Steps towards increasing bowel cancer screening uptake: a randomised controlled trial

INTERVENTION: Participants are randomised to one of four groups to evaluate the separate and combined effects of two psychological, evidence‐based interventions. All participants are sent an initial letter of invitation for bowel cancer screening and the standard NHS information booklet and the different groups receive one of the following before being sent a guaiac faecal occult blood test (gFOBT): 1) Implementations Intentions (IMPS) intervention: Four days after the initial letter participants receive an intervention pack containing an information sheet and a short, implementation intentions, paper‐based task designed to help them construct effective 'if‐then' plans. This involves connecting barriers likely to be encountered (IFs) with effective responses (THENs) to aid participants' decision‐making process with regards to completion of the guaiac faecal occult blood test (gFOBT) screening kit, which is sent in the post four days later. 2) Motivational intervention: Four days after the initial letter, participants receive an intervention pack containing an information sheet and a motivational‐intervention leaflet. The leaflet contains information regarding some of the social norms surrounding bowel cancer screening (e.g. how many people do engage in screening) and is designed to motivate participants to take part in gFOBT screening. Participants receive the gFOBT screening kit four days later. 3) Combination intervention: Four days after the initial letter, participants receive an intervention pack containing an information sheet, an implementation intentions paper‐based task and a motivational‐intervention leaflet. Participants read the information sheet, motivational leaflet and complete the short implementati CONDITION: Bowel cancer ; Cancer ; Bowel cancer PRIMARY OUTCOME: Screening uptake measured by the proportion of people in each intervention condition returning an adequate gFOBT kit within 8 weeks of being sent an invitation SECONDARY OUTCOME: ; 1. Time taken by participant to return kit; 2. Variation in screening uptake (defined as the return of an adequate gFOBT kit within 8 weeks of being sent an invitation) by; 2.1. Gender; 2.2. Age; 2.3. Past screening history; 2.4. Level of socioeconomic deprivation; INCLUSION CRITERIA: 1. Men and women eligible to be screened for bowel cancer in the North East region of England 2. Aged between 60‐74 years