Testing a Behavioural Approach to Improving Cancer Screening Rates

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

5525 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-05-10

Study Completion Date

2017-09-30

Brief Summary

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Family doctors can play a critical role in successfully arranging cancer screening tests to occur, especially if they know which patients are due for these tests. However, they don't always interact with or take advantage of registry data to this end. For example, in Ontario, the Screening Activity Report provides exactly this information to family doctors, helping them identify their patients who are overdue for screening. Unfortunately, less than half of family doctors regularly use the Screening Activity Report even though they get monthly email reminders. One possible reason is that the reminders they receive are not designed to compel action. They are easy for family doctors to miss or dismiss. This study will compare multiple different ways of designing the reminders. The different versions of the email are tested in a 2\^3 factorial trial testing three behaviour change techniques to see which ones will lead to more family physicians interacting with the Screening Activity Report and at increasing the number of patients that get all the appropriate screening tests for cervical, breast, and/or colon cancer.

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Detailed Description

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Screening is an important way to prevent cancer-related death, but many Ontarians do not receive guideline-recommended screening for cervical, breast, and colon cancer. Family physicians can play a critical role in successfully increasing screening rates. A recent evaluation by members of our team suggests that Screening Activity Report (SAR) use is associated with improved cancer screening, but there remains substantial room for improvement. For the SAR to reach its full potential to decrease cancer-related death by improving screening rates, family physicians must regularly access it and take the appropriate actions. Currently, family physicians receive monthly email reminders, which state that new data are available, but do not describe the benefits of the SAR for physicians or their patients. It is easy to imagine how a busy doctor would fail to act upon such emails, resulting in suboptimal use of the SAR and leading to avoidable delays in cancer screening, and management. Indeed, CCO data show that less than half of recipients attend to this email and \<7% click through to the SAR. The objectives for this trial are to compare different versions of the reminders in a randomized trial to identify the features that most increase use of the SAR. This is a pragmatic, 2\^3 factorial trial, comparing behaviour change techniques incorporated within email reminders to doctors increase their use of the SAR. Participants are those who are already sent monthly emails by CCO regarding the SAR. The trial will randomly assign participants to one of eight modified emails to determine which content is most effective at driving SAR-use over 4 months. With an expected sample size of over 5700 family physicians, we anticipate power to see differences of 3% across experimental conditions.

Conditions

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Early Detection of Cancer Clinical Trial

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

We will test three components of reminders to family physicians that could be embedded independently, in combinations of two, and all together in a reminder email. Family physicians will be randomly allocated to one of 8 experimental conditions. Each experimental condition comprises a different combination of the behaviour change techniques featured in the redesigned email reminder.

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

The randomization schedule will be generated by a statistician on study IDs. The allocation sequence is applied simultaneously to the full set of eligible family physicians so that each is assigned to one of eight experimental conditions. The assignment to study conditions will be concealed from investigators. The data collection system used for the 4 month outcome assessment will be standardized across all study conditions and conducted by personnel at CCO not already involved in the study trial. No un-blinding is planned or permitted.

Study Groups

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Email #1: FULLY TURNED OFF

No behavioural change techniques (BCTs) 'turned on' in the email. The email would contain only standardized content.

Group Type NO_INTERVENTION

No interventions assigned to this group

Email #2: ANTICIPATED REGRET

Anticipated regret content + standardized content

Group Type EXPERIMENTAL

Anticipated regret

Intervention Type BEHAVIORAL

Induce awareness of future regret about the unwanted behaviour

Email #3: MATERIAL INCENTIVE

Material incentive content + standardized content

Group Type EXPERIMENTAL

Material incentive

Intervention Type BEHAVIORAL

Inform that valued objects will be delivered if and only if that has been progress in performing the desired behaviours

Email #4: PROBLEM SOLVING

Problem solving content + standardized content

Group Type EXPERIMENTAL

Problem solving

Intervention Type BEHAVIORAL

Analyze or prompt the person to factors that influence the behaviour and select strategies that help overcome barriers

Email #5: REGRET + INCENTIVE

Anticipated regret content + Material incentive content + standardized content

Group Type EXPERIMENTAL

Anticipated regret

Intervention Type BEHAVIORAL

Induce awareness of future regret about the unwanted behaviour

Material incentive

Intervention Type BEHAVIORAL

Inform that valued objects will be delivered if and only if that has been progress in performing the desired behaviours

Email #6: REGRET + PROBLEM SOLVING

Anticipated regret content + Problem solving content + standardized content

Group Type EXPERIMENTAL

Anticipated regret

Intervention Type BEHAVIORAL

Induce awareness of future regret about the unwanted behaviour

Problem solving

Intervention Type BEHAVIORAL

Analyze or prompt the person to factors that influence the behaviour and select strategies that help overcome barriers

Email #7: INCENTIVE + PROBLEM SOLVING

Material incentive content + Problem solving content + standardized content

Group Type EXPERIMENTAL

Material incentive

Intervention Type BEHAVIORAL

Inform that valued objects will be delivered if and only if that has been progress in performing the desired behaviours

Problem solving

Intervention Type BEHAVIORAL

Analyze or prompt the person to factors that influence the behaviour and select strategies that help overcome barriers

Email #8: ALL BCTs

Anticipated regret content + Material incentive content + Problem solving content + standardized content

Group Type EXPERIMENTAL

Anticipated regret

Intervention Type BEHAVIORAL

Induce awareness of future regret about the unwanted behaviour

Material incentive

Intervention Type BEHAVIORAL

Inform that valued objects will be delivered if and only if that has been progress in performing the desired behaviours

Problem solving

Intervention Type BEHAVIORAL

Analyze or prompt the person to factors that influence the behaviour and select strategies that help overcome barriers

Interventions

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Anticipated regret

Induce awareness of future regret about the unwanted behaviour

Intervention Type BEHAVIORAL

Material incentive

Inform that valued objects will be delivered if and only if that has been progress in performing the desired behaviours

Intervention Type BEHAVIORAL

Problem solving

Analyze or prompt the person to factors that influence the behaviour and select strategies that help overcome barriers

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

Family physicians are eligible if they have signed up for the SAR and already receive reminder emails as part of their registration process for the SAR with CCO.

Eligible Sex

ALL

Accepts Healthy Volunteers

No