ASPO Abstracts
Can text message reminder content improve cervical screening participation: A randomised controlled trial
Category: Lifestyles Behavior, Energy Balance & Chemoprevention, Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2018
Abstract Body:
Introduction It is estimated that 83% of cervical cancer deaths could be avoided through regular screening. Between 2011 and 2016 coverage fell from 75.7% to 72.6% in England, and from approximately 69.5% to 66.7% in London. Recent evidence has shown that text message reminders (SMS-R) improved participation in breast and bowel cancer screening, and that the message content within an SMS-R can further affect attendance rates at outpatient appointments. Purpose We tested the effect of modifying SMS-R content on cervical screening uptake (i.e. attendance after invitation) in a low-coverage London borough. Methods Women aged 30 years and older, invited for screening from Feb 16, 2015, to Oct 5, 2015 were randomised to one of seven trial arms (1:1:1:1:1:1:1) using a random number generator, to receive no SMS-R or one of six SMS-Rs: a simple reminder, GP-endorsement, total and proportional social norms messages (communicating screening rates of peers) and gain and loss-framed messages (lives saved and lives lost associated with participating in screening). Women aged 25-29 years were randomised (1:1) to no SMS-R or a GP- endorsed SMS-R. Recipients were blinded to SMS-R content of other trial arms. The primary outcome was the percentage screened by 18 weeks. The data was analysed using logistic regression, adjusted for age, IMD decile. Results In total, 1568, 1522, 1493, 1514, 1488, 1560 and 1507 women aged 30-64 years were allocated no SMS-R, a simple reminder, GP-endorsement, total social norms, proportional social norms, gain or loss-framed SMS-R, respectively. The greatest difference in uptake was between no SMS-R (34.4%, n=540) and GP- endorsement (38.4%, n=575) (OR 1.19, 95% CI 1.03-1.38, p=0.02), followed by the simple SMS (38.1%, n=580) (OR 1.18, 95% CI 1.02-1.37, p=0.03). No overall significant difference between the control and other trial arms was observed. Participation among the 1453 and 1482 women aged 25-29 years randomised to no SMS-R or a GP-endorsement was 26.4% (n=384) and 31.4% (n=466) respectively (OR 1.29, 95% CI 1.09-1.51, p=0.002). Conclusion SMS-R messages can improve cervical screening uptake. The behavioural sciences can inform the message content that has the biggest impact on screening participation.
Keywords: Cervical screening Text message reminders Behavioural Science