Dataset Information

Improving uptake of colorectal cancer screening among primary care attendees

ABSTRACT: Interventions: The intervention group will receive a one-off individual intervention delivered in the primary care clinic. The intervention will involve the following: In the waiting room, a research assistant will provide intervention participants with an envelope prior to their GP appointment. The envelope will contain: a) a faecal occult blood test kit with: instructions for completion; pathology request form, and: pre-paid postage to mail the kit for analysis. b) A feedback sheet containing screening recommendations for those at average risk of colorectal cancer (including recommended: age to commence screening; screening test; frequency of testing). The sheet will also include methods to obtain FOBT as well as what to do with the FOBT provided. The research assistant will deliver the survey and for eligible patients will complete the pathology form but will not provide any medical advice or endorse completion of the intervention. The general practitioner will endorse the FOBT during the patient’s appointment. The GP will reinforce the importance of completing the FOBT and recommend the patient complete the FOBT using a script provided by the research team during a pre-study training session. Primary outcome(s): Uptake of FOBT screening will be assessed via self-report in the intervention and usual care groups.[6 weeks post baseline] Study Design: Purpose: Prevention; Allocation: Randomised controlled trial; Masking: Open (masking not used);Assignment: Parallel;Type of endpoint: Efficacy

DISEASE(S): Public Health-health Promotion/education,Colorectal Cancer,Cancer-bowel-back Passage (rectum) Or Large Bowel (colon)

PROVIDER: 2464342 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Interventions: The study aims to improve rates of bowel cancer screening by assessing uptake of Fecal Occult Blood test via General Practice compared to direct mail through the National Bowel Cancer Screening Program. Subjects will be invited to take part in the study during a routine visit to the GP. The GP or practice nurse will explain the study and provide the subject information and consent forms along with a FOBt kit to take home. How to use the kit will also be explained by the GP or practice nurse along with what the results mean. The FOBt kit will be completed by the participant at home and mailed to the pathology lab. Results from the kit will be sent by the pathology lab to the participant and the GP and the University NSW assistant researcher collating the data. If the kit is negative the GP will invite the participant back for another test kit in 2 years time as per medical guidelines. If the test kit is positive the participant will be invited back to see the GP and discuss the next step. Subjects will be requested to consent to take part in the study for a total period of 6 months. Results of the FOBt will be recorded along with any further investigations which may be required. All data will be non-identifiable. Subjects have the right to withdraw at any time. Primary outcome(s): On initial presentation to their GP, subjects who have consented to take part in the study will be given information (written & verbal) on bowel cancer screening and offered an FOBt kit. The number of FOBt kits offered compared to returned kits (results data recorded by the pathology company) will be compared to the same in the National Bowel Cancer Screening Program.[The primary time point (baseline) will be the day of signing the consent form and being given bowel cancer screening education and an FOBt kit. Once the kits have been dispensed participants are given a time period within which to return them (3 months) and for results to be recorded by the pathology company. The primary time point is baseline where number of participants are recorded along with number of kits distributed. ] Study Design: Purpose: Prevention; Allocation: Non-randomised trial; Masking: Open (masking not used);Assignment: Single group;Type of endpoint: Efficacy

Project description:Bowel cancer is the second biggest cancer killer in the UK, accounting for over 16,000 deaths per year. Screening can reduce deaths from bowel cancer if the people invited participate. The challenge is that high uptake of bowel screening is hard to achieve, and remains persistently below 65%. The faecal immunochemical test (FIT) is the most widely used bowel screening test worldwide. In the UK, FIT kits are mailed to people’s homes without guidance on when the kit should be returned and only brief instruction on how to use it. Some people have said that even though they intend to complete and return the kit, they often forget or put off doing it. Two approaches are proposed to addressing this issue: i) providing a suggested deadline for FIT return, because it is known from breast and cervical cancer screening that giving people an appointment time increases uptake compared to an open invitation, and ii) planning sheets, that have been found to help people act on their intentions in other health contexts. This trial aims to evaluate the impact of providing a suggested deadline and a planning sheet on the return of FIT bowel screening kits. The trial is integrated within the Scottish Bowel Screening Programme. The investigators will randomly allocate 40,000 consecutive people that are due to be sent a FIT kit to one of eight groups: (i) control group (no deadline, no planning sheet), (ii) intervention group (1-week deadline, no planning sheet), (iii) intervention group (2-week deadline, no planning sheet), (iv) intervention group (4-week deadline, no planning sheet), (v) intervention group (no deadline, with planning sheet), (vi) intervention group (1-week deadline, with planning sheet), (vii) intervention group (2-week deadline, with planning sheet), (viii) intervention group (4-week deadline, with planning sheet). It will then be examined if having a suggested deadline and a planning sheet affects how many people send back their completed FIT kit. It will also be examined if the deadline length makes a difference and whether having both a deadline and a planning sheet affects the number of people returning their kit. Finally, the cognitive and behavioural mechanisms underlying any intervention effects will be assessed and the acceptability of the interventions explored, using questionnaires and in-depth interviews.

