Using Behavioural and Cultural Insights to Increase Colorectal Cancer Home-testing in Croatia
- Conditions
- Colorectal CancerBehavior Change
- Interventions
- Behavioral: Standard letterBehavioral: Behaviorally informed letterBehavioral: Home testing colorectal cancer kit
- Registration Number
- NCT06341322
- Lead Sponsor
- Veerle Snijders
- Brief Summary
Colorectal cancer (CRC) is one of the leading causes of death in Croatia. An average of 3600 cases are diagnosed and an average of 2100 people die from the disease every year. Since 2007, Croatia has invited every man and woman aged 50-74 to participate in the home testing screening programme every two years. Currently only around 36% of the invited request the test-kit and 25% complete the home testing procedure, far below the target of 40-60%.
The Croatian Institute of Public Health with technical support from World Health Organization (WHO) Regional Office for Europe is undertaking a mixed-methods research study with the aim to increase the completion of colorectal cancer home testing and improve our knowledge of the barriers and drivers to do so. The study has a quantitative and a qualitative component:
1. Quantitative: testing the introduction of a reminder letter to encourage people to respond to the initial invite to participate in the CRC home test program and test which elements of a reminder letter improve response rates.
The quantitative component consists of a four-arm reminder letter randomized controlled trial (RCT) comparing no letter, standard letter, behaviorally informed letter, and behaviorally informed letter sent with a home testing kit to investigate the effectiveness of reminders in increasing uptake of home-testing for colorectal cancer. Recruitment and data collection for the reminder letter trial will be conducted utilizing the routine screening process and routinely collected screening data.
2. Qualitative: conducting in-depth interviews with people from the target population who did or did not respond to the CRC invite letter and reminder to better understand the barriers and drivers to participation.
The qualitative component consists of 24 in-depth interviews (IDIs) conducted with members of the target population to identify barriers and drivers to completing colorectal cancer screening home-testing. Data collection for IDIs will be face-to-face, using discussion guides, and will be audio recorded. The audio-recordings will then be analyzed using a rapid analysis approach based on by the modified Capability-Opportunity-Motivation-Behavior (COM-B) framework.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 13000
- eligible to participate in the national colorectal cancer screening programme
- live in a study location (Split-Dalmatia or Zagreb City counties)
- did not respond to the cancer screening invite letter
- participated in the colorectal screening programme in the last 24 months
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Standard letter Standard letter Participants receive a reminder letter which is based on the current colorectal cancer screening invitation. Behaviorally informed letter Behaviorally informed letter Participants receive a reminder letter which incorporates several behavioral components, including an active choice prompt, social norm, simplification, chunking and call to action. Behaviorally informed letter + testing kit Behaviorally informed letter Participants receive the behaviorally informed letter plus the colorectal home testing kit, which removes the current barrier of having to request a kit. Behaviorally informed letter + testing kit Home testing colorectal cancer kit Participants receive the behaviorally informed letter plus the colorectal home testing kit, which removes the current barrier of having to request a kit.
- Primary Outcome Measures
Name Time Method Completed colorectal cancer screening 5 weeks Did the participant complete the home testing kit and return it to the health authority? Routinely collected data.
Home test kit ordered 5 weeks Did the participant order the colorectal cancer home testing kit? Routinely collected data.
- Secondary Outcome Measures
Name Time Method Qualitative feedback 10 weeks Qualitative feedback on the intervention arms and colorectal cancer screening experience. Collected through 24 semi-structured interviews.
Opted out 5 weeks Did the participant actively opt out of participating in the screening program? Routinely collected data.
Trial Locations
- Locations (1)
Croatian Institute of Public Health
🇭🇷Zagreb, Croatia