Background: Despite public health initiatives, colorectal cancer screening (CRCS) adherence remains suboptimal in South-Italy. This study presents the protocol for T1 and T2 of an intervention designed to enhance CRCS participation through tailored and targeted communication. The intervention builds on baseline (T0) data, which identified psychosocial subgroups within the eligible population to enable message personalization.
Methods: A sample of participants eligible for CRCS in South-Italy with irregular past participation was engaged in a three-wave survey. T0 data (N=1089, aged 50-74) were analyzed using Reduced k-means clustering on psychosocial predictors of adherence (attitude, subjective norms, perceived behavioral control, action planning, coping planning, anticipated regret, self-identity) for classifying participants into three stable sub-groups. The intervention (T1) involves a randomized controlled trial (RCT) comparing tailored messaging, targeted messaging, and usual care. In the targeted condition, participants receive a persuasive message based on their cluster. The tailored condition combines cluster membership with individual motivation-based customization. Outcomes include intention post-intervention and behavior at six-month follow-up (T2).
Findings: Preliminary cluster analyses identified three profiles: (1) average levels on most predictors but low action planning, (2) high scores across all predictors, and (3) generally low scores with attitude lowest. These findings inform the intervention structure to maximize message relevance and impact.
Discussion: This study proposes a psychosocial approach to employing targeted and tailored persuasive messages for CRCS promotion. The proposed approach could be adapted to promote other health behaviors. The innovative intervention strategy may reduce health disparities by optimizing engagement strategies in healthcare programs.