Improving uptake of breast, bowel and cervical cancer screening among Muslim women: a non-randomised feasibility study of a peer-led, faith-based intervention

BACKGROUND Cancer screening saves lives but Muslim women are less likely to access screening than white-British women.

This is a concern as incidence rates of cancer appear to be increasing in ethnic minorities, making them less likely to benefit from earlier diagnosis of cancer.

Faith-based cancer communications, underpinned by the principles of one’s faith, provide a culturally acceptable additional strategy to addressing barriers to screening.

This study investigates the feasibility, effectiveness, and implementation of a co-designed, faith- based and peer-led intervention to improve breast, bowel, and cervical screening uptake among Muslim women in the UK. AIM The aim of this study is to improve cancer screening uptake among Muslim women.

METHODS We will conduct a non-randomised, two-arm feasibility trial with 200 Muslim women (aged 25-74-years, living in Glasgow or North-East England, not or partially up to date with screening they are eligible for), allocated to one of two arms, per site: i) face-to-face delivery, ii) online delivery.

Semi-structured interviews with key stakeholders (n=6), including Muslim scholars and community liaison, and focus groups with intervention participants (4 groups with n=6-8/group) and peer-educators involved in intervention delivery (n=10) will allow us to evaluate the acceptability of both intervention content and delivery and identify opportunities for modification in the feasibility trial and intervention.

An assessment of suitability of the trial’s parameters will inform development of a large-scale trial using pre- specified progression criteria and a traffic light system for evaluation of STOP-AMEND-GO criteria.

To gain a preliminary indication of intervention effectiveness we will capture knowledge, attitudinal change to screening, and behavioural outcomes, such as intention to use screening at baseline, 6-, and 12-months follow-up, as well as NHS screening attendance at 12 months.

HOW THE RESULTS OF THIS RESEARCH WILL BE USED Our vision is to tackle current cancer inequities by driving forward the development of a co-designed faith- based, peer-led intervention to improve engagement with breast, bowel and cervical screening among Muslim women in partnership with their communities.

Our proposal represents a rigorous feasibility and process evaluation of the first theory-driven and co-designed intervention for Muslim women using religious messages that support cancer screening for early diagnosis in this underserved group. We will seek further funding to test intervention effectiveness in a fully powered randomised controlled trial.

This will provide a prototype approach to the development of cancer control communications for religious minorities, relevant to countries with existing screening programmes worldwide.