The goal of this non-randomised trial is to test how a workshop that includes religiously-tailored messages can help increase the uptake of breast, colorectal and cervical cancer screening among Muslim women in North East England and Scotland. The results of this trial will inform the development of a full-scale randomised-controlled trial. Participants in this study will be asked to take part in a two-hour workshop, deliver either online or in-person.
Low rates of cancer screening among Muslim women puts them at higher risk of death from screening since they do not detect cancer early. This study will work to increase the uptake of cancer screening among Muslim women using two-hour workshops delivered in the community. The workshops were developed with the help of 10 Muslim women in Scotland. The workshops include four parts: * A discussion on the barriers and facilitators to breast, cervical and colorectal cancer screening * A health information session given by a female health provider on cancer screening * Videos of Muslim women talking about their experiences with cancer screening * A session given by a female religious scholar to discuss Islamic perspectives on cancer screening. Another eighteen Muslim women then took part in the workshops; they gave positive feedback on the content of the workshops and how the sessions were delivered. In the feasibility trial, the workshops will be delivered to 200 Muslim women to find out whether a full-scale randomised-controlled trial can take place. This study will be carried out with the help of 10 Muslim women who will give advice on the content of the workshops and plan for implementation; they will also help with the delivery of the workshops. It is expected that this study will lead to changes in knowledge and screening uptake among participants.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
200
The intervention includes a two-hour workshop, delivered in-person, that aims to improve the uptake of cancer screening among Muslim women. The workshop consists of four parts: * A peer-led discussion on barriers and facilitators to breast, cervical and colorectal cancer screening * A health information session led by a health professional * Videos of Muslim women talking about their experiences with cancer screening * A religious perspective on cancer screening led by a female religious scholar
The intervention includes a two-hour workshop, delivered online, that aims to improve the uptake of cancer screening among Muslim women. The workshop consists of four parts: * A peer-led discussion on barriers and facilitators to breast, cervical and colorectal cancer screening * A health information session led by a health professional * Videos of Muslim women talking about their experiences with cancer screening * A religious perspective on cancer screening led by a female religious scholar
University of Glasgow
Glasgow, Scotland, United Kingdom
RECRUITINGUniversity of Sunderland
Sunderland, Tyne and Wear, United Kingdom
RECRUITINGNarrative description of feasibility
The primary outcome of the project will be a narrative description of study feasibility, including recruitment and retention, protocol adherence and stakeholder acceptability. The primary outcome will be assessed using a mixed methods approach and assessed according the progression criteria, as described below.
Time frame: 12 months
Recruitment feasibility
Determine how many women accept the invitation to participate in the study and to estimate eligibility, recruitment and refusal rates. This will be assessed using project monitoring data maintained by the research team which logs in detail all study data, including number of people, time, missing data, and cost where relevant. Eligibility rate: Calculated as the number of participants screened/number of participants eligible x100% Recruitment rate: Calculated as the number of enrolled participants/number of eligible participants x 100% We will report recruitment and retention rates with 90% confidence intervals. Recruitment and retention rates will be summarised in relation to baseline characteristics, and differences in retention rates will be assessed using logistic regression methods.
Time frame: Baseline, 5 months, 7 months, 12 months
Screening status of participants and the proportion of participants who were partially/not up to date with screening
Estimate the screening-non-responder rate. Non-responder rate: Calculated as the number of enrolled participants who were screening non-responders/number of eligible participants x 100%
Time frame: Baseline
Retention rate
Estimate loss to follow up/retention rate. This will be assessed using project monitoring data Retention rate: Calculated as the number of participants who complete the 12 months follow up/number of participants in the intervention x100% This data will be compared for non-responders and partial responders.
Time frame: 6 months, 12 months
Peer educator recruitment feasibility
Number of women who accepted the invitation to become peer educators, and the number of peer educators retained at 12 months. This will be assessed using project monitoring data. Peer-educator recruitment rate: Calculated as the number of enrolled peer-educators/number of eligible peer-educators x 100% Peer-educator retention rate: calculated as the number of peer-educators at 12 months/number of peer-educators recruited x 100%
Time frame: baseline, 12 months
Feasibility of obtaining screening data
Whether the research team was able to obtain screening records for participants in all study location, and the proportion of participants who gave consent to access their screening records
Time frame: 12 months
Questionnaire response rate
The proportion of participants responding to questionnaires at baseline, 6 months and 12 months.
Time frame: Baseline, 6 months, 12 months
Feasibility of measuring secondary outcomes
Measure key secondary outcome measures including behavioural intention proxies, and feasibility of self-reported data, missing data, estimates, variances and 95% CIs for any comparisons. Baseline and follow up data Data will be assessed in relation to each of the 3 different types of screening, as well as generally, to ensure we capture whether the intervention has a differential impact on different screening types. We will also aim to compare behavioural change and self-reported data with the actual NHS screening data. Participants' scores on outcome scales, and changes over time, will be reported using descriptive methods. Paired t-tests, or non-parametric alternatives, will be used to estimate changes over time, with 90% confidence intervals. Correlations between baseline and follow-up measures will be reported with 90% confidence intervals.
