Healthcare providers' perspectives on implementing a primary care-based initiative to increase equitable bowel cancer screening participation in Australia

Bowel cancer is the fifth most common cancer in Australia and the second leading cause of cancer-related death. Although the National Bowel Cancer Screening Program mails test kits to eligible Australians, uptake remains suboptimal, particularly among underserved populations. The Alternative Access Model (AAM) is a primary care-based strategy through which healthcare providers (HCPs) distribute kits directly to eligible patients, enabling practitioner endorsement and patient navigation. This study explored HCPs' perceptions of the acceptability, feasibility, barriers, and enablers of implementing the AAM in general practices serving ethnically and socioeconomically diverse populations. Semi-structured interviews were conducted with primary HCPs in Melbourne, Australia. Nine general practice clinics participated in a two-phase study. Thirty-seven interviews were conducted with general practitioners (n = 13), practice nurses (n = 15), and practice managers (n = 9). Data were analysed using NVivo 15. Most participants (89%) were unfamiliar with the AAM. Once explained, the model was perceived as acceptable because it aligns with primary care's preventive role; however, implementation would be feasible only if barriers such as lack of financial incentives, system integration, and maintenance are addressed and provided. Improving equitable access requires more than making screening kits available. Tailored, culturally responsive, multi-faceted resources that could address perceived low bowel health literacy and cultural beliefs about screening, along with practitioners' endorsement and encouragement, and enhanced patient navigation within primary care are perceived having potential benefits in supporting more equitable bowel cancer screening participation among underserved populations.