Evaluating the impact of a novel behavioural science informed animation upon breast cancer screening uptake: protocol for a randomised controlled trial
Open accessAbstract
Background: Breast cancer screening is estimated to save 1300 lives annually in the United Kingdom. Despite this, uptake of invitations has fallen over the past decade. Behavioural science-informed interventions addressing the determinants of attendance behaviour have shown variable effectiveness. This may be due to the narrow repertoire of techniques trialled, and the difficulties of implementation at a population-scale. The aim of this study is to evaluate the impact on breast screening uptake of a novel behavioural video intervention which can contain more complex combinations of behavioural change techniques. Methods: A 3-armed randomised controlled trial will be undertaken in London comparing the impact of (1) the usual care SMS reminder, to (2) a behavioural plain text SMS reminder and (3) a novel video sent as a link within the behavioural plain text SMS reminder. A total of 8391 participants (2797 per group) will be allocated to one of the three trial arms using a computer randomisation process, based upon individuals’ healthcare identification numbers. The novel video has been co-designed with a diverse range of women to overcome the barriers faced by underserved communities and the wider population. The behavioural SMS content has also been co-designed through the same process as the video. Messages will be sent through the current reminder system used by the London screening programmes, with reminders 7 days and 2 days prior to a timed appointment. The primary outcome is attendance at breast cancer screening within 3 months of the initial invitation. Secondary outcomes will include evaluating the impact of each message amongst socio-demographic groups and according to the appointment type e.g. first invitation or recall. Discussion: In addition to general declining trends in attendance, there is also concern of increasing healthcare inequalities with breast cancer screening in London. The current novel intervention, designed with underserved groups and the general population, incorporates several behavioural techniques to overcome the barriers to attendance. Understanding its potential impact in a real-world setting therefore may provide significant information on how to address reducing attendance and healthcare disparities. Trial Registration: This study was registered on ClinicalTrials.gov (NCT05395871) on the 27 th May 2022.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
These prompts also increased CC and BC screening.
“These prompts also increased CC [11] and BC screening [57].”
From Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review (2026) · cites this paper as [57]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Michie, S., Richardson, M., Johnston, M., Abraham, C., Francis, J., Hardeman, W., Eccles, M. P., Cane, J., & Wood, C. E. (2013) · Annals of Behavioral Medicine · doi:10.1007/s12160-013-9486-6 · Cited by 7,629 · see citing works
Atkins, L., Francis, J., Islam, R., O’Connor, D., Patey, A., Ivers, N., Foy, R., Duncan, E. M., Colquhoun, H., Grimshaw, J. M., et al. (2017) · Implementation Science · doi:10.1186/s13012-017-0605-9 · Cited by 3,819 · see citing works
Cultural adaptations of behavioral health interventions: A progress report.
Barrera, M., Castro, F. G., Strycker, L. A., & Toobert, D. J. (2013) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0027085 · Cited by 783 · see citing works
Tuong, W., Larsen, E. R., & Armstrong, A. W. (2012) · Journal of Behavioral Medicine · doi:10.1007/s10865-012-9480-7 · Cited by 367 · see citing works
A Brief Introduction to the COM-B Model of Behaviour and the PRIME Theory of MotivationPreprint
West, R., & Michie, S. (2020) · Qeios · doi:10.32388/ww04e6.2 · Cited by 278 · see citing works
Use of Social Media to Promote Cancer Screening and Early Diagnosis: Scoping Review
Plackett, R., Kaushal, A., Kassianos, A. P., Cross, A., Lewins, D., Sheringham, J., Waller, J., & von Wagner, C. (2020) · Journal of Medical Internet Research · doi:10.2196/21582 · Cited by 129 · see citing works
Kerrison, R., Shukla, H., Cunningham, D., Oyebode, O. O., & Friedman, E. (2015) · British Journal of Cancer · doi:10.1038/bjc.2015.36 · Cited by 109 · see citing works
Self-citationJack, R. H., Møller, H., Robson, T., & Davies, E. (2014) · BMJ Open · doi:10.1136/bmjopen-2014-005586 · Cited by 73 · see citing works
Huf, S. W., Kerrison, R., King, D., Chadborn, T., Richmond, A., Cunningham, D., Friedman, E., Shukla, H., Tseng, F., Judah, G., et al. (2020) · Preventive Medicine · doi:10.1016/j.ypmed.2020.106170 · Cited by 72 · see citing works
Self-citationJensen, L. F., Pedersen, A., Andersen, B., Vestergaard, M., & Vedsted, P. (2015) · BMC Cancer · doi:10.1186/s12885-015-1829-1 · Cited by 50 · see citing works
Psychiatric morbidity and non-participation in breast cancer screening
Virgilsen, L. F., Pedersen, A. F., Bech, B. H., Andersen, B. S., & Vedsted, P. (2015) · The Breast · doi:10.1016/j.breast.2015.10.002 · Cited by 49 · see citing works
Massat, N. J., Douglas, E., Waller, J., Wardle, J., & Duffy, S. W. (2015) · BMJ Open · doi:10.1136/bmjopen-2015-007735 · Cited by 43 · see citing works
A systematic review of interventions to improve breast cancer screening health behaviours
Acharya, A., Sounderajah, V., Ashrafian, H., Darzi, A. W., & Judah, G. (2021) · Preventive Medicine · doi:10.1016/j.ypmed.2021.106828 · Cited by 39 · see citing works
Self-citationLoss-framed minimal intervention increases mammography use
Abood, D. A., Black, D. R., & Coster, D. C. (2005) · Women s Health Issues · doi:10.1016/j.whi.2005.07.005 · Cited by 35 · see citing works
Telephone Counseling and Attendance in a National Mammography-Screening Program
Hegenscheid, K., Hoffmann, W. U., Fochler, S., Domín, M., Weiß, S., Hartmann, B., Bick, U., & Hosten, N. (2011) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2011.06.040 · Cited by 24 · see citing works
Chambers, J. A., Gracie, K., Millar, R., Cavanagh, J., Archibald, D., Cook, A., & O’Carroll, R. E. (2015) · Journal of Medical Screening · doi:10.1177/0969141315608212 · Cited by 17 · see citing works
Huf, S. W., King, D., Judah, G., Fuller, C., Vlaev, I., Cunningham, D., & Darzi, A. W. (2017) · The Lancet · doi:10.1016/s0140-6736(17)32980-x · Cited by 3 · see citing works
Self-citation
Flagged first, then by citations
1 of the 18 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
- [21]Acharya A, Judah G, Ashrafian H, Cunningham D, Ruwende J, Darzi A. Evaluating the impact of a novel behavioural science informed animation upon breast cancer screening uptake: a randomised controlled trial. 2022. Online. Available from: https://osf.io/cm6uf/. [Accessed 01/06/2022] PMC9295097 35854267
- [24]Huf SW. The use of behavioural sciences in targeted health messages to improve the participation in cervical and breast screening programmes. 2017. Online. Available from: https://spiral.imperial.ac.uk/bitstream/10044/1/73281/1/Huf-S-2018-PhD-Thesis.pdf. [Accessed 24/04/2022]
Cited by
Sorted by citations
Improving cancer screening uptake: A behavioural and cultural insights perspective and rapid review
Palsola, M., Likki, T., Snijders, V., Corbex, M., Lasierra, L., & Curtis, B. (2026) · Glasnik javnog zdravlja · doi:10.5937/serbjph2601086p
Li, S. J., Brentnall, A. R., Cookson, J., Hudson, S., Quaife, S. L., Webb, S., O’Sullivan, E., Jenkins, J., Waller, J., Duffy, S. W., et al. (2026) · British Journal of Cancer · doi:10.1038/s41416-026-03436-8
SAIMSARA (2026) · SAIMSARA Journal · doi:10.62487/saimsarabe3a427b
- Authors
- Acharya, A., Ashrafian, H., Cunningham, D., Ruwende, J., Darzi, A., & Judah, G.
- Affiliations
- St Mary's Hospital (GB)
- Imperial College Healthcare NHS Trust (GB)
- NHS England (GB)
- Corresponding author
- Acharya, Amish
- Venue
- BMC Public Health
- Published
- 2022-07-19
- Volume
- 22
- Issue
- 1
- Pages
- 1388-1388
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC9295097
- OpenAlex
- W4286216721
- Cited by
- 4
- References
- 18
- Citations by year
- 2026: 3 · 2022: 1
- FWCI
- 0.10
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Spiral (Imperial College London) (submittedVersion, cc-by)
- Funders
- NHS England Project Award via the London Cancer Screening Board
- Topics
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Keywords
- breast cancer screening, screening uptake, behaviour change techniques, animation, video-based intervention, SMS reminders, co-design, health care disparities, underserved populations
- MeSH terms
- Behavioral Sciences, Breast Neoplasms, Female, Humans, Randomized Controlled Trials as Topic, Reminder Systems, Early Detection of Cancer, Text Messaging
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
