JMIR Publications

ABSTRACT

Population-based cancer screening programmes are designed to enable early detection and timely treatment of selected cancers, with the ultimate aim of reducing morbidity and mortality; yet participation remains critically low in the Campania region of southern Italy. Within the MIRIADE project, previous studies identified psychosocial antecedents of cervical, breast and colorectal cancer screening adherence (attitude, subjective norms, perceived behavioural control, self-identity, anticipated regret, action and coping planning). Based on these variables, a profiling study identified data-driven psychosocial subgroups among citizens eligible for colorectal cancer screening (CRCS; three profiles) and female-only cancer screenings (FOCS; four profiles), and one study developed and validated a framework for multiple reasons for screening participation. Building on these empirical foundations, the present paper describes a protocol for a randomized controlled trial (RCT) comparing the efficacy of targeted and tailored persuasive messaging strategies—and a usual-care control—for promoting screening participation. The T0 baseline assessment was conducted as part of the companion profiling study, during which participants completed psychosocial measures and ranked their personal reasons for screening participation, after which they were profiled via Reduced k-means. At T1, participants are randomly allocated to: (a) a targeted condition, receiving a persuasive message adapted to their profile’s psychosocial characteristics; (b) a tailored condition, receiving a message that additionally integrates the individual’s most personally relevant reason for screening; or (c) a usual-care control. The primary outcome is post-intervention screening intention (T1). A six-month behavioural follow-up (T2) assesses self-reported screening uptake. Message effectiveness and personal relevance are evaluated as process outcomes. Pre-tests with a subsample ensure message adequacy. This protocol provides a theory-grounded, empirically informed framework for experimental comparison of targeted and tailored interventions for both colorectal and female-only cancer screenings. It employs data-driven profiling, integrates individually relevant reason-based content, and is designed for scalability within regional public health infrastructure. Protocol version: Version 1.0, 15/05/2026.