None listed
Conditions
Brief summary
Maori, Pacific and Asian participants in bowel screening who do not submit a test kit within one month of being invited currently enter an active follow-up (AF) process whereby attempts are made to contact them by telephone, ensure that they received the invitation, and offer assistance with completing the screening test. This is a rather costly service and we are uncertain whether this cost can be justified by its impact on participation rates. The proposed trial will test this by randomly allocating eligible individuals to the usual active follow-up protocol or to the same active follow-up but delayed by eight weeks. The trial is designed to test whether AF has a significant impact on participation among the recipients of this service by comparing participation rates between the two groups at 8 weeks from the point that they are allocated to their groups. By eight weeks from initiating AF, approximately 90% of participants who will eventually submit a test kit have already done so. Thus the primary endpoint is the difference in participation between intervention and control groups at eight weeks from the time of allocation. Secondary endpoints will examine whether there are ethnic specific differences in this measure and whether there are differences in this outcome between the service provided directly by the Bowel Screening Coordination Centre and that subcontracted to external providers. There will be approximately 7000 subjects in the trial (3500 in each group).
Interventions
The intervention consists of a delay of 8 weeks in commencing the standard Active Follow (AF) pathway invitees to bowel screening who have not returned a test kit within 4 weeks of being sent an invitation letter. The standard AF service consists of the following. Eligible individuals are identified and extracted from the Bowel Screening Pilot register. This data is inserted into an Access (Registered Trademark) database. The database is available to the team of Community coordinators who ca
The intervention consists of a delay of 8 weeks in commencing the standard Active Follow (AF) pathway invitees to bowel screening who have not returned a test kit within 4 weeks of being sent an invitation letter. The standard AF service consists of the following. Eligible individuals are identified and extracted from the Bowel Screening Pilot register. This data is inserted into an Access (Registered Trademark) database. The database is available to the team of Community coordinators who carry out the AF activities. They use the database to filter the population according to the ethnicity that they serve. The Coordination Centre employs 0.4 FTE of Maori Community Coordinators, 0.4 FTE of Samoan/Other Pacific Coordinators and 0.9 FTE of Asian Coordinators. They phone the individuals and record the outcome of the calls. Key Performance Indicators set by the MOH require a minimum of 3 phone calls to be made within a 4 week period, one of which must be made after regular working hours. If a number appears to be invalid other data sources are searched for current contact details. These include the hospital systems, the Primary Health Organisation age/sex registers, the patient’s GP practice, and contacts the Community Coordinators have with their own communities. In the intervention group this active follow-up activity commences 12 weeks after being sent an invitation letter for bowel screening rather than 4 weeks after as in the control group.
Sponsors
Debbie Holdsworth
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Diagnosis
Masking
Blinded (masking used) (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
50 Years to 74 Years
Healthy volunteers
No
Inclusion criteria
All subjects will be recruited from the universe of population eligible for participation in the Waitemata Bowel Screening Pilot. This is (currently) men and women aged 50-74 who are eligible for publicly funded healthcare resident in the geographical area covered by Waitemata District Health Board. If the invitee has not returned a test kit within 4 weeks of the date of invitation, then s/he is sent a reminder letter. In addition, if that individual is recorded to have a Maori, Pacific or Asian ethnicity, then they are entered in the AF pathway. These are the individuals who are eligible to take part in the study.
Exclusion criteria
None other than those which make the invitees ineligible for the active follow-up pathway. Viz. returning a kit within 4 weeks of being sent and invitation or non-Maori, non-Pacific and non-Asian (prioritised) ethnicity.
Outcome results
None listed