# Evaluating the effectiveness and acceptability of free door-to-door transport to increase the uptake of breast screening appointments in Yorkshire: a cluster randomised GP feasibility trial (DOORSTEP protocol)

## TL;DR

This study tests if offering free door-to-door transport increases breast screening attendance in Yorkshire, focusing on feasibility and acceptability.

## Contribution

A novel approach to improving breast screening uptake by providing free transport and evaluating its feasibility in a GP cluster-randomized trial.

## Key findings

- The trial will assess GP recruitment, randomization, and intervention fidelity as primary feasibility outcomes.
- Secondary outcomes include understanding travel behavior, cost-effectiveness, and screening uptake.
- Patient and public involvement is embedded throughout the study design and implementation.

## Abstract

Breast screening uptake remains low in parts of the UK, partly due to barriers including limited transport access. Offering free transport to screening appointments may help address this and improve uptake. This general practitioner (GP) cluster-randomised feasibility trial will assess whether offering free door-to-door transport alongside routine screening invitations increases attendance.

Eight general practices in Yorkshire will be randomised to either the intervention (routine invitation plus information about booking free door-to-door transport) or control (routine invitation only) group. Around 8000 women due for routine breast screening will be included. Primary feasibility outcomes include GP recruitment and randomisation, intervention fidelity, proportion of women from the 10% most deprived areas, acceptability and data transfer processes. Secondary outcomes include understanding travel behaviour, cost-effectiveness and screening uptake. Data will be collected from routine National Health Service (NHS) screening records, data linkage with NHS England, travel surveys and qualitative interviews exploring experiences and acceptability. Patient and public involvement is embedded throughout with members contributing to advisory and oversight roles.

The trial has received ethical approval from the London–Harrow Research Ethics Committee, Section 251 approval from the Confidentiality Advisory Group and other relevant regulatory bodies. The University of Hull is the study sponsor. Results will be disseminated through peer-reviewed journal publications, conference presentations and plain English summaries for participants and the public. Findings will inform the feasibility and design of a potential larger trial to improve breast screening uptake via transport support.

ISRCTN17087898.