Behavioural Science Messages in Breast Cancer Screening

NCT05395871 | Completed Results DMC

• 1 other identifier: 22IC7498
• Study Type: interventional
• Target: 34,047
• Locations: 1 country
• Sites: 1

Brief Summary

Breast cancer is the most common cancer in the United Kingdom, with 1 in 8 women affected during their lifetime. Whilst survival rates are high, the 5-year survival rate is 72% higher with the earliest stage breast cancer, compared to the latest disease stage. The National Health Service Breast Screening Programme invites women aged 50 to 70 years old every three years to a mammogram. By enabling earlier detection, it is estimated that the National Health Service Breast Screening Programme saves 1300 lives per year. Despite the potential benefits of breast cancer screening, attendance is falling. Behavioural Science is a field of study concerning understanding the processes underpinning human action. Behavioural theories, such as the Capability Opportunity Motivation-Behaviour model. Recent studies have shown the application of behavioural science to screening may also facilitate uptake of invitations. However, the use of plain text messages limits which behavioural determinants can be feasibly addressed, and what techniques can be used. Video messages can allow for more complex and a broader range of behavioural change techniques to be incorporated, and therefore have greater impact upon attendance. Whilst behavioural science-informed messages have previously been trialed by groups to facilitate breast screening attendance, their effectiveness has been variable. One of the reasons for this, is that text messages are of limited length and formatting capability, thus restricting the number of behavioural change techniques that can be included. Moreover, some behavioural techniques are more complex than others, and plain text can limit the extent to which these can be feasibly incorporated. Video messaging provides a delivery mechanism that may enable more complex, and different combinations to be trialed. There is however, a paucity of data regarding the impact of sending a video-based behavioural science message upon attendance rates at breast cancer screening programmes. This study looks to investigate the impact of a video-message, compared to behavioural science-based text messages and standard reminder messages. The primary object is to determine the impact of behavioural science informed (1) video and (2) text messages compared to usual care, upon uptake of breast cancer screening. Secondary objectives involve how this impact on attendance differs between population subgroups including people from differing demographic groups.

Conditions

Breast Cancer

Keywords

Breast Cancer Screening; Behavioural Science; Mobile Messaging; Behavioural Interventions; Healthcare Inequalities

Outcome Measures

Primary Outcomes (2)

• No. of Participants Taking up Breast Cancer Screening at Three Months- Intention to Treat

  Percentage uptake of breast cancer screening, three months after the initial invitation letter- intention to treat.

  3 months

• No. of Participants Taking up Breast Cancer Screening at Three Months- Per Protocol

  No. of participants taking up breast cancer screening, three months after the initial invitation letter- per protocol

  3 months

Secondary Outcomes (3)

• No. of Participants Taking up Breast Cancer Screening, Three Months After the Initial Invitation Amongst Those From Sociodemographic Groups (Deprivation, Ethnicity)

  3 months

• No. of Participants Taking up Uptake of Breast Cancer Screening, Three Months After the Initial Invitation Letter, Amongst Those Given Different Invitation Types.

  3 months

• No. of Participants Taking up Breast Cancer Screening, Three Months After the Initial Invitation Letter, Amongst Those With Different Screening History

  3 months

Study Arms (3)

Usual Care

ACTIVE COMPARATOR

A text message sent 7 days prior then 48 hours before a booked/timed appointment. The content of the message will be the 'usual care' content that is currently sent by the London Breast Cancer Screening Programme. This includes a link to a YouTube hosted video.

Other: Usual Care Message

Behavioural Message

EXPERIMENTAL

A text message sent 7 days prior then 48 hours before a booked/timed appointment. The content of the message has been informed by previous co-design work, and incorporate behavioural change techniques. This will include the same link to a YouTube hosted video, as the usual care arm.

Behavioral: Behavioural Message

Behavioural Message + Video

EXPERIMENTAL

An text message sent 7 days prior then 48 hours before a booked/timed appointment. The content of the message will be the same as the Behavioural text, however the link will be replaced with a weblink to an animated video. This video has been designed through an extensive co-design process involving several behavioural change techniques designed to overcome barriers highlighted in this qualitative work.

Behavioral: Behavioural Message + Video

Interventions

Behavioural Message BEHAVIORAL

Messaging involving increased salience, increasing positive emotions and information on health consequences

Behavioural Message

Behavioural Message + Video BEHAVIORAL

Messaging as above. The video also includes information on emotional consequences, problem solving, anticipated regret, reducing negative emotions and credible source techniques.

