214 A Coproduction approach to recruiting GPs and participants to the decode cluster randomised controlled trial

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Introduction Colorectal cancer screening programmes improve survival. However, limited health literacy and lower socio-economic position are known barriers to participation. The DECODE trial aimed to assess the impact of a coproduced, mixed intervention combining general practitioners (GPs) training and tailored information for participants in socially disadvantaged areas. Here we present how we engaged GPs, citizens and other stakeholders to achieve our recruitment target. Methods DECODE is a multicentre, two-arm cluster-randomised controlled trial using a community- based participatory research approach. This involved GPs, the Regional Cancer Screening Coordination Centres, patients, citizens from the communities involved and researchers as equal contributors to all aspects of the research. The coproduced, mixed intervention combined training for GPs and a leaflet and video for participants. The primary outcome was uptake of CRC screening. We aimed to enrol 1024 participants through GPs in 4 French regions, using the European Deprivation Index (EDI) to select highly deprived areas (EDI 4 or 5). We encouraged recruitment using a variety of strategies coproduced with our stakeholders to engage GPs and participants. Results 52 GPs were recruited using a participatory sampling approach, and randomised (intervention group: 34 and control group: 18). Between October 2021 and April 2023, 1143 eligible patients were invited with 1025 recruited, meeting out recruitment target. The most effective recruitment strategies included regular communications and monthly neswletters coproduced with our stakeholders, recruitment competitions between regions and routine recruitment monitoring. Discussion A community-based participatory approach contributed to the successful recruitment outcome. Follow-up, using a variety of strategies and engagement with our stakeholders enabled our recruitment strategies to be adapted during the recruitment period. The full results of the trial are due by December 2024. Conclusion A community-based participatory approach and the simultaneous adaptation of recruitment strategies helped achieve our recruitment targets in a randomised trial in socially disadvantaged areas.

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