Table 2 Interaction of demographic characteristics and behavioural drivers

Age

Older physicians were influenced to screen based on TDF domains of Emotion (past negative experience) and Social influence of the patient

Younger Physicians described the TDF domain facilitator of Beliefs in Capabilities to explain when screening not recommended

“You know, over years, I’ve been in practice for 16 years… based on the positive cases that I saw in real life, I don’t believe that we have to wait until age 50 to start the screening. I saw lots of women that, you know, we missed or we diagnosed Grade 3 definitely below age 50. So, my belief in, based on my clinical experience is that age 50 for start screening is too late.” -013

“I would say 98% of the women I’ve spoken to, as long as I sit down and give them a proper explanation [of why screening not recommended routinely], and sometimes I would even refer them to Task Force. Most of them were very satisfied and don’t bring it up again.” – P16

Gender

Physicians who identified as female described TDF domain barriers of Emotion & Beliefs about Consequences

“It’s been proven to be so with my clinical experience all this year. And just like when they’re younger, we miss them. I just find it quite devastating. They just literally have more [tortuous] difficult journey than people older. So I’m just totally sold on that.” -P09

Location of medical training

Physicians with Canadian Training described Beliefs about Capabilities to discuss why screening not routinely recommended

Non-Canadian Trained physicians held the Beliefs about Consequences that not screening would lead to inappropriate outcomes

“And that’s kind of been drilled into our heads…choosing wisely… our generation is probably a little bit more mindful… it’s minimal testing for things that are not guideline” -P14

“I’m conscious that everything should be evidence-based on guidelines but I just feel like it’s a little too late. I always do let people know that at least previously the guidelines in the States sort of were to start at age 40… there’s some degree of financial conservatism driving those guidelines in Canada, potentially.”- P02

Geographic area

Physicians working in higher resourced areas descrived Beliefs about consequences that patients still want screening even if harms were discussed; physicians working in lower resourced areas described the beliefs in capabilities to explain why screening not recommended

“I work in a pretty well-educated and affluent area, and I find people are pretty pro early screening..”. – P06

“I think with my training… not wasting resources doing things; I had some really good attendings that would question ‘are you doing something because that’s what you were taught or are you doing it because there’s actually research behind it’ and that was one of the things that really carried through with my practice” -P16