Development and feasibility of an evidence-based and theory-driven tailored mHealth communication intervention to increase colonoscopy screening rate in first-degree relatives of people with colorectal cancer.

Abstract

To develop and investigate the feasibility of an evidence-based and theory-driven tailored communication to increase colonoscopy screening rates amongst first-degree relatives of colorectal cancer patients. Based on the tailoring process and identified evidence from the systematic review conducted by the research team, the tailored communication was developed from four aspects: (1) tailoring variables (e.g., demographic, behavioural, and psychosocial characteristics), (2) decision rules, (3) tailored messages and (4) delivery plan. Expert (n=5) and layman review (n=5) were conducted to ensure the content validity of decision rules and tailored messages. A single-blinded, family-based cluster randomised controlled trial (n=21) tested the feasibility and acceptability of the intervention. A three-session mobile-based tailored intervention with clear decision rules and 27 tailored messages were developed. In the feasibility study, the recruitment rate was 34.4%. The response rate at 1-month post-intervention was 61.9%. After a voice call was added for nonresponders, the response rate at the 3-month post-intervention increased to 81%. All participants were satisfied with the intervention and agreed that the intervention helped them understand the risks and appropriate screening recommendations. The development of a three-session mobile-based tailored intervention with an integrated tailoring decision and message system was reported in this study. Given its remote nature, the mobile-based tailored intervention may encounter challenges in family recruitment and online assessment. Suggestions on (1) study design to avoid contamination, (2) recruitment approaches and (3) strategies to promote response to online questionnaires were made for a future definitive trial.