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Using Facebook to Improve Participation in Colorectal Cancer Screening: Protocol for a Cluster Randomized Controlled

Arlinda Ruco¹, Natalie Baker², Melissa Howse¹

¹Interdisciplinary Health Program, St. Francis Xavier University, Antigonish, NS, Canada.

JMIR Research Protocols

|May 14, 2026

Summary

This summary is machine-generated.

Social media advertisements on Facebook (FB) show promise for increasing colorectal cancer (CRC) screening intentions. This study tested FB ads to boost CRC screening participation cost-effectively.

Keywords:

Facebook cancer screening cluster RCT cluster randomized controlled trial mass screening social media

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Area of Science:

Public Health
Digital Health Interventions
Cancer Screening Promotion

Background:

Colorectal cancer (CRC) screening rates in Canada fall below national targets, with existing interventions proving costly and minimally effective.
Social media platforms, particularly Facebook (FB), offer a novel and potentially cost-effective strategy to enhance cancer screening participation among eligible populations.

Purpose of the Study:

To report the protocol for a pragmatic cluster randomized controlled trial evaluating the effectiveness of CRC social media advertisements.
To assess the impact of FB advertisements on user engagement and screening intentions for colorectal cancer.

Main Methods:

A cluster randomized controlled trial targeting Facebook (FB) users aged 45-64 in Ontario, Canada, with randomization at the forward sortation area (FSA) level.
Six study arms were established: four receiving different social media advertisements, one with a sex-tailored strategy, and a control arm with no ads.
Primary outcome: number of individuals per FSA pledging CRC screening intention; secondary outcomes: user engagement metrics (impressions, clicks, cost per click, click-through rate, comments).

Main Results:

The trial will provide evidence on utilizing FB for delivering CRC screening messages and influencing screening intentions.
Comparison of advertisement types within a fixed budget aims to identify effective strategies for promoting user engagement in both urban and rural settings.

Conclusions:

Social media presents a potentially cost-efficient and scalable method for promoting colorectal cancer (CRC) screening.
This approach is adaptable for other cancer screening programs, offering evidence-based digital strategies for public health initiatives.