Testing a Behavioural Approach to Improving Cancer Screening Rates
- Conditions
- Early Detection of CancerClinical Trial
- Interventions
- Behavioral: Anticipated regretBehavioral: Material incentiveBehavioral: Problem solving
- Registration Number
- NCT03124316
- Lead Sponsor
- Women's College Hospital
- Brief Summary
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.
- Detailed Description
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.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 5525
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- FACTORIAL
- Arm && Interventions
Group Intervention Description Email #5: REGRET + INCENTIVE Material incentive Anticipated regret content + Material incentive content + standardized content Email #7: INCENTIVE + PROBLEM SOLVING Material incentive Material incentive content + Problem solving content + standardized content Email #3: MATERIAL INCENTIVE Material incentive Material incentive content + standardized content Email #5: REGRET + INCENTIVE Anticipated regret Anticipated regret content + Material incentive content + standardized content Email #7: INCENTIVE + PROBLEM SOLVING Problem solving Material incentive content + Problem solving content + standardized content Email #2: ANTICIPATED REGRET Anticipated regret Anticipated regret content + standardized content Email #4: PROBLEM SOLVING Problem solving Problem solving content + standardized content Email #6: REGRET + PROBLEM SOLVING Anticipated regret Anticipated regret content + Problem solving content + standardized content Email #6: REGRET + PROBLEM SOLVING Problem solving Anticipated regret content + Problem solving content + standardized content Email #8: ALL BCTs Problem solving Anticipated regret content + Material incentive content + Problem solving content + standardized content Email #8: ALL BCTs Material incentive Anticipated regret content + Material incentive content + Problem solving content + standardized content Email #8: ALL BCTs Anticipated regret Anticipated regret content + Material incentive content + Problem solving content + standardized content
- Primary Outcome Measures
Name Time Method SAR access 4 months The primary outcome will be whether eligible family physicians access the SAR during the 4 months of the trial (Yes/No)
- Secondary Outcome Measures
Name Time Method SAR access rate 4 months Number of times the SAR was accessed
Adherence to screening guidelines for breast, colon, and cervical cancer in patients of eligible PCPs 4 months Proportion of patients meeting screening guidelines for breast, colon, and cervical cancer; and efforts made by participants to access the SAR-use
Trial Locations
- Locations (1)
Cancer Care Ontario
🇨🇦Toronto, Ontario, Canada