A Personalised and Gamified Digital Decision Aid for Colorectal Cancer Screening: A Randomised Controlled Pilot Study
Abstract
BACKGROUND: Colorectal cancer (CRC) is the second leading cause of tumour-related mortality worldwide, accounting for approximately 903,000 deaths annually. Despite the proven effectiveness of population-based screening in reducing mortality, participation rates remain suboptimal, hindered by cognitive, psychological, and socioeconomic barriers.
OBJECTIVE: This study assessed the effectiveness of the PREVenGO smartphone application, a digital decision aid (DA) incorporating personalisation and gamification elements, in supporting informed decision-making and adherence to CRC screening.
METHODS: DA-CRC is a two-arm randomised controlled pilot trial. Individuals born in 1973-1974 and invited for the first time to the CRC screening programme by the Local Health Authority of Brescia (Northern Italy) were eligible. Invitation letters included instructions to download the PREVenGO app, which randomised participants into intervention or control arms. The intervention app integrated questionnaires on family history, prevention knowledge, and locus of control (LoC), together with gamified features and rewards, while the control version provided static educational material. Both groups received follow-up notifications at 3 (T1) and 6 months (T2).
RESULTS: Among those invited, 1% (n = 248) downloaded the app and completed onboarding. Follow-up retention was limited: only 18 participants (7.3%) completed the 3-month questionnaire (T1) and 1 (0.4%) the 6-month assessment (T2). The…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 248 participants or records.
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