Can messages based on behavioral economics increase participation in colorectal cancer screening programmes?

ISRCTN ISRCTN16923805
DOI https://doi.org/10.1186/ISRCTN16923805
Secondary identifying numbers BET2013CYP
Submission date
28/05/2021
Registration date
17/06/2021
Last edited
12/04/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
While colorectal cancer (CRC) screening can detect cancer at an early stage, participation in CRC screening programmes is often below recommended levels. In order to be effective, CRC screening programs high participation. There is therefore an interest in studying possible interventions to achieve high participation. While interventions such as pre-notification letters, tailored reminder letters and telephone contact can increase participation, they are often too costly for the screening programmes. Interventions based on behavioural economics only manipulate the decision setting and are therefore potentially cost-neutral. The aim of this study is to test whether messages derived from behavioral economics can increase participation in the context of the Cypriot pilot program for colorectal cancer screening.

Who can participate?
All residents aged 50-69 years who are eligible for colorectal cancer screening.

What does the study involve?
In the first study participants are randomly allocated to receive the standard invitation letter with one of six additional behavioral economics-based messages included, or the standard invitation letter with no manipulation. The additional behavioural economics-based messages are built on the following principles: (1) social responsibility to look after own health, (2) anticipated regret of non-attendance, (3) financial opportunity costs of non-attendance, (4) benefit of early detection, (5) limited duration of the offer and (6) social norms. In the second study participants are randomly allocated to receive either the standard invitation letter with the most effective message from the first study, or the standard invitation letter with no manipulation.

What are the possible benefits and risks of participating?
This study presents participants with an invitation for CRC screening. Cancer can often evoke mild anxiety in people. The invitation letter clearly outlined the topic which allowed participants to decide whether they want to participate in the screening programme. In terms of benefit, the participants will help to test invitation material that will hopefully increase participation rates. This would speed up the diagnostic pathway of CRC as well as have financial implications.

When is the study running?
February 2013 to March 2015

Who is funding the study?
1. The Ministry of Health (Cyprus)
2. European Commission

Who is the main contact?
Sandro Stoffel
sandro.stoffel@unibas.ch

Contact information

Dr Sandro Stoffel
Scientific

Klingelbergstrasse 61
Basel
4056
Switzerland

ORCiD logoORCID ID 0000-0002-0124-0941
Phone +41 (0)792190931
Email sandro.stoffel@unibas.ch

Study information

Study designTwo interventional single-blinded randomized controlled trials
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Home
Study typeScreening
Participant information sheet No participant information sheet available
Scientific titleTesting messages from behavioral economics to improve participation in the Cypriot colorectal cancer screening program in two field experiments
Study objectivesMessages derived from behavioral economics can increase participation in colorectal cancer screening.
Ethics approval(s)Approved 14/9/2013, ethics committee of the Cyprus Ministry of Health (National Bioethics Committee of Cyprus, Laertou 22, 2365 Agios Dometios, Nicosia, Cyprus; +357 (0)22809038/+357 (0)22809039; cnbc@bioethics.gov.cy), ref: not applicable
Health condition(s) or problem(s) studiedColorectal cancer
InterventionThe intervention consists of adding an additional paragraph, containing a message based on behavioural economics, in the invitation letter for colorectal cancer screening.

The researchers perform two randomized controlled trials (RCTs). The first RCT is a seven-arm RCT in which individuals are randomly allocated to receive the standard invitation letter with one of six additional behavioral economics-based messages included, or the standard invitation letter with no manipulation (i.e. control). The additional behavioural economics-based messages are built on the following principles: (1) social responsibility to look after own health, (2) anticipated regret of non-attendance, (3) financial opportunity costs of non-attendance, (4) benefit of early detection, (5) limited duration of the offer and (6) social norms.

The second RCT is a two-arm RCT, in which individuals are randomly allocated to receive either the standard invitation letter with the most efficacious message from the first RCT, or the standard invitation letter with no manipulation (i.e. control). The primary aim of the first RCT is to identify the most efficacious message, which is then tested in the second RCT with more participants per trial arm.
Intervention typeBehavioural
Primary outcome measureParticipation (i.e. return of a completed FIT kit) measured 8 weeks after sending out the screening invitation
Secondary outcome measuresThere are no secondary outcome measures
Overall study start date01/02/2013
Completion date31/03/2015

Eligibility

Participant type(s)All
Age groupAdult
SexBoth
Target number of participants6500
Total final enrolment6286
Key inclusion criteriaMen and women aged 50 to 69 years
Key exclusion criteriaNot resident in Cyprus
Date of first enrolment01/10/2013
Date of final enrolment31/12/2014

Locations

Countries of recruitment

  • Cyprus

Study participating centre

MInistry of Health
Prodromou 1
Nicosia
1148
Cyprus

Sponsor information

Joint Research Center
Government

Via Enrico Fermi 2749
Ispra
21027
Italy

Phone +38 (0)635020401
Email benedikt.herrmann@ec.europa.eu
Website https://ec.europa.eu/info/departments/joint-research-centre_en
ROR logo "ROR" https://ror.org/05a4nj078

Funders

Funder type

Government

Ministry of Health (Cyprus)

No information available

European Commission
Government organisation / National government
Alternative name(s)
European Union, Comisión Europea, Europäische Kommission, EU-Kommissionen, Euroopa Komisjoni, Ευρωπαϊκής Επιτροπής, Европейската комисия, Evropské komise, Commission européenne, Choimisiúin Eorpaigh, Europskoj komisiji, Commissione europea, La Commissione europea, Eiropas Komisiju, Europos Komisijos, Európai Bizottságról, Europese Commissie, Komisja Europejska, Comissão Europeia, Comisia Europeană, Európskej komisii, Evropski komisiji, Euroopan komission, Europeiska kommissionen, EC, EU

Results and Publications

Intention to publish date01/07/2021
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryStored in publicly available repository
Publication and dissemination planPlanned publication in a high-impact peer-reviewed journal. Additional documents are not available.
IPD sharing planAnonymous data will be stored in a repository and made available for all researchers at https://osf.io/wx7je/.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Dataset 30/01/2020 12/04/2022 No No
Results article 28/07/2021 12/04/2022 Yes No

Editorial Notes

12/04/2022: Publication reference added.
17/06/2021: Trial's existence confirmed by the ethics committee of the Cyprus Ministry of Health.