Feasibility and acceptability of a mHealth intervention to increase colonoscopy uptake among Chinese first-degree relatives: A pilot cluster randomized controlled trial

Abstract

Background: Colonoscopy is recommended as preferred test for first-degree relatives (FDRs) of colorectal cancer (CRC) patients. However, colonoscopy screening rate remains low. A systematic review and meta-analysis conducted by the research team show that tailored communication is an effective approach to increase uptake of colonoscopy. However, the decision rules that guide the tailored process remain unclear. Based on the identified evidences, a mHealth intervention with an integrated tailoring decision system was developed. This study aimed to test the feasibility and acceptability of this mHealth intervention in Chinese FDRs. Methods: A single-blinded, family-based cluster randomized controlled trial was conducted. 20 families with CRC patients were randomized to intervention (10 families, n = 11) or control group (10 families, n = 10). Intervention consists of 3 sessions that provided tailored cancer and screening messages on response of personal assessment. All participants received an e-brochure on CRC and CRC screening. Feasibility was measured by recruitment and completion rate, whereas acceptability was assessed by a self-developed questionnaire. Results: 34.5% of eligible family members agreed to participate. 70% of participants completed the trial and all of them completed 3 sessions. All the participants satisfied with the intervention, and agreed the intervention help them understand their risks and appropriate screening recommendations. The main reason for low recruitment rate is that cancer cases were contacted through phone to identify FDRs. Even this is a common strategy when conducting family trials, it is difficult to obtain the trust of FDRs by phone due to the adverse influence of phone scam. Conclusions: It is acceptable to provide mHealth intervention to Chinese FDRs. However, family recruitment utilizing cancer registry-identified cases seems less feasible in Chinese population. Recruitment through direct contact with FDRs is recommended, for example, through current screening program or clinical units. Furthermore, a definitive trial to test the effectiveness of developed intervention is warranted. Legal entity responsible for the study: Bai Yang. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.