Social Media for Colorectal Cancer Screening

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 Cancer Care Ontario 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 four study arms - users assigned to each arm will receive one of the social media messages. 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.

This arm will receive one of three social media messages that is preferred by our target population through focus groups that are being conducted as part of a previous study.

This arm will receive the second social media message that is preferred by our target population as identified from our previous focus group study.

This arm will receive the third social media message that is preferred by our target population as identified from our previous focus group study.

This arm will receive social media messages that will be tailored by one of the following variables: gender (men/women), age (younger/older), location (urban/rural), or social economic status (level of education). Testing to be conducted in a previous study will identify the variable that messages are tailored by.

The proportion of individuals in each arm that click on the ad and confirm their intention to get screened for CRC

The average cost per link click calculated as the total amount spent on the ad campaign divided by total number of link clicks

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.