EQUITy in Black Adult health (EQUITA) - a randomised feasibility trial of a co-produced and faith-placed intervention to increase uptake of breast, cervical, bowel, and AAA screening in the North East of England, Leeds and Scotland: study protocol

Background: Breast, bowel, cervical, and abdominal aortic aneurysm (AAA) screening save lives, yet significant inequities in uptake persist among ethnic minority groups, particularly within Black communities. Lower screening rates increase the risk of late diagnosis and mortality. Culturally tailored, community-centred, and participatory approaches show promise in addressing these inequities. This 24-month study aims to assess the feasibility and acceptability of a co-produced, faith-placed intervention to increase uptake of these four screening programmes among Black communities. Methods: Building on earlier work co-producing a faith-based intervention with Muslim women and adapting it for prostate cancer awareness among Black men, this study will co-design and tailor a peer-led, church-based workshop in partnership with Black communities. The intervention will incorporate education from a Black GP, video testimonials, survivor and community perspectives, discussions on navigating healthcare, religious leader input, and a social component with food and music. Guided by the Integrated Screening Action Model, a mixed-methods, multicentre, two-arm randomised feasibility trial will be conducted. Three hundred Black participants (women aged 25–74; men aged 50–74), not fully up to date with eligible NHS screening programmes, will be recruited from churches in Scotland, North East of England, and Leeds. Churches will be randomised to intervention or control arms. A process evaluation will explore feasibility and acceptability through six focus groups with up to 8 participants, one online focus group with Public Involvement Community Engagement (PICE) members and peer facilitators (n=12) and interviews with key stakeholders (n=10). A preliminary health economic evaluation will also be conducted. Trial parameters will be assessed using pre-specified progression criteria and a traffic-light system (STOP-AMEND-GO) to inform a future definitive trial. Preliminary indications of effectiveness will be captured through changes in knowledge, screening intentions (baseline and three-month follow-up), and NHS screening attendance (six-month follow-up). Discussion: This study addresses critical health inequities through the development and feasibility testing of a peer-led, culturally appropriate intervention tailored to Black communities in the UK. A rigorous process evaluation and strong community engagement will inform future scalability and effectiveness testing. A knowledge-mobilisation plan will support dissemination, and further funding will be sought if progression criteria are met. Trial registration: ClinicalTrials.gov Identifier: NCT06981182. https://clinicaltrials.gov/study/NCT06981182?term=NCT06981182&rank=1