Behavioural Message + Video

Usual Care Message OTHER

Standard usual care message involving link to non-behavioural science informed video

Usual Care

Eligibility Criteria

• Age: 50 Years - 70 Years
• Gender Eligibility Details: Registered with primary care physician as female and therefore will be invited to the breast cancer screening programme
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Aged between 50 to 70 at the time of invitation
• Lives within London screening region
• Registered as female with primary care physician

You may not qualify if:

• Previous attendance at breast screening in the current (3-year cycle)
• Opted out of receiving text messages
• Opted out of screening
• Previous bilateral mastectomy

Sponsors & Collaborators

• Imperial College London: lead
• NHS England: collaborator

Study Sites (1)

NHS Breast Screening Hub

Edgware, London, United Kingdom

Location

Related Publications (7)

• Kerrison RS, Shukla H, Cunningham D, Oyebode O, Friedman E. Text-message reminders increase uptake of routine breast screening appointments: a randomised controlled trial in a hard-to-reach population. Br J Cancer. 2015 Mar 17;112(6):1005-10. doi: 10.1038/bjc.2015.36.

  PMID: 25668008 BACKGROUND

• Acharya A, Sounderajah V, Ashrafian H, Darzi A, Judah G. A systematic review of interventions to improve breast cancer screening health behaviours. Prev Med. 2021 Dec;153:106828. doi: 10.1016/j.ypmed.2021.106828. Epub 2021 Oct 5.

  PMID: 34624390 BACKGROUND

• Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011 Apr 23;6:42. doi: 10.1186/1748-5908-6-42.

  PMID: 21513547 BACKGROUND

• NHS Digital. Breast Screening Programme, England 2019-20 [Internet]. 2021 [cited 2021 Jun 14]. Available from: https://digital.nhs.uk/data-and-information/publications/statistical/breast-screening-programme/england---2019-20

  BACKGROUND

• Huf S, Kerrison RS, King D, Chadborn T, Richmond A, Cunningham D, Friedman E, Shukla H, Tseng FM, Judah G, Darzi A, Vlaev I. Behavioral economics informed message content in text message reminders to improve cervical screening participation: Two pragmatic randomized controlled trials. Prev Med. 2020 Oct;139:106170. doi: 10.1016/j.ypmed.2020.106170. Epub 2020 Jun 29.

  PMID: 32610059 BACKGROUND

• Acharya A, Darzi A, Judah G. An SMS and animated video intervention to increase uptake of breast cancer screening: a randomised controlled trial. Lancet. 2023 Nov;402 Suppl 1:S17. doi: 10.1016/S0140-6736(23)02133-5.

  PMID: 37997056 DERIVED

• Acharya A, Ashrafian H, Cunningham D, Ruwende J, Darzi A, Judah G. Evaluating the impact of a novel behavioural science informed animation upon breast cancer screening uptake: protocol for a randomised controlled trial. BMC Public Health. 2022 Jul 19;22(1):1388. doi: 10.1186/s12889-022-13781-x.

  PMID: 35854267 DERIVED

MeSH Terms

Conditions

Breast Neoplasms

Interventions

Videotape Recording

Condition Hierarchy (Ancestors)

Neoplasms by Site; Neoplasms; Breast Diseases; Skin Diseases; Skin and Connective Tissue Diseases

Intervention Hierarchy (Ancestors)

Tape Recording; Audiovisual Aids; Educational Technology; Technology; Technology, Industry, and Agriculture; Television

Results Point of Contact

• Title: Amish Acharya
• Organization: Imperial College London

aa2107@ic.ac.uk

0203312 6666

Study Officials

• Ara Darzi, FRCS

  Imperial College London

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: CARE PROVIDER
• Masking Details: The screening services will not have access to the allocation of participants and will be masked. They will not be able to determine which messages are being sent to different women being invited to screen, as allocation will be undertaken by the third party messaging company following provision of a screening invitation list by the service.
• Purpose: SCREENING
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: 3 arm randomised controlled trial

Study Record Dates

• First Submitted: May 24, 2022
• First Posted: May 27, 2022
• Study Start: July 15, 2022
• Primary Completion: January 15, 2023
• Study Completion: January 15, 2023
• Last Updated: January 30, 2025
• Results First Posted: January 30, 2025

Record last verified: 2025-01

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)