Uncovering the Barriers of Colorectal Cancer Screening Amongst Siblings of Colorectal Cancer Patients.
Condition: Colorectal Cancer
MeSH terms: Colorectal Neoplasms
Study type: Interventional

Summary: 
      To determine amongst siblings of colorectal cancer patients:1. The knowledge, perception and
      barriers towards screening colonoscopy. 2. The current screening colonoscopy adoption rate.
      3. If patients would engage them through active engagement by healthcare providers in a bid
      to improve their receptiveness towards and partake in colorectal cancer screening. 4. The
      method(s) that Colorectal cancer patients adopt to communicate with them. 5. If tailored
      interventions addressing logistical, psychological and cost barriers could increase the
      adoption of screening colonoscopy.
    

Detailed description: 
      Part I: Randomised control trial. Patients will be approached to participate in the study
      following recovery from their initial operation, after approximately three months, which
      often corresponds to the initial stages of adjuvant chemotherapy or active disease
      surveillance. Upon obtaining informed consent for the participant, the number of age
      appropriate siblings that are eligible for screening colonoscopy will be determined. Only
      siblings who have fulfilled the study inclusion criteria will be contacted. Siblings who
      accompany the participant for their follow-up appointment will directly be approached to
      participate in the qualitative component of the study. The Colorectal cancer patient will
      then be excluded from the Randomised control trial. However, given the findings of the
      preliminary study, most of the first degree relatives who came with the patients are the
      children and not siblings. As such the above mentioned scenario is unlikely. Participants
      will be enrolled into the randomised control trial and randomised to either "Intervention A"
      or "Intervention B". "Intervention A" depicts current practices by having the research team
      educate the participants on the Ministry of Health Singapore screening guidelines akin to
      counselling sessions carried out during the patient's clinical consultation. The research
      team would highlight that we would be happy to assist if necessary. The research team would
      then contact the patients in 4 weeks to check if they have communicated with their siblings
      and if they have gone for screening. The research team would also find out which method did
      they adopt to communicate with their siblings."Intervention B" involves a series of proactive
      engagements in hope to spur patients into contacting their siblings and improve their
      receptiveness towards colorectal cancer screening. The engagements would include (1) a sealed
      envelope containing a cancer information sheet and an invitation letter directed towards
      siblings for them to contact the research team, (2) weekly phone reminders to the
      participants for a total of 4 weeks in a bid to remind participants of the need to convey the
      screening message to their siblings. The envelope will contain information on the various
      means for the siblings to contact the research team. These include communication means such
      as electronic mails (emails), telephone, hard copy returned mails through pre-paid envelopes,
      short messaging services (SMSs) or clinic consult. A soft copy can also be given if requested
      by the patients.Once the participant has successfully contacted their siblings, the research
      team would inquire about the means of communication and the research team will proceed to
      invite the siblings to partake in the study. If the participant has yet contacted their
      siblings, the research team would inquire from participants as to why so. The research team
      will encourage the participant then to continue attempting to contact their siblings. Failing
      which at the end of 4 weeks, if the siblings remain not contactable, the participants will
      not be disturbed henceforth. Siblings who reject invitation to participate in the study will
      also not be contacted by the research team. Where possible, reasons for not being able to
      contact the siblings and rejections will be documented.

      Siblings response rate will be determined in this study. The research team deem sibling
      replies as either "active" or "passive" by the way they use to contact the research team.
      "Active" approach would be for the siblings to contact the study team via the contact
      information provided to patients. "Passive" approach would be for the siblings to give verbal
      consent to the patient for the study team to contact them directly. This process is so
      tedious due to the Personal Data Protection Act (PDPA) that has been passed that prevent
      random calling of the siblings without informed consent.
    

Intervention name(s): Proactive engagement; Current practice
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The engagements would include (1) a sealed envelope containing a cancer information sheet and an invitation letter directed towards siblings for them to contact the research team, (2) weekly phone reminders to the participants for a total of 4 weeks in a bid to remind participants of the need to convey the screening message to their siblings. The envelope will contain information on the various means for the siblings to contact the research team. These include communication means such as electronic mails (emails), telephone, hard copy returned mails through pre-paid envelopes, short messaging services (SMSs) or clinic consult.; This intervention depicts current practices by having the research team educate the participants on the Ministry of Health Singapore screening guidelines akin to counselling sessions carried out during the patient's clinical consultation. The research team would highlight that we would be happy to assist if necessary. The research team would then contact the patients in 4 weeks to check if they have communicated with their siblings and if they have gone for screening. We would also find out which method did they adopt to communicate with their siblings.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Screening
Keywords: SCREENING