Background
Testing interventions to increase the current low uptake (44%) of the Australian National Bowel Cancer Screening Program (NBCSP) is critical to increasing screening for bowel cancer to increase early detection of colorectal cancer and maximise cost-effectiveness.
Aim
To test the effectiveness, acceptability, and feasibility of sending an evidence-based multi-intervention SMS from general practice to prompt patients to complete NBCSP kits.
Design and setting
In 2020 we trialled an SMS containing a GP endorsement of NBCSP, relatable narrative discussing screening benefits, NBCSP animated step-by-step video of how-to do a NBCSP kit and link to NBCSP information to increase screening for colorectal cancer. The primary outcome was the difference in the FOBT results recorded between the intervention and control group for up to 12 months after sending SMSs. A qualitative process evaluation explored acceptability and feasibility factors among clinicians, staff, and patients.
Results
A total of 21 general practices in Victoria’s Western District were randomised. 2645 patients received the SMS compared to 2537 usual care. NBCSP FOBT results recorded by intervention group was 1143 compared with 583 control group. (difference=16.5% 95% CI: 2.02-30.9%). Clinicians and staff found sending SMSs compatible with clinical workflow while patients associated the SMS as a link between the GP and NBCSP.
Conclusion
Receiving a GP endorsed multi-intervention SMS prompt from general practice before getting the NBCSP kit has a significant positive impact on NBCSP uptake. Optimising the SMS content to broaden engagement inclusive of diverse groups of Australians is required to further increase effectiveness. We are conducting a larger RCT ('SMARTERscreen') to co-design and test the SMS in the broader Australian context.