Condition category
Not Applicable
Date applied
24/01/2014
Date assigned
08/04/2014
Last edited
23/06/2014
Prospective/Retrospective
Retrospectively registered
Overall trial status
Completed
Recruitment status
No longer recruiting

Plain English Summary

Background and study aims
The NHS Health Check is offered to 40-74 year olds in England who do not have an excluding medical condition. These 15 million patients are invited over a rolling five-year period i.e. one fifth per year. The programme is a policy priority for the Department of Health, NHS England and Public Health England and local authorities in their efforts to tackle premature mortality and promote healthy lifestyles. However, uptake rates are significantly lower than desired, at around 50 per cent.
Local authority commissioners of the NHS Health Check currently use a range of different letters and marketing to invite the eligible population. We do not know which approach works better but we know that making a change to the content of the invitation letter or a reminder text message may help change people’s behaviour.
The aim of the study is to determine the most effective patient invitation letter to maximise attendance of NHS Health Checks. The study will also consider other invitation or reminder methods, such as SMS messages and will test whether introducing a text message at the invitation stage changes levels of uptake.

Who can participate?
People eligible for an NHS Health Check and resident in the London Borough of Southwark, London (UK).

What does the study involve?
Participants will be randomly allocated to different groups: receive the standard letter or one of the other letters (15 different combinations, for example with or without testimonials, with or without text reminders, etc).

What are the possible benefits and risks of participating?
There are no direct benefits. We anticipate that participants will be more likely to attend their Health Check and therefore to receive any benefits associated with this NHS Health Check.
There are no risks to participants. The standard NHS leaflet explaining the risks of attending a Health Check or not is included in both the standard and other letters.

Where is the study run from?
The London Borough of Southwark. 38 GP practices have consented to participate in the trial

When is the study starting and how long is it expected to run for?
November 2013 to April 2014.

Who is funding the study?
The Department of Health, England (UK)

Who is the main contact?
Annabelle Bonus, Principal Social Researcher, Behaviour Change Team, Department of Health

Trial website

Contact information

Type

Scientific

Primary contact

Ms Annabelle Bonus

ORCID ID

Contact details

Wellington House
133-135 Waterloo Road
London
SE1 8UG
United Kingdom

Additional identifiers

EudraCT number

ClinicalTrials.gov number

Protocol/serial number

IRAS project ID:138943

Study information

Scientific title

Using behavioural insights to change uptake of the NHS Health Check

Acronym

Study hypothesis

Does making small, low-cost changes, based on behavioural insight, to the NHS Health Check invitation process change levels of uptake?

Ethics approval

NHS Health Research Authority NRES Committee, 23/09/2013, REC reference:13/SW/0293

Study design

Multicentre factorial randomised controlled trial

Primary study design

Interventional

Secondary study design

Randomised controlled trial

Trial setting

Other

Trial type

Screening

Patient information sheet

Condition

NHS Health Checks

Intervention

The main aim of this trial is to investigate whether making small changes to the invitation letter for NHS Health Checks results in a difference in uptake. T

The changes to the letters to be trialled include:
1.Control letter (the national template)
2. Short, letter with personalised tear off slip
3. Short, letter with personalised tear off slip and deadline
4. Short letter with social norms and testimonials
The impact of these letters will be tested against a control letter (the national template).

The new text messages to be trialled include:
1. Text message primer: patients receive a text message one week before the invitation letter telling them to expect the letter
2. Text message reminder: patients receive a text message one week after the invitation letter reminding them to respond to their letter.
The impact of these messages will be tested against the control of receiving no message.

This trial is a factorial design made up of three levels, all of which make up the initial invitation to a health check. We propose a 2 (Text primer: yes/no) x4 (Letter: Ctrl/social norms/open/closed) x2 (Text reminder: yes/no) between subjects factorial trial design.

1. Control letter (the national template), Text primer: Yes, Text reminder: Yes
2. Control letter (the national template), Text primer: Yes, Text reminder: No
3. Control letter (the national template), Text primer: No, Text reminder: Yes
4. Control letter (the national template), Text primer: No, Text reminder: No
5. Short letter with social norms and testimonials, Text primer: Yes, text reminder: Yes
6. Short letter with social norms and testimonials, Text primer: Yes, text reminder: No
7. Short letter with social norms and testimonials, Text primer: No, text reminder: Yes
8. Short letter with social norms and testimonials, Text primer: No, text reminder: No
9. Short, letter with personalised tear off slip, Text primer: Yes, text reminder: Yes
10. Short, letter with personalised tear off slip, Text primer: Yes, text reminder: No
11. Short, letter with personalised tear off slip, Text primer: No, text reminder: Yes
12. Short, letter with personalised tear off slip, Text primer: No, text reminder: No
13. Short, letter with personalised tear off slip and deadline, Text primer: Yes, text reminder: Yes
14. Short, letter with personalised tear off slip and deadline, Text primer: Yes, text reminder: No
15. Short, letter with personalised tear off slip and deadline, Text primer: No, text reminder: Yes
16. Short, letter with personalised tear off slip and deadline, Text primer: No, text reminder: No

Intervention type

Other

Phase

Not Specified

Drug names

Primary outcome measures

Attendance at an NHS Health Check. This will be measured against the control group. We will get interim results in March 2014 and the final results in June 2014. This data is captured anyway by the invitation letter provider.

Secondary outcome measures

No secondary outcome measures

Overall trial start date

01/11/2013

Overall trial end date

01/05/2014

Reason abandoned

Eligibility

Participant inclusion criteria

1. Any patient registered at a consenting GP practice in Southwark during the trial duration who is due to be invited for an NHS Health Check.
2. Patients aged between 40-74 are invited to attend for a Health Check via an invitation letter sent to the address held in their medical records. Invitation letters and leaflets are sent on 24th of each month to the eligible population (starting on their 40th birthdays, and then every five years after that).

Participant type

Patient

Age group

Not Specified

Gender

Not Specified

Target number of participants

8368

Participant exclusion criteria

Participants will only be excluded if they are no longer eligible for an NHS Health Check at their GP's surgery, for example, if they have had one at a local pharmacy already.

Recruitment start date

01/11/2013

Recruitment end date

01/05/2014

Locations

Countries of recruitment

United Kingdom

Trial participating centre

Wellington House, 133-135 Waterloo Road
London
SE1 8UG
United Kingdom

Sponsor information

Organisation

Department of Health (UK)

Sponsor details

c/o Tabitha Brufal
Wellington House
133-135 Waterloo Road
London
SE1 8UG
United Kingdom

Sponsor type

Government

Website

Funders

Funder type

Government

Funder name

Department of Health (UK)

Alternative name(s)

Funding Body Type

Funding Body Subtype

Location

Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Results - basic reporting

Publication summary

Publication citations

Additional files

Editorial Notes