Encouraging compliance with bowel and cervical cancer screening using behavioural nudges
| ISRCTN | ISRCTN94361793 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN94361793 |
| Secondary identifying numbers | 2018123 |
- Submission date
- 23/10/2018
- Registration date
- 20/12/2018
- Last edited
- 04/04/2023
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Plain English summary of protocol
Background and study aims
Screening programmes have become widespread in developed countries, but how to improve uptake is an understudied area especially in deprived regions. This study aims to test whether it is possible to increase attendance rates for cervical and bowel screening in the deprived area of East and West Marsh, Grimsby, North East Lincolnshire by sending a behaviourally-informed reminder letter from GP practices to non-attenders and by entering people into a lottery, if they get screened.
Who can participate?
All patients of the recruited GP patients can participate if they are eligible for the relevant screening programmes (cervical or bowel cancer). Participants must have not booked and attended a previous screening appointment in the previous twelve months after being sent a letter.
What does the study involve?
Participants will be randomly assigned to one of three groups - either the control group, the letter group and the lottery and letter group. The control group will not receive any intervention. The letter group will receive a behaviourally informed letter. The lottery and letter group will receive the same letter, and will be offered the chance to win a lottery if they get screened. GP practices will then report back about who attended screenings following the study.
What are the possible benefits and risks of participating?
The benefits and risks are the same for the screening programmes themselves, and are discussed in more detail here: https://www.nhs.uk/conditions/bowel-cancer-screening/ and here: https://www.nhs.uk/conditions/cervical-screening/. There are no new benefits or risks to participants taking part in this study
Where is the study run from?
The study is run from the Behavioural Insights Team in London and will take place in 8 GP practices in North East Lincolnshire (UK)
When is the study starting and how long is it expected to run for? (what is the anticipated start date and the approximate duration of the trial?)
February 2018 to August 2019
Who is funding the study?
North East Lincolnshire (UK)
Who is the main contact?
Helen Brown (an advisor at the Behavioural Insights Team)
helen.brown@bi.team.
Contact information
Scientific
4 Matthew Parker Street
London
SW1H 9NP
United Kingdom
 ORCID ID |
0000-0001-7869-5218 |
|---|---|
| Phone | 07490219701 |
| daniel.gibbons@bi.team |
Study information
| Study design | Interventional three-armed randomised controlled trial |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Randomised controlled trial |
| Study setting(s) | GP practice |
| Study type | Screening |
| Participant information sheet | Not available in web format, please use contact details to request a participant information sheet. |
| Scientific title | Encouraging compliance with bowel and cervical cancer screening in previously non-compliant adults in the North Lincolnshire Area using a Behavioural Letter and a Letter and Lottery Combination |
| Study objectives | We want to test the two following hypotheses: 1. In the context of deprived communities, a behaviourally-informed self-referral letter incorporating anticipated regret messaging is effective at promoting previous non-attenders to complete screening 2. In the context of deprived communities, incentivisation using a regret lottery with a behaviourally-informed self-referral letter incorporating anticipated regret messaging is effective at encouraging the uptake of screening We will analyse these separately for bowel and cervical cancer, for a total of four primary study hypotheses. We will also test the treatment arms against each other, which constitute 2 secondary hypotheses: 1. In the context of deprived communities, incentivisation using a regret lottery with a behaviourally-informed self-referral letter incorporating anticipated regret messaging is more effective at encouraging the uptake of cervical cancer screening than just a behaviourally-informed self-referral letter 2. In the context of deprived communities, incentivisation using a regret lottery with a behaviourally-informed self-referral letter incorporating anticipated regret messaging is more effective at encouraging the uptake of bowel cancer screening than just a behaviourally-informed self-referral letter |
| Ethics approval(s) | The following ethics committees have been submitted to: 1. NHS Research Ethics Committee 2. Health Research Authority 3. PHE Screening Programmes Bowel Research Advisory Committee 4. PHE Cervical Research Advisory Committee 5. PHE Office for Data Release |
| Health condition(s) or problem(s) studied | Compliance with mass cancer screening programmes |
| Intervention | All participants will have either not attended a cervical cancer screening appointment, or not sent a bowel screening test back in the previous 12 months. Participants will be randomly allocated to one of three groups: the control arm which will receive no additional intervention, a letter-only arm who will receive a behavioural science informed letter and a lottery arm who will receive the same basic letter and be entered into a regret lottery. Randomisation will be individual and will be a simple randomisation. Randomisation will be conducted by GP practices. For all arms, we will monitor whether they book and attend an appointment (cervical cancer screening patients) or send back the screening kit (bowel cancer screening patients) 12 weeks after the letter is sent out (both arms receiving letters will be sent on the same day). There will be no follow-up. GP practices are responsible for informing the investigators which people send their bowel cancer screening kits back, and which individuals attend a cervical cancer screening. Participants will be blind to the condition they are in, though GP practices will maintain a record of who is in what arm as they will be sending the letters to households. |
| Intervention type | Behavioural |
| Primary outcome measure | 1. Attendance at cervical cancer screening appointments within 12 weeks of the letter being sent for the cervical cancer group, measured using the date of booking and attending the appointment and reported by GP practices (if any) 2. Ordering and sending back a bowel cancer screening kit within 12 weeks of the letter being sent for the bowel cancer group and reported by GP practices (measured using the date of sending back the kit (if any) |
| Secondary outcome measures | N/A |
| Overall study start date | 01/02/2018 |
| Completion date | 31/08/2019 |
Eligibility
| Participant type(s) | Patient |
|---|---|
| Age group | Adult |
| Lower age limit | 18 Years |
| Sex | Both |
| Target number of participants | 3000 |
| Key inclusion criteria | 1. Eligible and sent a letter for but not attended a cervical cancer screening appointment OR not sent a bowel cancer screening test back in the previous twelve months. 2. Aged 18 years or older 3. Attending North Lincolnshire practices |
| Key exclusion criteria | N/A |
| Date of first enrolment | 01/04/2018 |
| Date of final enrolment | 30/04/2018 |
Locations
Countries of recruitment
- England
- United Kingdom
Study participating centres
Grimsby
DN32 9EF
United Kingdom
Grimsby
DN32 7DL
United Kingdom
Grimsby
DN32 7DY
United Kingdom
Grimsby
DN31 3AE
United Kingdom
Grimsby
DN31 3AE
United Kingdom
Grimsby
DN31 1QZ
United Kingdom
Grimsby
DN40 1JW
United Kingdom
Grimsby
DN31 1QZ
United Kingdom
Sponsor information
Industry
4 Matthew Parker Street, Westminster
London
SW1H 9NP
United Kingdom
| Phone | 07490219701 |
|---|---|
| daniel.gibbons@bi.team | |
| Website | https://www.behaviouralinsights.co.uk/ |
"ROR" |
https://ror.org/03mk5b468 |
Funders
Funder type
Government
No information available
No information available
Results and Publications
| Intention to publish date | 31/12/2019 |
|---|---|
| Individual participant data (IPD) Intention to share | No |
| IPD sharing plan summary | Not expected to be made available |
| Publication and dissemination plan | We intend to publish the results only on the above hypotheses in a healthcare journal article. |
| IPD sharing plan | The datasets generated during and/or analysed during the current study are not expected to be made available as this is sensitive, personal data and we would not be able to get relevant permissions from GP clinics |
Editorial Notes
04/04/2023: Internal review.
03/09/2020: Internal review.
07/01/2020: Internal review.
11/01/2019: Internal review.
