Overview

SMARTERscreen is three-arm cluster randomised controlled trial of patient SMS messaging in general practice to increase participation in the Australian National Bowel Cancer Screening Program 

SMARTERscreen is building on the success of its predecessor, SMARTscreen, which was a two-arm cluster randomised controlled trial. The aim of the latter was to test the effectiveness of sending an SMS with motivational and instructional videos from general practices to encourage participation in the National Bowel Cancer Screening Program (NBCSP). 

Progress

Both SMARTscreen and SMARTERscreen target younger individuals in the NBCSP, specifically those aged 50-60 years, as they have the lowest participation rates and are more likely to use smartphones regularly.

In SMARTscreen, the intervention group (those who received an SMS plus videos) showed a 16% higher uptake of the NBCSP kit compared to the control group where general practitioners conducted screening according to the guidelines of ‘usual care’ (39% vs. 23%). 

SMARTERscreen is a three-arm trial, where the SMS intervention with motivational and instructional videos has been modified based on consumer testing by Associate Professor Belinda Goodwin’s Cancer Council Queensland team. The three-arm trial will compare (1) the modified SMS intervention with (2) a SMS-only approach and (3) a control group (‘usual care’ by general practitioners). 

 The six-month trial was conducted in 59 general practices, 29 in Queensland and 30 in Victoria. The intervention period ran from May to December 2024, and the follow-up period ended in March 2025. This achievement was made possible by the efforts of Tamara Jolley, Anna Wood, Sabine Fletcher, Sandra Sursock and Lyn Buchanan. 

To facilitate the intervention delivery, the team has been collaborating with health technology company, Healthily, to send the SMS-only, and the SMS with the weblink to the motivational/instructional material, through their GoShare platform. Healthily also adaptedtheir scheduling system to send messages on weekends when people were more likely to read them. 

To enhance data accuracy and obtain more detailed insights on intervention response based on factors like sex, age, and location, SMARTERscreen have worked closely with the National Cancer Screening Register to collect deidentified data directly from them. 

The SMARTERscreen team are currently finalising the data analysis and working on a process evaluation. This will include the quantitative results from the NCSR and Healthily data, as well as qualitative results based on interviews of participants and general practice staff who were involved in the trial.

The SMARTERscreen protocol paper and the results paper from SMARTscreen are now available. An animation regarding the SMARTscreen results has been been created https://www.youtube.com/watch?v=3erzLk7q8YA

Funding

This research is funded by a National Health and Medical Research Council (NHMRC) Targeted Call For Participation in Cancer Screening Programs grant (ID 2014703).

Publications

Find publications related to this research here 

Investigators

Jennifer G McIntosh^1,2,3, Jon D Emery^1,2, Anna Wood^1,2, Patty Chondros², Belinda C Goodwin^3,5, Judy Trevena ², Carlene Wilson³, Shanton Chang⁶, Jane Hocking³, Tina Campbell⁷, Finlay Macrae⁸, Kristi Milley ^1,2,9, Jie-Bin Lew¹⁰, Claire Nightingale³, Ian Dixon¹¹, Makala Castelli¹¹, Nicholas Lee¹¹, Lyle Innes⁷, Tamara Jolley⁴, Sally Doncovio¹², Kate Broun¹³, Glenn Austin¹⁴, Joyce Jiang¹⁵, Mark A Jenkins³   

Affiliated organisations 

1. Centre for Cancer Research, University of Melbourne, Australia
2. Department of General Practice and Primary Care, University of Melbourne, Australia
3. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Australia
4. Cancer Council Queensland, Fortitude Valley, Brisbane, Australia
5. Centre for Health Research, University of Southern Queensland, Springfield, Australia
6. School of Computing and Information Systems, The University of Melbourne, Australia
7. Healthily Pty Ltd, Melbourne, Australia
8. Colorectal Medicine and Genetics, The Royal Melbourne Hospital and University of Melbourne Dept of Medicine, Melbourne, Australia
9. Primary Care Collaborative Cancer Clinical Trials Group (PC4), Australia
10. The Daffodil Centre, a joint venture between Cancer Council NSW and the University of Sydney, Sydney, Australia
11. Consumer representative
12. Victorian Department of Health, Melbourne, Australia
13. Cancer Council Victoria, Melbourne, Australia
14. Queensland Health, Brisbane, Australia.
15. Multicultural Centre for Women’s Health, Melbourne, Australia.