Evaluating the impact of a novel behavioural science informed animation upon breast cancer screening uptake: protocol for a randomised controlled trial

Amish Acharya; Hutan Ashrafian; Deborah Cunningham; Josephine Ruwende; Ara Darzi; Gaby Judah

doi:10.1186/s12889-022-13781-x

Evaluating the impact of a novel behavioural science informed animation upon breast cancer screening uptake: protocol for a randomised controlled trial

BMC Public Health. 2022 Jul 19;22(1):1388. doi: 10.1186/s12889-022-13781-x.

Authors

Amish Acharya¹, Hutan Ashrafian², Deborah Cunningham³, Josephine Ruwende⁴, Ara Darzi², Gaby Judah²

Affiliations

¹ Department of Surgery and Cancer, St Mary's Hospital, 10th Floor Queen Elizabeth Queen Mother Building, W2 1NY, London, UK. aa2107@ic.ac.uk.
² Department of Surgery and Cancer, St Mary's Hospital, 10th Floor Queen Elizabeth Queen Mother Building, W2 1NY, London, UK.
³ Department of Radiology, Imperial College Healthcare NHS Trust, W2 1NY, London, UK.
⁴ NHS England (London Region), London, UK.

Abstract

Background: Breast cancer screening is estimated to save 1300 lives annually in the United Kingdom. Despite this, uptake of invitations has fallen over the past decade. Behavioural science-informed interventions addressing the determinants of attendance behaviour have shown variable effectiveness. This may be due to the narrow repertoire of techniques trialled, and the difficulties of implementation at a population-scale. The aim of this study is to evaluate the impact on breast screening uptake of a novel behavioural video intervention which can contain more complex combinations of behavioural change techniques.

Methods: A 3-armed randomised controlled trial will be undertaken in London comparing the impact of (1) the usual care SMS reminder, to (2) a behavioural plain text SMS reminder and (3) a novel video sent as a link within the behavioural plain text SMS reminder. A total of 8391 participants (2797 per group) will be allocated to one of the three trial arms using a computer randomisation process, based upon individuals' healthcare identification numbers. The novel video has been co-designed with a diverse range of women to overcome the barriers faced by underserved communities and the wider population. The behavioural SMS content has also been co-designed through the same process as the video. Messages will be sent through the current reminder system used by the London screening programmes, with reminders 7 days and 2 days prior to a timed appointment. The primary outcome is attendance at breast cancer screening within 3 months of the initial invitation. Secondary outcomes will include evaluating the impact of each message amongst socio-demographic groups and according to the appointment type e.g. first invitation or recall.

Discussion: In addition to general declining trends in attendance, there is also concern of increasing healthcare inequalities with breast cancer screening in London. The current novel intervention, designed with underserved groups and the general population, incorporates several behavioural techniques to overcome the barriers to attendance. Understanding its potential impact in a real-world setting therefore may provide significant information on how to address reducing attendance and healthcare disparities.

Trial registration: This study was registered on ClinicalTrials.gov ( NCT05395871 ) on the 27^th May 2022.

Keywords: Behavioural science; Breast cancer screening; Healthcare inequalities; Screening uptake; Video messaging.

Publication types

Clinical Trial Protocol
Research Support, Non-U.S. Gov't

MeSH terms

Behavioral Sciences*
Breast Neoplasms* / diagnosis
Breast Neoplasms* / prevention & control
Early Detection of Cancer / methods
Female
Humans
Randomized Controlled Trials as Topic
Reminder Systems
Text Messaging*

Associated data

ClinicalTrials.gov/NCT05395871