EQUITA - A Feasibility Trial of a Faith-placed Intervention to Increase Screening Uptake in Black Adults

Over 2.4 million Black, Black British, Black Caribbean or African people live in the UK Black community, where lower screening rates place them at a higher risk of death due to lack of early diagnosis and provision of effective early treatment. Population health screening is largely under-researched in Black communities in the UK. Few studies have been conducted focusing on Black people and national screening programmes.

The EQUITA study builds on the IMCAN (Improving Muslim Women's CANcer Screening Uptake), and PROCAN-B ((Early diagnosis of PROstate CANcer for Black men) studies by using the same community-centred and participatory approach to apply a whole-community, multi-screening strategy to encourage uptake of breast, bowel, cervical, and AAA screening among Black communities. The intervention will retain the core elements of the participatory approach, including the Community Recruitment Leads on the research team, Public Involvement and Community Engagement (PICE) group for co-production, trained peer-facilitators, and faith-based engagement. The structured workshop format, which has demonstrated feasibility and acceptability in previous studies, will be tailored in collaboration with Black communities to ensure cultural relevance.

The study consists of six objectives with aligned work packages:

1. Can the existing intervention be adapted in partnership with a PICE group to improve engagement with breast, cervical, bowel, and AAA screening programmes in the Black community? 2. Can a two-arm cluster-randomised feasibility trial of the peer-led intervention be delivered in three sites: Leeds, North East of England and Scotland? 3. What are the perspectives of participants, peer facilitators, and key stakeholders on intervention and trial methodology, acceptability, and intervention implementation? 4. What is the feasibility trial's performance on key parameters and predefined progression criteria? 5. Is it feasible to conduct an economic evaluation to assess the cost-effectiveness of the intervention? 6. What are effective data dissemination strategies, and can the next phase be prepared by designing a study protocol for a definitive trial and logic model for implementation?

This feasibility trial will involve delivering a 2-hour workshop to 300 Black people (females aged 25-74 and males 50-74) in churches in Scotland, North East of England, and Leeds, who are either not or partially up to date with the screening they are eligible for. Participants will be randomly allocated to either the intervention or control group at each site. A process evaluation, including focus groups and stakeholder interviews, will guide modifications to the trial and intervention.

• Attitude [Time frame: Baseline (prior to intervention), Within 2 week post-intervention, 3 months post-intervention, 6 months post-intervention]
• Religious Health Fatalism Questionnaire (RHFQ) [Time frame: Baseline (prior to intervention)]
• Modesty [Time frame: Baseline (prior to intervention)]
• Socio-demographic Descriptions [Time frame: Baseline (prior to intervention)]
• Cancer knowledge questions adapted from Cancer Awareness Measures (CAM) by Cancer Research UK [Time frame: Baseline (prior to intervention), Within 2 week post-intervention, 3 months post-intervention, 6 months post-intervention]
• AAA Knowledge Screening [Time frame: Baseline (prior to intervention), Within 2 week post-intervention, 3 months post-intervention, 6 months post-intervention]
• Self-reported screening uptake [Time frame: Baseline (prior to intervention), Within 2 week post-intervention, 3 months post-intervention]
• Actual screening uptake [Time frame: 6 months post- intervention]
• Quality of life measure [Time frame: Baseline (prior to intervention)]
• Multimorbidity measure [Time frame: Baseline (prior to intervention)]