Accepted for/Published in: JMIR Research Protocols
Date Submitted: Nov 7, 2025
Date Accepted: Apr 14, 2026
Utilizing social media for colorectal cancer screening: a protocol for a Cluster Randomized Controlled Trial using Facebook to improve participation in cancer screening
ABSTRACT
Background:
Colorectal Cancer (CRC) screening participation in Canada is lower than the national target and interventions designed to increase screening participation are generally expensive and have limited impact. Social media can be used as an innovative strategy to increase participation in cancer screening, particularly Facebook (FB), as it is the most popular social media platform for the population eligible for CRC screening.
Objective:
The aim of this study is to report on the protocol for a pragmatic cluster randomized controlled trial (cluster RCT) that will test the effectiveness of social media ads for CRC screening on user engagement and screening intention.
Methods:
The trial will target FB users over the age of 45 who reside in the province of Ontario, Canada. There are 521 Forward Sortation Areas (FSA) in Ontario, and the randomization will be done at this level using the first 3 digits of the postal code. Rural and urban FSAs will be randomly allocated to one of the six study arms. In four arms, FB users will all receive one of four social media ads developed in previous studies while in the fifth arm, a tailored strategy by sex will be tested. In the final arm, FB users will not be shown any ads. If users click on any of the ads, they will be directed to a webpage with more information on screening and a place to indicate if they intend to get screened for CRC (the study’s primary outcome tested as a binary measure). User engagement metrics including impressions, link clicks, cost per link click, link click through rate and user comments will be tracked across the 5 trial arms with ads shown.
Results:
This cluster RTC has the potential to provide evidence on the effectiveness of FB as a tool for delivering CRC screening messages and influencing screening intentions. The comparison of message types within a fixed campaign budget could identify which approaches most effectively promote engagement and screening uptake in both urban and rural populations.
Conclusions:
This study has the potential to show that social media offers a cost-efficient, scalable approach to promoting CRC screening. This approach is adaptable to other cancer screening programs and could inform evidence-based digital strategies to improve population-level screening uptake. Clinical Trial: NCT04296630
Citation
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Copyright
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