TIC-TOC

• Research type

  Research Study

• Full title

  TIC-TOC (Targeted Intensive Community-based campaign To Optimise Cancer awareness): feasibility of a symptom awareness campaign to support the Multidisciplinary/Rapid Diagnostic Centre referral pathway in a socioeconomically deprived area

• IRAS ID

  297568

• Contact name

  Katherine Brain

• Contact email

  brainke@cardiff.ac.uk

• Sponsor organisation

  Cardiff University

• ISRCTN Number

  ISRCTN14801566

• Duration of Study in the UK

  2 years, 6 months, 31 days

• Research summary

  Research Summary:
  We have developed a public awareness campaign designed to help people living in deprived communities recognise vague cancer symptoms (e.g. persistent tiredness) and get advice from their GP. The six-month campaign will spread positive messages on local media including buses, radio and Facebook, and with trained cancer champions who will encourage people living in deprived communities to go to the GP with vague symptoms. We will test whether the campaign can be delivered, whether the public thought the campaign was acceptable, and whether the campaign reached people in the local community.
  We also need to find out whether we can collect the data needed for a future trial to test if the campaign works. This will include: how many patients agree to complete a questionnaire to measure how long they took from spotting a symptom to visiting the GP; whether we can access hospital data such as the number of patients referred for suspected cancer, and whether we can estimate the costs of the awareness campaign. Finally, we will bring together a group of experts to help us decide whether we should do a larger trial to test whether the campaign can encourage people to seek help sooner with vague symptoms. The findings will be used to improve cancer services in Wales and the UK.

  Lay summary of study results:
  Background Rapid Diagnostic Centres (RDCs) are being implemented across the UK to accelerate diagnosis of patients presenting with non-specific but suspected cancer symptoms. We assessed the feasibility of delivering and evaluating a targeted community-based symptom awareness intervention.
  Methods
  Mixed-methods study to assess feasibility of delivering and evaluating a multi-faceted intervention delivered during COVID-19 (July 2021-March 2022), in an area of high socioeconomic deprivation in Wales, UK. Intervention messages aligned to the Behaviour Change Wheel were delivered by trained cancer champions and through broadcast, printed, outdoor and social media channels. Questionnaires with RDC patients and Facebook metrics assessed reach. Qualitative interviews with RDC patients, cancer champions, study managers and healthcare staff, and focus groups with local residents, assessed reach, acceptability and feasibility. Feasibility was assessed using a traffic light system, based on pre-set parameters indicating green (deliverable with no amendments), amber (consider amendments with stakeholder involvement) and red (not deliverable without major amendments). Feasibility of obtaining linked data and cost data for a health economic evaluation was assessed. Key findings were reviewed during a stakeholder workshop.
  Results
  Of 559 RDC patients screened for eligibility, 9% (n=52) completed the questionnaire (red) with <20% missing data (green). Most (72%) intervention participants were from the two most deprived quintiles (green). Facebook advertisements reached 237,023 people and received 8,164 post engagements. Most intervention components were delivered (7/13), however COVID-19 limited community advertising and in-person events, and was considered by stakeholders to impact questionnaire recruitment. Five cancer champions were recruited. Qualitative findings highlighted that the cancer champion role was acceptable to the public and stakeholders. The importance of confidence, teamwork, defined roles and pre-existing community links for the cancer champions. It was feasible to collect health economics and linked data relevant for a future trial. Stakeholders considered the role of cancer champions important in supporting early diagnosis in deprived communities.
  Conclusions
  The intervention was broadly feasible to deliver and evaluate, with findings offering insights into optimal methods of implementing and evaluating behavioural interventions to support RDCs in deprived populations. Further evaluation would require refinements to data collection methods and the cancer champion role

• REC name

  London - West London & GTAC Research Ethics Committee

• REC reference

  21/LO/0402

• Date of REC Opinion

  30 Jun 2021

• REC opinion

  Further Information Favourable Opinion