Using Behavioural and Cultural Insights to Understand and Address Barriers and Drivers to Colorectal Cancer Home-testing in Croatia

Status: Recruiting
Location: See location...
Intervention Type: Behavioral
Study Type: Interventional
Study Phase: Not Applicable
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.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 50
Maximum Age: 74
Healthy Volunteers: t
View:

• 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

Locations
Other Locations
Croatia
Croatian Institute of Public Health
RECRUITING
Zagreb
Contact Information
Primary
Veerle Snijders
snijdersv@who.int
+31642641587
Backup
Tiina Likki
likkit@who.int
+4531396157
Time Frame
Start Date: 2024-03-05
Estimated Completion Date: 2024-07
Participants
Target number of participants: 13000
Treatments
No_intervention: Control
Participants do not receive a reminder letter, which is treatment as usual.
Experimental: Standard letter
Participants receive a reminder letter which is based on the current colorectal cancer screening invitation.
Experimental: 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.
Experimental: Behaviorally informed letter + testing kit
Participants receive the behaviorally informed letter plus the colorectal home testing kit, which removes the current barrier of having to request a kit.
Related Therapeutic Areas
Sponsors
Leads: Veerle Snijders
Collaborators: Andrija Štampar School of Public Health, Croatian Institute of Public Health

This content was sourced from clinicaltrials.gov