Breast screening is a service offered by the NHS to help detect breast cancer and
precancerous changes early at a time when treatment is more likely to be curative. An
effective service must reach the 'at risk' but asymptomatic population. Breast screening
uptake in London, consistently falls below the national target and is well below the national
average. Uptake in West London is particularly low, with boroughs in Inner North West London
having the some of lowest uptake rates in the country.
Routine text message reminders have proven effective at improving uptake of breast screening
appointments. However little attention is paid to the content of the messages. Previous
studies of text message reminders in other clinical areas have shown that the content of
these messages matters and some text messages are more effective than others.
This protocol describes the design of a randomized controlled trial to investigate the effect
of differently worded text messages on the engagement with breast screening in West London.
Two intervention arms were designed taking into consideration results of a 1000 woman survey
to highlight the behavioural barriers that most predict attendance. The survey tested 15
behavioural constructs and the two that most strongly predicted history of attendance were
used to inform the text message content of the intervention arms for this trial.
To this end, this randomised controlled trial (RCT) will test the current standard practice
text message reminder against two intervention text message trial arms informed by the above
The setting is West of London Breast Screening Service and women aged 47-73 who are due for
screening will be randomized to receive one of the three trial arms.
The primary outcome is the difference in uptake between trial arms. Further statistical
analysis will analyse the difference in uptake by age group, deprivation score and previous
Result will inform how small changes to the word content may have significant effects on
attendance at screening mammogram appointments.