Investigating the use of image-based communication to improve uptake of breast cancer screening

INTERVENTION: This study will include three workstreams: A, B and C: Workstream A will consist of workshops to explore preferences around breast cancer screening invitations and to refine image‐based interventions. Workstream B will be an RCT of an image‐based leaflet included alongside usual care breast cancer screening invitation letters. The image‐based leaflet will be based on the animation video included in workstream C of the trial, which was originally developed and trialled as part of a previous study based out of Imperial to improve breast cancer screening uptake. Workstream C (conducted in a hub that is not included in workstream B) will be an RCT of the inclusion of a link to a video animation included within usual care SMS reminders for breast cancer screening. There will be an anonymous online questionnaire at the end of the animation video which individuals can choose to take part in. The study will be conducted as a Randomised Controlled Trial (RCT) in the London and southeast screening region of NHSBSP. The administrative hub for the NHSBSP in London is based at the Royal Free Hospital, which will oversee invitation printing, scheduling, and outcome data collation through their existing delivery systems. Workstream C will rely on SMS messages so will not require the same level of administrative centralisation. Participants in both workstreams B and C will be randomised using a simple randomisation method in a 1:1 fashion to either intervention arm or usual care using a computerised system in which each participant who is due for screening in the study period is randomly allocated a number corresponding to the invitation they will receive according to the final digit of the NHS number. In this way, women who phone to reschedule are not reallocated to a different tr CONDITION: Screening for breast cancer ; Cancer PRIMARY OUTCOME: Percentage uptake of breast cancer screening is measured as attendance (did/did not attend) using the breast cancer screening service hub data, at baseline and three months after the initial invitation letter INCLUSION CRITERIA: 1. Eligible for the NHS Breast Screening Programme (NHSBSP) 2. Aged 50 to 70 years old 3. Lives within the London screening regions included in the trial 4. Registered as female with the GP For the workshops: 1. Registered as female with the GP 2. Lives within the London screening region included in the trial 3. Aged 47 to 73 years old SECONDARY OUTCOME: 1. Percentage uptake of breast cancer screening amongst different demographic subgroups measured as attendance (did/did not attend) using the breast cancer screening service hub data at baseline and three months after the initial invitation letter ; 2. Perceptions of the animation video sent in workstream C measured using an online questionnaire at [timepoint]; 3. Barriers to breast cancer screening uptake, and perceptions of communication materials [measured using] data collected during qualitative workshops at [timepoint]; 4. Percentage uptake of breast cancer screening [measured using] at baseline and si Xmonths after the initial invitation letter ; ; 1. Percentage uptake of breast cancer screening amongst different demographic subgroups measured as attendance (did/did not attend) using the breast cancer screening service hub data at baseline and three months after the initial invitation letter; 2. Perceptions of the animation video sent in workstream C measured using an online questionnaire which will be available to individuals via a landing page once they have watched the video (link provided in SMS message); 3. Barriers to breast cancer screening uptake, and perceptions of communication materials measured via focus group discussion qualitative data collected during qualitative workshops before the leaflet is made available in workstream B; 4. Percentage uptake of breast cancer screening as attendance (did/did not attend) using the breast cancer screening service hub data at baseline and si Xmonths after the initial invitation letter; ;