ABACus

ABACus (Awareness and beliefs about cancer) is a randomised controlled trial of the health check intervention to improve cancer symptom awareness and help-seeking among people living in socioeconomically deprived communities.

ABACus (Awareness and Beliefs about Cancer) Study results and next steps

Background to ABACus

Evidence shows that cancer survival rates are lower in disadvantaged communities, possibly due to low awareness of symptoms and delayed help-seeking. It is important that people increase their knowledge of cancer symptoms, so that it can be detected earlier and improve their treatment outcomes.

Interactive online questionnaire

We have developed an interactive online health check questionnaire to be delivered in these communities by trained advisors. In completing it, the individual is asked a total of 29 questions covering information on their background, lifestyle and health.  They are then provided with a summary page which colour codes their responses using a traffic light system (red, amber, green) to highlight areas where action and or advice should be taken.

Recruitment

A previous study has assessed the feasibility and acceptability of the online health check, which has resulted in a few minor adjustments. We are now testing the health check for effectiveness. To do this, we will recruit 246 participants over a 12 month period who speak English and are over 40 years old from South West Yorkshire and South Wales. Participants will be asked to complete a questionnaire at three time points during the study (when recruited, 2 weeks later, and then 6 months later). Questions will ask participants about their knowledge of specific (e.g. an unusual lump) and non-specific (e.g. unexplained weight loss) cancer symptoms as well as some background health information and their readiness to seek medical help and advice.

Retention strategy

After completing the questionnaires, participants will be randomly assigned to one of two groups (treatment or control). Those who are allocated to the treatment group will be asked to complete the online health check, facilitated by an advisor. All participants will receive a £10 high-street voucher at recruitment and £5 at 6 months, totalling £15, as a thank you for taking part.

Cancer symptom awareness and process evaluation

Once all participants have completed the follow-up questionnaires the responses from the two groups will be collated and compared to test if people in the treatment group had an increase of cancer symptom awareness after completing the online health check compared to the control group. In addition to this, we also want to find out about how the intervention is implemented and conducted (this is called a process evaluation). To do this a researcher will observe some of the health checks taking place and ask some participants to take part in a one-to-one interview about their experience of taking part. All responses will be collected to give an overview of experiences.

Related publications

• Smits, S. et al. 2018. Development of a behaviour change intervention to encourage timely cancer symptom presentation among people living in deprived communities using the Behaviour Change Wheel. Annals of Behavioral Medicine 52 (6), pp.474-488. (10.1007/s12160-016-9849-x)
• McCutchan, G. et al. 2016. Barriers to cancer symptom presentation among people from low socioeconomic groups: a qualitative study. BMC Public Health 16 (1) 1052. (10.1186/s12889-016-3733-2)