Time frame: Baseline, 6 months, 12 months
Difference on key domains between intervention modalities (online/face to face)
Comparison of measures on key domains for trial parameters will provide insight into the feasibility of the two different modes of delivery. This will be inspected using project monitoring data baseline and follow up measures. Including: eligibility rate, recruitment rate, retention rate, all measures non-responders/attenders and missing data Visual inspection of trends and descriptive data will be used to establish whether comparisons between modalities is feasible.
Time frame: Baseline, 6 months, 12 months
The acceptability of the study engagement process to peer-educators
Qualitative exploration of the acceptability of the process of recruitment, co-design phase, training, experiences and delivery of intervention. Qualitative process evaluation focus groups with peer-educators. Including: experiences of co-design phase, experiences of recruitment of peer-educators, experiences of training, experiences of delivery of the intervention, language and use of interpreters, and perspectives on the intervention and study.
Time frame: 12 months
The acceptability of the intervention and its implementation to participants and stakeholders, including intervention components and delivery mode (online/face-to-face)
Qualitative exploration of the acceptability of the intervention and its delivery with participants and key stakeholders. Qualitative process evaluation focus groups with participants and interviews with stakeholders. This explores the following: content of the intervention, delivery mode of the intervention (face-to-face/online), delivery of the intervention (peer-educators, health care provider, religious perspective, personal testimonials), and experience and perspectives of taking part in the intervention
Time frame: 12 months
The acceptability of data collection methods used to participants and stakeholders
Qualitative exploration of the acceptability of the data collection methods and secondary outcome measures with participants and key stakeholders. Qualitative process evaluation focus groups with participants and interviews with stakeholders Including: invitation to participate , recruitment processes, consent taking, baseline and follow-up secondary outcome measures, engagement in baseline and follow-up processes, and willingness to be randomised.
Time frame: 12 months
Adherence to protocol
Explore qualitatively protocol adherence and barriers and enablers to key stakeholders such as research staff and collaborators. Qualitative process evaluation interviews with research staff and collaborators.
Time frame: 12 months
Religious health fatalism questionnaire (RHFQ)
A questionnaire will be given to participants to test how religious beliefs influence health beliefs and willingness to obtain screening and medical treatments. RHFQ includes 8 statements that are answered on 5-point Likert scale: 1=strongly disagree, 2=disagree, 3=undecided, 4=agree, 5=strongly agree Higher scores indicate higher levels of religious fatalism, thus a lower willingness to attend screening due to religious beliefs
Time frame: Baseline
Modesty
The Modesty Measure for Muslim women (MMM-W) will be given to participants to examine how self-representation among Muslim women can affect their health seeking behaviours. The questionnaire will ask participants to indicate whether they 'agree', 'disagree' or 'ambivalent' to 10 statements about modest behaviour and healthcare
Time frame: Baseline
Sociodemographic descriptors
Participant characteristics, such as age, location, education level, ethnicity, professional occupation and marital status, will be recorded
Time frame: Baseline
Cancer knowledge questions adapted from Cancer Awareness Measures (CAM) by Cancer Research UK
This measure will assess changes in knowledge about the risk factors, symptoms and screening of breast, bowel and cervical cancer among participants. The questionnaire will be administered online through Qualtrics (a telephone option will also be offered). Multiple choice questions are used for this measure.
Time frame: baseline, 6 months and 12 months
Cancer screening behaviour
A cancer screening behaviour questionnaire will be given to participants. This consists of 2 parts: 1. Participants will be asked about whether they attended breast, bowel or cervical cancer screening and if they are planning to attend screening. The answers for these questions will be: 'yes', 'no' or 'I don't know'. 2. The second part includes statements that represent barrier and facilitator beliefs that might affect screening behaviour. Participants will be asked to indicate the level of agreement with each statement on 5-point liker scale: 1=strongly disagree, 2=disagree, 3=undecided, 4=agree, 5=strongly agree
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Time frame: baseline, 6 months and 12 months
Self-reported screening uptake
Change in the number of participants who obtained screening following the intervention. This outcome is self-reported by participants
Time frame: baseline, 6 months and 12 months
Actual screening uptake
Screening data from the National Health Services (NHS) will be analysed to examine the change in the number of participants who obtained screening following the intervention.
Time frame: baseline, 6 months and 12 months
Quality of life measures
Intervention participants will be asked to fill EQ-5D-5L questionnaires, which comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems.
Time frame: Baseline, 6 months, 12 months