Supporting Imperial College London to co-design inclusive service touchpoints to increase attendance of breast cancer screening
Project aims:
Detecting breast cancer early boosts the likelihood of treatment being successful. Despite the important role that screening can play in breast cancer detection, many people miss their appointments or choose not to attend.
The NHS has been encouraging people to attend their screening appointments by sending them text message reminders but also wanted to explore if a video animation could be a good way of offering information about the screening process, dispel myths, acknowledge cultural values and showcase a wide range of stories to help people see people like them attending breast screening.
This project focused on further understanding the barriers to attending breast screening appointments and co-creating SMS reminders and a short video animation with healthcare professionals and end-users to help increase the uptake of breast cancer screening. This co-designed SMS and video animation is now being piloted across London.
Project background:
Breast cancer is one of the most common cancers, 1 out of every 7 women in the UK will face a breast cancer diagnosis in their lifetime. The likelihood of developing breast cancer increases with age. All people in the UK who are registered as female with their GP between the ages of 50 and 70 are invited for breast screening every three years.
However, breast screening uptake is declining, with London demonstrating the lowest rates nationally. In particular, there is lower uptake across areas with high deprivation, people from ethnic backgrounds, people with physical or intellectual disabilities, and people with mental health illnesses.
To kick off this project we looked at previous research conducted and helped to pull out the key barriers so that we could take these into a workshop with people with lived experience or breast screening and understand what barriers and messaging resonated the most.
“Research has shown that the barriers can vary across different ethnic groups. For example a recent study of British-Pakistani women highlighted the need for reading materials to be translated into native languages. For people who speak limited English, this can improve their access to information.
Other research conducted into the attendance of Black, African women showed that factors such as the fear of a fatal cancer diagnosis can prevent them from turning up to appointments. Compared to women from minority ethnic groups…”
- Nikita Rathod - Read more here from Imperial College London
Co-design workshops with end users
We conducted two co-design workshops with participants who had attended breast screening in the past or had been invited but not yet attended their screening appointment. Within the first workshop, we focused on understanding and prioritising what were the main barriers people face to not attending breast screening appointments and what messaging most resonated so that we knew what needed to be included in an SMS reminder and the animation to help increase attendance rates.
This enabled us to create a storyboard to bring together these prioritised barriers and create a narrative to help reduce those barriers. We worked closely with behavioral scientists to understand what the best behavior change techniques would be to use. The focus of the animation is on stories from a range of people that references each of the key barriers that were identified.
Storyboarding and iterations based on feedback
Within the second workshop, we walked through a storyboard and co-designed key areas to ensure the stories were resonating and representative.
This storyboard was then iterated and shared with a wide range of participants, people across the NHS, charities and breast cancer screening commissioners for further feedback. We made iterations based on feedback and made sure to create an animation that could easily be translated into multiple languages. We asked for feedback and input at multiple points across the development of the SMS and animation to ensure it was inclusive, accessible, representative and felt like a supportive message for people to receive. We worked with Kymo animation studios on this project.
Outcomes and impact
Throughout this project, we created a deeper understanding of the barriers to attending breast screening appointments and co-designed a video and SMS to help reduce those barriers. These interventions are now being piloted across London. The rates of attendance will be monitored and further feedback will be gathered and iterations may be made to ensure the animation and SMS is helping to increase attendance rates as much as possible.
“Working with Inclusively was a fantastic experience that far exceeded my expectations. The team were knowledgeable, hardworking and flexible in helping us deliver a fantastic product. Their collaborative approach fostered an open forum of ideas and a real sense of shared ownership and team working in the projects they delivered.”
- Dr Amish Acharya, Clinical Research Fellow at the Institute of Global Health Innovation
A big thanks to Amish Acharya and Gaby Judah from Imperial College London for being such a joy to work with and for all of your expertise and brilliant research recruitment.
Huge shout out Ky Moodie, Lucy Stewart and Ben Young for helping to make this project so enjoyable and brilliant!
Client: Imperial College London and the NHS
Services: Service Design, User Research, Preparation for implementation, Animation
Team: Charley Pothecary, Lucy Stewart, Ben Young and Ky Moodie