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Evaluating the impact of a novel behavioural science informed animation upon breast cancer screening uptake: protocol
Amish Acharya1, Hutan Ashrafian2, Deborah Cunningham3
1Department of Surgery and Cancer, St Mary's Hospital, 10th Floor Queen Elizabeth Queen Mother Building, W2 1NY, London, UK. aa2107@ic.ac.uk.
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 27th May 2022.
Insights
This study tested a new video intervention to improve breast cancer screening attendance. The novel approach aims to increase uptake, especially among underserved communities, by addressing attendance barriers.
Area of Science:
- Public Health
- Behavioural Science
- Health Services Research
Background:
- Breast cancer screening saves lives but faces declining invitation uptake in the UK.
- Existing behavioural interventions show variable effectiveness due to limited techniques and implementation challenges.
- Addressing declining attendance and healthcare inequalities in breast cancer screening is crucial.
Purpose of the Study:
- To evaluate the impact of a novel behavioural video intervention on breast cancer screening uptake.
- To assess if a video intervention, co-designed with diverse women, can overcome attendance barriers.
- To compare the effectiveness of a video intervention against SMS reminders.
Main Methods:
- A 3-armed randomised controlled trial in London involving 8391 participants.
- Comparison of usual care SMS reminder, behavioural SMS reminder, and a behavioural SMS with a video link.
- Primary outcome: breast cancer screening attendance within 3 months; secondary outcomes: impact across socio-demographic groups and appointment types.
Main Results:
- The study is ongoing; results are pending.
- The novel video and SMS content were co-designed with diverse women to address barriers.
- The intervention aims to improve attendance in underserved communities and the general population.
Conclusions:
- The study will provide insights into addressing declining breast cancer screening attendance.
- Findings may inform strategies to reduce healthcare disparities in screening uptake.
- This research explores scalable, behaviourally-informed interventions for public health challenges.
