The Impact of Picture Narrative Format on Print Lung Screening Communication Outcomes

The Impact of Picture Narrative Format on Knowledge and Acceptability for Lung Screening Print Decision Support Materials

The purpose of this study is to test whether a picture narrative format is more successful, than text with pictures or text alone, in communicating lung screening information (primarily defined by positive attitudes towards the design and increase in knowledge) to people likely to be invited to lung screening where available.

Study Overview

• Status: Completed
• Conditions: Cancer Screening
• Intervention / Treatment: Behavioral: Picture narrative information format; Behavioral: Text with pictures information format; Behavioral: Text-only information format

Detailed Description

Population screening is key to detecting lung cancer early at a more treatable stage. Uptake of screening should be equitable (i.e., screening benefits all eligible members of the population and does not contribute further to health disparities) and informed (i.e., participants have been involved in the decision to take part and their decision aligns with their values and circumstances). Print decision support materials are the primary mechanism for encouraging engagement with cancer screening and supporting decision making. It is essential that we identify print communication techniques that are effective in informing invitees about lung screening.

The intervention, picture narrative information about lung screening, was previously developed through codesign and prototype testing with people likely to be eligible for lung screening (50 to 75 years old, past or current heavy smokers). Participants will be randomised to one of three groups: Picture narrative format, Text with pictures (control 1) or, Text-only (control 2). This study will assess whether presenting lung screening information in a picture narrative format can improve lung cancer screening knowledge, eligibility self-assessment and attitudes. It will also assess whether perceptions of the information designs can explain any impact of the intervention on these outcomes and whether there are differences across socioeconomic groups.

• Study Type: Interventional
• Enrollment (Actual): 326
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United Kingdom
  • Glasgow, United Kingdom, G12 0XH
    • Mental Health and Wellbeing, University of Glasgow

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 49 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Living in Glasgow
• Willing and able to respond unaided to invitation to participate in the trial and give informed consent.
• Aged between 49 and 75 years

Exclusion Criteria:

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Picture narrative lung screening information; Participants in this arm receive information about lung screening purpose, eligibility, benefits and risks in a format which uses text in combination with sequences of pictures to communicate a coherent message. The designs follow conventions from comics/graphic narratives and key stakeholders were involved during the design process.	Behavioral: Picture narrative information format; Lung screening information formatted as picture narratives
Active Comparator: Text with pictures lung screening information; Participants in this arm receive information about lung screening purpose, eligibility, benefits and risks in a format that uses text with non-narrative pictures for decoration. The pictures have been extracted from the picture narratives being used Arm 1.	Behavioral: Text with pictures information format; Lung screening information formatted as text and non-narrative pictures
Active Comparator: Text-only lung screening information; Participants in this arm receive information about lung screening purpose, eligibility, benefits and risks in a format that uses text and no pictures.	Behavioral: Text-only information format; Lung screening information formatted as text with no pictures

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Participant Lung Cancer Screening Knowledge scores	Participants will be asked 6 multiple choice questions related to the lung screening information presented to the participants during the intervention, covering; Procedure, Eligibility - who, Eligibility - why, Benefits, Adverse effects, Potential results.	Immediately post-intervention
Lung Cancer Screening Eligibility self-assessment	Concordance between self-reported personal eligibility for lung cancer screening and actual eligibility based on self-reported age and smoking behaviour.	Immediately post-intervention
Participant Lung Cancer Screening Attitudes	Self-administered four-item lung cancer screening attitudes measure covering cancer fear, fatalism, benefits, and worry, previously used by Smits et al 2018.	Immediately post-intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Participant Design appraisal ratings	Self-administered nine-item measure rating perceptions of appeal, enjoyment, interest, ease of use, trustworthiness, appropriateness, helpfulness, informativity. Alongside a single item asking participants whether enough information was provided.	Immediately post-intervention

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Treatment compliance	Self-reported length of time spent reading the lung screening information.	Immediately post-intervention

Collaborators and Investigators

• Sponsor: University of Glasgow
• Investigators: Principal Investigator: Kathryn Robb, PhD, University of Glasgow

Study record dates

Study Major Dates

• Study Start (Actual): August 27, 2021
• Primary Completion (Actual): October 8, 2021
• Study Completion (Actual): October 8, 2021

Study Registration Dates

• First Submitted: August 17, 2021
• First Submitted That Met QC Criteria: August 17, 2021
• First Posted (Actual): August 23, 2021

Study Record Updates

• Last Update Posted (Actual): October 26, 2021
• Last Update Submitted That Met QC Criteria: October 18, 2021
• Last Verified: October 1, 2021

More Information

Terms related to this study

• Keywords: Health Communication; Lung cancer screening; Comprehension; Narrative; Visual; Messages; Comics
• Other Study ID Numbers: 200200021

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Anonymised individual level study data will be shared via the University of Glasgow's repository Enlighten: Research Data.
• IPD Sharing Time Frame: On publication of the study results for a period of ten years.
• IPD Sharing Access Criteria: Data will be made publicly available.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; ICF

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No