• Br J Gen Pract · Apr 2024

    Randomized Controlled Trial

    Increasing bowel cancer screening using SMS in general practice: the SMARTscreen trial.

    • Jennifer G McIntosh, Mark Jenkins, Anna Wood, Patty Chondros, Tina Campbell, Edweana Wenkart, Clare O'Reilly, Ian Dixon, Julie Toner, Javiera Martinez-Gutierrez, Linda Govan, and Jon D Emery.
    • Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne.
    • Br J Gen Pract. 2024 Apr 1; 74 (741): e275e282e275-e282.

    BackgroundAustralia has one of the highest incidences of colorectal cancer (CRC) worldwide. The Australian National Bowel Cancer Screening Program (NBCSP) is a best-practice, organised screening programme, but uptake is low (40.9%) and increasing participation could reduce morbidity and mortality associated with CRC. Endorsement by GPs is strongly associated with increasing screening uptake.AimThis study (SMARTscreen) aimed to test whether a multi-intervention short message service (SMS) sent by general practices to 50-60-year-old patients who were due to receive the NBCSP kit would increase NBCSP uptake, by comparing it with usual care.Design And SettingA stratified cluster randomised controlled trial was undertaken, involving 21 Australian general practices in Western Victoria, Australia.MethodFor intervention practices, people due to receive the NBCSP kit within a 6-month study period were sent an SMS just before receiving the kit. The SMS included a personalised message from the person's general practice endorsing the kit, a motivational narrative video, an instructional video, and a link to more information. Control practices continued with usual care, comprising at-home testing with a faecal immunochemical test (FIT) through the NBCSP. The primary outcome was the between-arm percentage difference in uptake of FIT screening within 12 months from randomisation, which was estimated using generalised linear model regression.ResultsIn total, 39.2% (1143/2914) of people in 11 intervention practices and 23.0% (583/2537) of people in 10 control practices had a FIT result in their electronic health records - a difference of 16.5% (95% confidence interval = 2.02 to 30.9).ConclusionThe SMS intervention increased NBCSP kit return in 50-60-year-old patients in general practice. This finding informed a larger trial - SMARTERscreen - to test this intervention in a broader Australian population.© The Authors.

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