sure if by the biopsy and that's false cancer, false operation. It's not right’. M_56_CS: ‘they can't even get the testing right, what's the point? And I'm not been given cancer drugs and cancer treatment for something that I haven't even got. I'm not having my life disrupted for something that I haven't even got… you're taking a 13% chance of that happening or whatever, you know? Because, that's what would put me off’. F_58_FS: ‘if you're going to be overdiagnosed and put you through a worrying time, thinking you've got lung cancer that's not going to cause you harm. If you're going to be so worried, how high, what rate does that happen at?’. |
| 4. Engagement in symptom appraisal and awareness |
F_70_CS: ‘short of breath. No I haven't got any of that. Coughing or change in your normal cough, coughing blood, no haven't got all of these, short of breath, no I haven't lost weight, no and I'm still eating, putting on bloody weight’. F_59_FS: ‘persistent cough, yes, coughing up blood, I've heard of that, tiredness or weight loss. Oh, so it can cause weight loss, is that because your throat hurts and you can't eat, or? I don't know. An ache or pain when breathing or coughing, yes, anything to do with my throat I'd be worried, appetite loss, yes. I wouldn't of put appetite loss to lung cancer’. M_56_CS: ‘I'm surprised they're saying there's usually no signs or symptoms, because usually if there's something up with the body you'll find something that will alert you to it’. |
Note: Participant codes (e.g., M_65_CS) represent participants' gender (M = male, F = female), age and smoking status (CS = current smoker, FS = former smoker).