Eligible participants in the National Bowel Cancer Screening Program currently receive three letters: (1) advanced notification that they will soon receive a NBCSP invitation (4-6 weeks prior to the invitation) (2) the invitation letter with a test kit and (3) a reminder letter eight weeks later if they have not returned the kit.

BCSA partner, the Queensland Cancer Council, is leading research in codesigning National Bowel Cancer Screening Program invitation materials with the aim of increasing the number of participants returning the kit.  

The researchers with expertise in behaviour change, led by Associate Professor Belinda Goodwin, are working with consumers to co-design enhancements to these letters. The team have interviewed and surveyed over 750 Australians between the ages of 48-74 years old to gather insights and opinions on the current letters and as well as suggestions for the redesigned versions.


Based on interview findings, BCSA investigator workshops, our knowledge of behaviour change techniques and discussion with the NBCSP, we have created enhanced versions of the pre-invitation and invitation letters for further testing with consumers.

Pre-invitation letter

We have presented three versions of the pre-invitation letter via an online survey to over 700 Australians aged 48-74 years old to assess whether they were effective in increasing intentions to return their next NBCSP kit. Our findings showed that making minor changes to the content of the pre-invitation letter is unlikely to result in significant increases in intention to participate.

Invitation letter

The re-design of the invitation letter has been workshopped in consultation with the NBCSP and the new prototype letter is currently being designed by the NBCSP. This new letter will include aesthetic improvements, clear images and text demonstrating what the test includes and how to use it, and user-accepted messaging around risk and benefits of screening.

Next, we will ask 1,000 Australian adults between the ages of 45 -74 to rate and provide feedback on the current and new versions of the invitation letter via an online survey. 

Through community co-design and the application of behaviour change theory, it is hoped to reduce barriers and increase bowel cancer screening participation in Australia.


Find publications related to this research here 


Investigators on this research include:

Belinda Goodwin (1,4,5)
Mark Jenkins (1,3)
Jennifer McIntosh (1,2,3)
Carlene Wilson (3)
Laura Anderson (4,6)
Sabine Fletcher (4)
Katelyn Collins (4,5)
Nicole Perry (4)

Affiliated organisations

  1. Centre for Cancer Research, University of Melbourne, Melbourne, Australia
  2. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
  3. Cancer Council Queensland, Fortitude Valley, Queensland, Australia
  4. Centre for Health Research, University of Southern Queensland, Springfield, Australia
  5. University of Queensland, St Lucia, Queensland
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