Dr Robert Kerrison is a research fellow at the Department of Behavioural Science and Health, University College London (UCL). He specializes in the development and evaluation of behavioural interventions for cancer screening. His research has led to the implementation of text message reminders for breast and cervical screening within London, as well as the implementation of self-referral reminders and locally tailored leaflets. More recently, he has focussed on understanding and addressing reasons for non-attendance in bowel cancer screening, with a special focus on more socioeconomically deprived and ethnically diverse populations. His current research seeks to test the impact of locally-tailored interventions in Hull.
Questions & Answers
The interventions are easily adapted to different audiences and populations. The primary change required is to the locations mentioned throughout (e.g. 'St. Mark's Hospital' should be changed to the name of the relevant local Hospital, and so on). Adapting these aspects of the program materials is unlikely to have any affect on the program's effectiveness. The program was intended for flexible sigmoidoscopy screening invitees in England (e.g. aged 55-59). It can be adapted for the same test offered elsewhere, irrespective of the age (although it should be adapted to reflect the correct age range targeted by the screening provider.
The facilitators to implementation are resources. For example, it is not possible to implement the program if the provider does not have sufficient endoscopy capacity to meet demand. Another facilitator would be the flexibility of the provider to incorporate the self-referrals. This may be more difficult in contexts where pre-scheduled appointments are already offered, and a flexibility is required to 'slot in' self-referral around this.
I do not have specific evaluation tools that would be appropriate for practitioners when they evaluate this prorgram. It is relatively simple to implement and highly malleable. The provider simply needs to be able to identify individuals who are not up to date with flexible sigmoidoscopy screening and whether these individuals are suitable to have the test (ideally - e.g. not already receiving cancer treatment). The number of individuals sent the reminder can be decided by the provider, to ensure it does not exceed capacity (i.e. a situation where the provider is unable to facilitate all of the flexible sigmoidoscopy appointments within a reasonable time frame due to limited endoscopy capacity).
I am further exploring the potential for this intervention. At present, I am involved in two Randomized Controlled Trials (RCTs), one exploring the impact of adding a primary care endorsement to the self-referral reminder letter and another comparing the effectiveness of the self-referral reminder against patient navigation.