Feasibility of a Targeted Intensive Community-based campaign To Optimise vague Cancer (TIC-TOC) symptom awareness and help-seeking in an area of high socioeconomic deprivation

Problem

Rapid Diagnostic Centres (RDCs) are being implemented across the UK to accelerate the diagnosis of vague suspected cancer symptoms such as unexplained weight loss and persistent fatigue. While public awareness of classic alarm symptoms such as unexplained lumps and bleeding is good, awareness of vague cancer symptoms is poor and when combined with high cancer fear and fatalism, may contribute to prolonged symptom presentation in socioeconomically deprived populations. Targeted behavioural interventions are needed to augment RDCs that serve socioeconomically deprived populations who are disproportionately affected by cancer. This mixed-methods study is assessing the feasibility of delivering and evaluating a community-based symptom awareness intervention in an area of high socioeconomic deprivation in South Wales, UK.

Approach

A co-produced intervention aligned to the COM-B Model (Michie et al., 2011) is being delivered from July 2021-March 2022, targeting members of the public aged 18+. The multi-faceted intervention comprises messages designed to increase cancer symptom knowledge, modify beliefs about cancer and encourage timely symptom help-seeking. Cancer champions who are lay members of the local community have been trained to deliver intervention messages using dissemination channels including broadcast (e.g. local radio adverts), social/digital (e.g. targeted Facebook adverts) and outdoor/printed (e.g. supermarket billboards, leaflets, pharmacy bags) media.Consent rate and proportion of missing data are assessed using questionnaires administered to patients referred to RDCs in the intervention and comparator areas (target n=189). Measures include the adapted C-SIM (Neal et al., 2014) to assess self-reported patient interval. Facebook metrics, including reach and post engagement will be captured. Qualitative interviews and/or focus groups (n=40) are assessing intervention acceptability and barriers/facilitators to delivery and evaluation.

Findings

Ongoing COVID-19 restrictions required flexible adaptation of study procedures to reduce barriers to remote data collection. Four cancer champions were successfully recruited to deliver the intervention. Targeted Facebook advertisements have reached 118,400 people in the Cwm Taf area with 19,300 post engagements. Reach of and engagement with paid advertisements was higher for females and those aged 55 years +. To date, 156 RDC patients have agreed to be contacted about the study (55 intervention area, 101 comparator area) of whom 17 have completed the questionnaire. Interviews have been conducted with four patients and six cancer champion interviews have been completed. Preliminary findings will be presented.

Consequences

The TICTOC study launched against a challenging backdrop of continued COVID-19 restrictions. The results will inform optimal methods of implementing and evaluating behavioural interventions to support RDCs in highly deprived populations, during and beyond the pandemic.