Project description:Background and study aims: Colorectal (bowel) cancer is the second leading cause of cancer death in the UK, and costs the National Health Service (NHS) more than £300 million a year in treatment costs. Patient survival could be increased and, costs very much reduced, if patients with bowel cancer received their diagnosis earlier, allowing treatment to begin earlier. The NHS Bowel Cancer Screening Programme (NHSBCSP) was introduced in England in 2006, and aims to screen men and women aged between 60 to 74 years of age for bowel cancer every two years using the faecal occult blood test (FOBt). Initial studies have shown that bowel screening is effective, but the number of patients who participate in screening have been quite low, with only around half of all the people who are invited to participate returning their FOBt kit. The success of the NHSBCSP relies on a high number of patients participating, and the development of new ways to improve the number participating after they are invited to participate. The main aim of the study is to assess how effective a GP reminder and additional FOBt kit are on increasing the number who participate in bowel cancer screening, when they have not participated following a previous invitation. Who can participate? All adults eligible for bowel screening (aged between 60 to 74 years old). These were patients at a participating general practice in the West Midlands, where the screening rate is less than 50%. These patients had been invited to participate in bowel screening but had not returned their FOBt within 13 weeks of initial invitation by the Midlands and North West Bowel Cancer Screening Hub. What does the study involve? We will randomly allocate the participants to one of two groups: 1. GP reminder to participate in bowel screening and additional FOBt kit, OR 2. No additional contact We compared how may people participated in bowel screening after 13 weeks. This was measured by the number of FOBt kits that were returned to the bowel screening hub by patients in each group. This allowed us to assess if the GP reminder to participate in bowel screening and additional FOBt kit was successful in increasing the participation in bowel screening. A small interview was carried out with some patients who received the GP reminder who returned a FOBt kit.

Project description:Interventions: Eligible general practice patients will complete a brief (approximately 5 to 10 minutes) touchscreen computer survey on a tablet device while in the waiting room prior to their appointment. The survey will assess the patient’s potential health risks related to under-screening for bowel cancer, cervical (women only) and breast cancer (women only), smoking, risky alcohol consumption and depression. For intervention participants, preferences for help with identified health risks will be elicited as part of the survey. Upon completion of the survey, intervention participants will receive printed feedback on health risks identified from their survey along with recommended self-management actions as endorsed by a range of Australian Government-supported organisations aimed at promoting health in these areas. Participants who report being under-screened for cancer (bowel, breast, cervical) will be encouraged to discuss screening options with their doctor. Participants identified as smokers will be presented with self-management options such as referral to Quitline (a telephone-based smoking cessation intervention), talking to their doctor, and nicotine replacement therapy etc. Participants identified as drinking above recommended levels will be presented with options for reducing alcohol intake such as choosing alcoholic drinks with lower alcohol content, and discussing approaches with their doctor etc. Participants who report depressed mood will be presented with options such as attending counselling, contacting Beyondblue (a telephone-based emotional support service), and discussing with their GP etc. The printed feedback will be given to patients in an envelope by a research assistant immediately after completion of the baseline survey in the primary care clinic. This f Primary outcome(s): The primary outcome will be the proportion of patients within each group who report undertaking one or more self-management actions in relation to health risk factors identified at baseline. Self management actions will be elicited by a survey specifically designed for this study.[1-month follow-up.] Study Design: Purpose: Prevention; Allocation: Randomised controlled trial; Masking: Open (masking not used);Assignment: Parallel;Type of endpoint: Efficacy

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Improving uptake of colorectal cancer screening among primary care attendees

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