title: A pilot telephone intervention to increase uptake of breast cancer screening in socially deprived areas in Scotland (TELBRECS): study protocol for a randomised controlled trial.
abstract: BACKGROUND
  Breast cancer accounts for almost 30% of all cancers and is the second leading cause of cancer deaths in women in Scotland. Screening is key to early detection. The Scottish Breast Screening Programme is a nationwide, free at point of delivery screening service, to which all women aged between 50 and 70 years are invited to attend every 3 years. Currently over three-quarters of invited women regularly attend screening. However, women from more deprived areas are much less likely to attend: for example in the 3 years from 2010-2012 only 63% of women in the most deprived area attended the East of Scotland Breast Screening programme versus 81% in the least deprived. Research has suggested that reminders (telephone or letter) and brief, personalised interventions addressing barriers to attendance may be helpful in increasing uptake in low-income women.
  
  
  METHODS
  We will employ a brief telephone reminder and support intervention, whose purpose is to elicit and address any mistaken beliefs women have about breast screening, with the aim that the perceived benefits of screening come to outweigh any perceived barriers for individuals. We will test whether this intervention, plus a simple anticipated regret manipulation, will lead to an increase in the uptake of breast cancer screening amongst low-income women who have failed to attend a first appointment, in a randomised controlled trial with 600 women. Participants will be randomly allocated to one of four treatment arms i.e. 1) Letter reminder (i.e. Treatment as usual: CONTROL); 2) Telephone reminder (TEL), 3) Telephone reminder plus telephone support (TEL-SUPP) and 4) Telephone reminder plus support plus AR (TEL-SUPP-AR). The primary outcome will be attendance at breast screening within 3 months of the reminder letter.
  
  
  CONCLUSIONS
  If this simple telephone support intervention (with or without AR intervention) leads to a significant increase in breast screening attendance, this would represent a rare example of a theoretically-driven, relatively simple psychological intervention that could result in earlier detection of breast cancer amongst an under-served group of lower socio-economic women.
  
  
  BACKGROUND
  Current Controlled trials: ISRCTN06039270. Registered 16th January 2014.
authors.affiliation: Psychology, School of Natural Sciences, Stirling University, Stirling FK9 4LA, UK. j.a.chambers@stir.ac.uk.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Chambers
authors.forename: Ronan E
authors.initials: RE
authors.lastname: O'Carroll
authors.forename: Alan
authors.initials: A
authors.lastname: Cook
authors.forename: Julie
authors.initials: J
authors.lastname: Cavanagh
authors.forename: Debbie
authors.initials: D
authors.lastname: Archibald
authors.forename: Rosemary
authors.initials: R
authors.lastname: Millar
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008507:Medically Underserved Area; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D017010:Reminder Systems; D012606:Scotland; D011795:Surveys and Questionnaires; D013689:Telephone
references.citation: Br J Health Psychol. 2011 Sep;16(3):592-609
references.pmid: 21199537
references.citation: Breast Cancer Res Treat. 2009 Jul;116(1):179-85
references.pmid: 18622697
references.citation: Br J Soc Psychol. 2003 Dec;42(Pt 4):495-511
references.pmid: 14715114
references.citation: BMJ. 2005 Apr 9;330(7495):843
references.pmid: 15817555
references.citation: Health Educ Q. 1988 Summer;15(2):175-83
references.pmid: 3378902
references.citation: Health Psychol. 2011 Nov;30(6):702-9
references.pmid: 21639637
references.citation: Prev Med. 2010 Apr;50(4):159-64
references.pmid: 20093138
references.citation: Am J Prev Med. 2008 Jul;35(1 Suppl):S34-55
references.pmid: 18541187
references.citation: Contemp Clin Trials. 2013 May;35(1):35-42
references.pmid: 23415629
references.citation: Ann Behav Med. 2013 Dec;46(3):358-68
references.pmid: 23670112
references.citation: BMC Public Health. 2013 Sep 16;13:849
references.pmid: 24041309
references.citation: Br J Cancer. 2012 Jul 10;107(2):255-9
references.pmid: 22735907
references.citation: Br J Soc Psychol. 2009 Jun;48(Pt 2):221-36
references.pmid: 18793492
references.citation: J Womens Health (Larchmt). 2011 Dec;20(12):1887-94
references.pmid: 22023414
references.citation: Health Psychol. 2011 Sep;30(5):661-4
references.pmid: 21644807
references.citation: Health Psychol. 2011 Mar;30(2):236-45
references.pmid: 21401258
references.citation: Implement Sci. 2011 Sep 29;6:112
references.pmid: 21958602