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Shared decision making with breast cancer patients – does it work?
214 A Coproduction approach to recruiting GPs and participants to the decode cluster randomised controlled trial
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  1. Niamh M Redmond1,2,
  2. Aurore Lamouroux3,4,
  3. Maria-Claudia Addamiano1,
  4. Zineb Doukhi5,
  5. Françoise Couranjou6,
  6. Myriam Kaou7,
  7. Julien Mancini8,
  8. Michel Rotily3,6,
  9. Helene Delattre Massy9,
  10. Raoudha Grami7,
  11. Amalia Martinez1,
  12. Anne-Marie Schott7,
  13. Adèle Frachon10,
  14. Julie Haesebaert7,
  15. Julia Bardes9,
  16. Aurélie Bourmaud5,
  17. Marie Bichara11,
  18. Clémence Casanova8,
  19. Géraldine Cazorla8,
  20. Alix Boirot8,
  21. Patricia Marino12,
  22. Cyrille Delpierre1,
  23. Marie-Anne Durand1,13,14
  1. 1Cerpop, Inserm, University of Toulouse III Paul Sabatier, Toulouse, France
  2. 2ARC West/Bristol Medical School, University of Bristol, UK
  3. 3Assistance Publique – Hôpitaux de Marseille, Marseille, France
  4. 4Vaucluse Departmental Health Education Committee (CoDES 84), Avignon, France
  5. 5Clinical Epidemiology Unit, INSERM CIC 1426, Hôpital Robert Debré, University of Paris, France
  6. 6Aix-Marseille University, Centre de recherche sur les services de santé et la qualité de vie, Marseille, France
  7. 7INSERM, UMR 1290 RESHAPE University Lyon 1, Lyon, France
  8. 8Aix Marseille Univ, INSERM, IRD, ISSPAM, SESSTIM (Economic and Social Sciences of Health and Medical Information Processing), Marseille, France
  9. 9Centre Régional de Coordination du Dépistage des Cancers d’Ile de France (CRCDC-IDF), Paris, France
  10. 10Department of General Medicine, Université Paris Cité, Paris, France
  11. 11Centre Régional de Coordination du Dépistage des Cancers Occitanie (CRCDC-Oc), Toulouse, France
  12. 12Institut Paoli Calmettes, SESSTIM UMR1252, Marseille, France
  13. 13The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH, USA
  14. 14Unisanté, University Centre for General Medicine and Public Health, CH-1011 Lausanne, Switzerland

Abstract

Introduction Colorectal cancer screening programmes improve survival. However, limited health literacy and lower socio-economic position are known barriers to participation. The DECODE trial aimed to assess the impact of a coproduced, mixed intervention combining general practitioners (GPs) training and tailored information for participants in socially disadvantaged areas. Here we present how we engaged GPs, citizens and other stakeholders to achieve our recruitment target.

Methods DECODE is a multicentre, two-arm cluster-randomised controlled trial using a community- based participatory research approach. This involved GPs, the Regional Cancer Screening Coordination Centres, patients, citizens from the communities involved and researchers as equal contributors to all aspects of the research. The coproduced, mixed intervention combined training for GPs and a leaflet and video for participants. The primary outcome was uptake of CRC screening. We aimed to enrol 1024 participants through GPs in 4 French regions, using the European Deprivation Index (EDI) to select highly deprived areas (EDI 4 or 5). We encouraged recruitment using a variety of strategies coproduced with our stakeholders to engage GPs and participants.

Results 52 GPs were recruited using a participatory sampling approach, and randomised (intervention group: 34 and control group: 18). Between October 2021 and April 2023, 1143 eligible patients were invited with 1025 recruited, meeting out recruitment target. The most effective recruitment strategies included regular communications and monthly neswletters coproduced with our stakeholders, recruitment competitions between regions and routine recruitment monitoring.

Discussion A community-based participatory approach contributed to the successful recruitment outcome. Follow-up, using a variety of strategies and engagement with our stakeholders enabled our recruitment strategies to be adapted during the recruitment period. The full results of the trial are due by December 2024.

Conclusion A community-based participatory approach and the simultaneous adaptation of recruitment strategies helped achieve our recruitment targets in a randomised trial in socially disadvantaged areas.

https://doi.org/10.1136/bmjebm-2024-SDC.213

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