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| Name | Class |
|---|---|
| Canadian Institutes of Health Research (CIHR) | OTHER_GOV |
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Using social media for health promotion is an innovative and emerging approach but remains relatively unexplored in cancer screening. Uptake of colorectal cancer (CRC) screening remains low and standard methods of reaching out are expensive with limited impact. The objective of this study is to conduct a cluster randomized controlled trial (RCT) to test the effectiveness of social media messages for CRC screening on screening intention (primary outcome). The results of this trial will be of interest to Ontario Health and are likely to be taken up by other screening programs looking for innovative and novel ways to increase screening participation. The study results will be easily translatable identifying the most compelling CRC screening messages while the approach can easily be translated to other cancer disease sites with screening programs.
The investigators will conduct a cluster randomized controlled trial (RCT) in Facebook users (aged 50+) in Ontario. Randomization will be done at the level of the forward sortation area (FSA) - the first three characters of the postal code. All FSAs in Ontario will be randomized to one of six study arms - users assigned to each arm will receive one of the social media messages or no message (control). If users click on the message, a webpage with further information on screening will appear and participants will be asked to indicate intention to get screened for CRC. The primary outcome will be intention to screen and secondary outcomes will include other engagement metrics such as reach, cost-per-click, click-through rates, number of likes, number of impressions, and post comments.
This study will inform the feasibility of using social media for CRC screening and identify the most compelling CRC screening messages for the screen-eligible population.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Message #1 | Active Comparator | This arm will receive one of five social media messages that is preferred by our target population through focus groups that are being conducted as part of a previous study. |
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| Message #2 | Active Comparator | This arm will receive the second social media message that is preferred by our target population as identified from our previous focus group study. |
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| Message #3 | Active Comparator | This arm will receive the third social media message that is preferred by our target population as identified from our previous focus group study. |
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| Arm #4 | Active Comparator | This arm will receive the fourth social media message that is preferred by our target population as identified from our previous focus group study. |
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| Tailored Arm | Active Comparator | This arm will receive social media messages that will be tailored by sex. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Social media message #1 | Other | Social media message promoting colorectal cancer screening |
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| Measure | Description | Time Frame |
|---|---|---|
| Screening intention | The proportion of individuals in each arm that click on the ad and confirm their intention to get screened for CRC | From date of randomization to end of data collection (1 month) |
| Measure | Description | Time Frame |
|---|---|---|
| Cost-per-click | The average cost per link click calculated as the total amount spent on the ad campaign divided by total number of link clicks | From date of randomization to end of data collection (1 month) |
| Click-through-rate |
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Inclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Nancy N. Baxter, MD, FRCSC, FACS, PhD | Unity Health Toronto | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Unity Health Toronto | Toronto | Ontario | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42133942 | Derived | Ruco A, Baker N, Howse M, Sorvari A, Jacobson J, Llovet D, Tinmouth J, Moineddin R, Baxter NN. Using Facebook to Improve Participation in Colorectal Cancer Screening: Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc. 2026 May 14;15:e86829. doi: 10.2196/86829. |
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Individual participant data will not be available to share because the study results will not be at the individual-level and therefore this is not applicable.
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| ID | Term |
|---|---|
| D015179 | Colorectal Neoplasms |
| ID | Term |
|---|---|
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
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Pragmatic cluster randomized controlled trial
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| Control Arm | No Intervention | This arm will not receive any intervention. |
| Social media message #2 |
| Other |
A different social media message promoting colorectal cancer screening |
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| Social media message #3 | Other | A different social media message promoting colorectal cancer screening |
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| Social Media Message #4 | Other | A different social media message promoting colorectal cancer screening. |
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| Tailored Social Media Message | Other | Tailored social media messages promoting colorectal cancer screening. |
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Percentage of times that individuals saw the ads and performed a click
| From date of randomization to the end of data collection (1 month) |
| Number of likes | Total number of Facebook likes for each ad | At the end of the study period at 1 month |
| Number of impressions | Number of times that each ad was on screen | At the end of the study period at 1 month |
| Post comments | Number of comments on each ad | At the end of the study period at 1 month |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |