(Funded by Chief Scientist Office)

Colorectal cancer (CRC) survival has improved, but in Scotland, survivors still have notable excess mortality within the first year post diagnosis compared to other European countries. In addition, survivors have high rates of co-morbidities. This study aims to assess the feasibility of delivering an intervention programme (TreatWELL) for CRC patients undergoing potentially curative treatments. The programme will facilitate stepped changes towards smoking cessation, increase in activity to 150 minutes and caloric intake appropriate to weight status. Feasibility outcomes include recruitment rates, ease of programme implementation, adherence, patient acceptability of the programme factors influencing adherence, retention and delivery costs.

ISM Staff: Martine Stead, Douglas Eadie and Jennifer McKell

Reducing Lifestyle Associated Cancer Risk in People Attending Family History Clinics
(Funded by Dundee Cancer Centre)

This collaborative, multi-disciplinary, project aims to assess modifiable health behaviours associated with increased risk of breast/colorectal cancer and to identify promising approaches to the design and uptake of interventions amongst attendees of family history clinics. It is aimed at  informing a full research proposal to assess the impact of an innovative intervention trial on reducing lifestyle associated cancer risk in people referred to NHS family history clinics.

ISM Staff: Martine Stead and Douglas Eadie

Cancer Diagnosis as an Opportunity for Increasing Uptake of Smoking Cessation Services among Families: An Exploratory Study of Patients’, Family members’ and Health Professionals’ Views
(Funded by the Chief Scientist Office)

Smoking after a diagnosis of cancer is associated with significantly worse morbidity and mortality, therefore uptake of effective smoking cessation services is particularly important for people with cancer. Evidence suggests that cancer diagnosis can be a powerful catalyst to behaviour change. However, the influence of family members and health professionals at this highly emotive time is likely to be important, and there is considerable evidence to suggest that opportunities to discuss smoking cessation with patients and families are currently under-used. This qualitative study explores the experiences and views of patients, family members and healthcare professionals in relation to smoking and smoking cessation around the time of a cancer diagnosis, in order to identify whether and how recently diagnosed cancer patients and their close family members can effectively and appropriately be encouraged to engage with smoking cessation services. Findings will be used to identify a number of potential approaches to improve uptake of existing smoking cessation services in the context of a cancer diagnosis, and consensus will be established through a nominal group technique, using an expert group comprised of health care professionals and patient advisors. For further information contact Mary Wells.

ISM Staff: Linda Bauld

Research Team: Mary Wells, Brian Williams, Gozde Ozakinci, Alastair Munro, Vikki Entwistle, Sally Haw, Andrew Radley, Fiona Harris

BeWEL - Development and Evaluation of a Lifestyle Intervention
(Commissioned by the Medical Research Council)

The BeWEL study, led by Professor Annie Anderson at the University of Dundee, aims to develop and evaluate the impact of a lifestyle (diet, physical activity and behaviour change) intervention programme ("BeWEL”) on body weight change and waist circumference in healthy individuals attending routine NHS clinics who have had pre-cancerous bowel polyps removed. A 3 year, two-arm, multicentre, randomised controlled trial is being conducted to compare the BeWEL programme against usual care for men and women aged 50 to 74. The study's primary outcome measures are changes in body weight and waist circumference. Secondary outcomes will include cardiovascular risk factors, psycho-social measures and intervention costs.

ISM is one of the collaborating partners in the study. Our role is twofold: to conduct qualitative exploratory research with individuals representative of the target group, to help inform the development of the intervention, and to conduct a process evaluation to explore feasibility and acceptability of the interventions' implementation.

Other partners in BeWEL are: University of Dundee, University of Aberdeen, University of Strathclyde, and University College London.

ISM Staff: Martine Stead and Jennifer McKell

Anderson AS, Caswell S, Macleod M, Craigie AM, Stead M, Steele RJC and the BeWEL Team (2015). Awareness of lifestyle and colorectal cancer risk: Findings from the BeWEL study. BioMed Research International, 2015.

Stead M, Craigie AM, Macleod M, McKell J, Caswell S, Steele RJ and Anderson AS (2015). Why are some people more successful at lifestyle change than others? Factors associated with successful weight loss in the BeWEL randomised controlled trial of adults at risk of colorectal cancer. International Journal of Behavioral Nutrition and Physical Activity, 12: 87. doi:10.1186/s12966-015-0240-2

Anderson A, Craigie AM, Caswell S, Treweek S, Stead M, Macleod M, Daly F, Belch J, Rodger J, Kirk A, Ludbrook A, Rauchhaus P, Norwood P, Thompson J, Wardle J and Steele RJ (2014). The impact of a bodyweight and physical activity intervention (BeWEL) initiated through a national colorectal cancer screening programme: randomised controlled trial. British Medical Journal, 348: g1823. doi: 10.1136/bmj.g1823.

Treweek  S, Wilkie  E, Craigie AM, Caswell  S, Thompson  J, Steele RJC, Stead  M and Anderson AS (2013 Online). Meeting the challenges of recruitment to multicentre, community-based, lifestyle-change trials: A case study of the BeWEL trial. Trials, 14: 436. doi: 10.1186/1745-6215-14-436.

Caswell S, Craigie AM, Wardle J, Stead M, Anderson AS and the BeWEL team (2012). Detailed protocol for the lifestyle intervention in the BeWEL randomised controlled trial of weight loss in adults who have had a colorectal adenoma. BMJ OPEN, 2(3): e001276, doi:10.1136/bmjopen-2012-001276.

Stead M, Casswell S, Craigie AM, Eadie D and Anderson AS (2012). Understanding the potential and challenges of adenoma treatment as a prevention opportunity: Insights from the BeWEL formative study. Preventive Medicine, 54: 97-103. Online

Craigie AM, Caswell S, Paterson C, Treweek S, Belch JJ, Daly F, Rodger J, Thompson J, Kirk A, Ludbrook A, Stead M, Wardle J, Steele RJ, Anderson AS (2011).  Study protocol for BeWEL: The impact of a BodyWEight and physicaL activity intervention on adults at risk of developing colorectal adenomas.  BMC Public Health, 11: 184.  Online

University News

Improving Breast Awareness in Women Aged 45-54 Years
(Commissioned by Breakthrough Breast Cancer)

One in every nine women in the UK will develop breast cancer at some point during their lives. Accounting for nearly one-third of all cancers in women, breast cancer is the leading cause of death for women aged 34 to 54 (ONS 2005). Improving breast awareness and increasing the uptake of breast screening amongst women is a key factor in the fight against breast cancer.

The Breakthrough Breast Cancer project supported the development, implementation and evaluation of a pilot breast cancer education and awareness campaign. The campaign had two main aims: to improve knowledge and awareness of breast cancer (including the benefits of early diagnosis), breast awareness and breast screening; and to promote early detection. ISM conducted an integrated research programme which included a review of the published literature evaluating breast cancer awareness and an in-depth exploration of women's current knowledge, perceptions and attitudes towards breast cancer using qualitative research methodology. The findings of this research were used to guide the development of Breakthrough Breast Cancer's education and awareness campaign.

ISM Staff: Joanne Freeman (left 2008) and Douglas Eadie

Ovarian Cancer Leaflet Evaluation
(Commissioned by Cancer Research UK)

Cancer Research UK developed a new series of lifestyle and cancer awareness leaflets to complement the existing series of cancer-specific leaflets. At the time it had 11 cancer awareness leaflets, mostly dealing with specific cancers. In 2007 it added a new title to the series - ovarian cancer. It was intended that the leaflet would provide advice on early detection and how to reduce the risk of ovarian cancer. ISM undertook a series of focus group discussions with women in Scotland and England to help with the development of the leaflet by identifying appropriate ways to communicate CRUK's key messages about the early detection and risk of ovarian cancer, and examine the accessibility and tone of the leaflet text, the attractiveness of the design, and the 'pickup' ability of the leaflet as a whole.

ISM Staff: Laura McDermott (left 2008) and Douglas Eadie

SunSmart: Research to Guide the Development of a National Skin Cancer Prevention Programme
(Commissioned by Cancer Research UK)

SunSmart is a national skin cancer prevention awareness raising campaign developed by Cancer Research UK with support from the Department of Health. The Institute was involved in a series of qualitative studies to guide the development of the programme. The first, conducted during the campaign's formative phase, provided consumer insights into how key target audiences receive, process and utilised sun protection messages, the findings from which were instrumental in informing the 2004 campaign, Kids Cook Quick, and in guiding the national SunSmart 5-year strategy. This was followed by a two-stage qualitative study to guide the creative strategy for the SunSmart youth and adult summer campaign of 2005, and then in Spring 2006 a communication pretest of the Cancer Research UK skin cancer prevention and early detection leaflets designed to promote the SunSmart code.

ISM Staff: Douglas Eadie and Susan MacAskill

Eadie D and MacAskill S (2007). Results from an exploratory study of sun protection practice: Implications for the design of health promotion messages. Health Education, 107(3): 250-260.

SunSmart: Qualitative Research to Guide the Conceptual Development of SunSmart
(Commissioned by Cancer Research UK)

Sunsmart is a national skin cancer prevention awareness raising campaign developed by Cancer Research UK with support from the UK health departments. This qualitative study was conducted to guide the creative decision-making for the youth and adult campaigns for Summer 2005. Both campaigns form part of the SunSmart 5-year strategy and have been designed to promote the SunSmart code using a variety of media, including electronic and print. The fieldwork, which employs focus group techniques, was conducted in two stages and is integral to the campaign's creative development process.

ISM Staff: Douglas Eadie

SunSmart: Qualitative Research to Investigate Attitudes to the Sun, Sun Protection and Skin Cancer with Parents and Young People
(Commissioned by Cancer Research UK)

SunSmart is a national skin cancer prevention awareness raising campaign developed by Cancer Research UK with support from the Department of Health. This qualitative study was conducted during the campaign's formative phase to provide insights into how key target audiences receive, process and utilise sun protection messages. It explored attitudes and behaviour in relation to sun, sun protection and skin cancer, together with response to sun protection messages and materials, among key target groups of teens, young adults and mothers of young children. The findings have been instrumental in informing the SunSmart 2004 campaign, Kids Cook Quick, and in guiding the national SunSmart 5-year strategy.

ISM Staff: Douglas Eadie and Susan MacAskill

West of Scotland Cancer Awareness Project: Public Awareness Study
(Commissioned by West of Scotland Cancer Awareness Project, hosted by Argyll & Clyde Health Board, with funding from the New Opportunities Fund and NHS Health Scotland)

The West of Scotland Cancer Awareness Project (WoSCAP) was a multi-component early cancer detection campaign. It aimed to encourage 'at risk' populations living in the West of Scotland to present earlier to the NHS if they experience signs and symptoms of oral cancer and colorectal cancer. ISM worked with the project from its inception, conducted both formative research to guide the development of the Campaign's communication strategy and evaluative research to monitor its impact.

A three-staged research design was employed, combining strategic research (S1), formative research (S2) and evaluative research (S3). S1 combined a literature review with exploratory research to guide strategic decisions relating to target audience, media selection, communication objectives, tone of voice etc, and would support the development of the agency brief; S2 employed qualitative pre-testing (or creative development research) techniques to help guide the development and execution of the creative strategy; and S3 used tracking survey methods to monitor response to individual campaign elements and the impact of the Campaign on awareness and knowledge of early detection and propensity to self-refer. NHS Health Scotland provided additional funding to incorporate a control and comparison group into the study design.

After extensive pretesting, the oral campaign was successfully launched in October 2003. Results from the first year follow-up of the oral cancer campaign were presented at the UICC World Conference for Cancer Organisations in Dublin in November 2004. The campaign won Best Campaign in Inequalities in Public Health at the UK Association of Healthcare Communicators Conference 2004. The colorectal cancer campaign was launched in November 2004 by the Minister for Health.

WoSCAP oral cancer campaign won a silver award at the UK IPA (Institute of Practitioners in Advertising) Advertising Effectiveness Awards, Belfast, December 2005.

ISM Staff: Douglas Eadie, Susan MacAskill, Martine Stead, Anne Marie MacKintosh and Laura McDermott (left 2008)

Eadie D, MacKintosh AM, MacAskill S and Brown A (2009). Development and evaluation of an early detection intervention for mouth cancer employing a mass media approach. British Journal of Cancer, 101: S73-S79, doi:10.1038/sj.bjc.6605395.  

Eadie D and MacAskill S (2008). Symptom awareness and cancer prevention: Exploratory findings from an at-risk population. Health Education, 108(4): 332-345.

Eadie D and MacAskill S (2007). Consumer attitudes towards self-referral with early signs of cancer: Implications for symptom awareness campaigns. International Journal of Non-profit and Voluntary Sector Marketing, 12(4): 338-349.

BCAP: Bowel Cancer Awareness Project: Public Awareness Study
(Commissioned by The Bowel Cancer Awareness Project, hosted by Forth Valley and Lanarkshire Health Boards, with funding from the New Opportunities Fund)

In non-smoking men and women, bowel cancer (cancer of the large intestine or rectum) is the most prevalent form of cancer in Scotland responsible for around 1,600 deaths each year. It has also been clinically proven that survival outcomes and quality of life for many patients can be improved if people present early enough with signs and symptoms of bowel cancer However, public awareness of the potential signs and symptoms is generally poor. Bowel cancer is therefore a top priority for the Scottish Executive and the NHS in Scotland. The Bowel Cancer Awareness Project is a community-based intervention combining primary prevention and early detection strategies and targeting an at-risk population of those aged 50 and over in specific disadvantaged communities.

The Project provides a critical opportunity to examine the role and impact that a community-based programme can have on public awareness, knowledge and early-detection behaviour. A pre-post study design incorporating a matched non-probability quota sample of the target population was employed to assess intervention impact on awareness, knowledge, and attitudes towards bowel cancer and its early detection within the target communities. The campaign was launched in September 2003 and the results were reported in April 2005.

BCAP campaign won 'Best Campaign for Improving Health' at the Association of Healthcare Communicators Awards, Bristol, 20th October 2005

ISM Staff: Douglas Eadie, Anne Marie MacKintosh and Susan Anderson (left 2005)

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