Can messages based on behavioral economics increase participation in colorectal cancer screening programmes?
| ISRCTN | ISRCTN16923805 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN16923805 |
| ClinicalTrials.gov (NCT) | Nil known |
| Clinical Trials Information System (CTIS) | Nil known |
| Protocol serial number | BET2013CYP |
| Sponsor | Joint Research Center |
| Funders | Ministry of Health (Cyprus), European Commission |
- 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
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
Scientific
Klingelbergstrasse 61
Basel
4056
Switzerland
 ORCID ID |
0000-0002-0124-0941 |
|---|---|
| Phone | +41 (0)792190931 |
| sandro.stoffel@unibas.ch |
Study information
| Primary study design | Interventional |
|---|---|
| Study design | Two interventional single-blinded randomized controlled trials |
| Secondary study design | Randomised controlled trial |
| Study type | Participant information sheet |
| Scientific title | Testing messages from behavioral economics to improve participation in the Cypriot colorectal cancer screening program in two field experiments |
| Study objectives | Messages 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) studied | Colorectal cancer |
| Intervention | The 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 type | Behavioural |
| Primary outcome measure(s) |
Participation (i.e. return of a completed FIT kit) measured 8 weeks after sending out the screening invitation |
| Key secondary outcome measure(s) |
There are no secondary outcome measures |
| Completion date | 31/03/2015 |
Eligibility
| Participant type(s) | All |
|---|---|
| Age group | Adult |
| Sex | All |
| Target sample size at registration | 6500 |
| Total final enrolment | 6286 |
| Key inclusion criteria | Men and women aged 50 to 69 years |
| Key exclusion criteria | Not resident in Cyprus |
| Date of first enrolment | 01/10/2013 |
| Date of final enrolment | 31/12/2014 |
Locations
Countries of recruitment
- Cyprus
Study participating centre
Nicosia
1148
Cyprus
Results and Publications
| Individual participant data (IPD) Intention to share | Yes |
|---|---|
| IPD sharing plan summary | Stored in publicly available repository |
| IPD sharing plan | Anonymous 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? |
|---|---|---|---|---|---|
| Results article | 28/07/2021 | 12/04/2022 | Yes | No | |
| Dataset | 30/01/2020 | 12/04/2022 | No | No | |
| Participant information sheet | Participant information sheet | 11/11/2025 | 11/11/2025 | No | Yes |
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.
