Text Messaging and Opt-out Mailed Outreach in Colorectal Cancer Screening: a Randomized Clinical Trial.
behavioral economics
colorectal cancer screening
fecal immunochemistry test (FIT)
mailed outreach
text message reminders
Journal
Journal of general internal medicine
ISSN: 1525-1497
Titre abrégé: J Gen Intern Med
Pays: United States
ID NLM: 8605834
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
19
06
2020
accepted:
08
12
2020
pubmed:
30
1
2021
medline:
6
8
2021
entrez:
29
1
2021
Statut:
ppublish
Résumé
Routine screening reduces colorectal cancer mortality, but screening rates fall below national targets and are particularly low in underserved populations. To compare the effectiveness of a single text message outreach to serial text messaging and mailed fecal home test kits on colorectal cancer screening rates. A two-armed randomized clinical trial. An urban community health center in Philadelphia. Adults aged 50-74 who were due for colorectal cancer screening had at least one visit to the practice in the previously year, and had a cell phone number recorded. Participants were randomized (1:1 ratio). Individuals in the control arm were sent a simple text message reminder as per usual practice. Those in the intervention arm were sent a pre-alert text message offering the options to opt-out of receiving a mailed fecal immunochemical test (FIT) kit, followed by up to three behaviorally informed text message reminders. The primary outcome was participation in colorectal cancer screening at 12 weeks. The secondary outcome was the FIT kit return rate at 12 weeks. Four hundred forty participants were included. The mean age was 57.4 years (SD ± 6.1). 63.4% were women, 87.7% were Black, 19.1% were uninsured, and 49.6% were Medicaid beneficiaries. At 12 weeks, there was an absolute 17.3 percentage point increase in colorectal cancer screening in the intervention arm (19.6%), compared to the control arm (2.3%, p < 0.001). There was an absolute 17.7 percentage point increase in FIT kit return in the intervention arm (19.1%) compared to the control arm (1.4%, p < 0.001). Serial text messaging with opt-out mailed FIT kit outreach can substantially improve colorectal cancer screening rates in an underserved population. clinicaltrials.gov ( https://clinicaltrials.gov/ct2/show/NCT03479645 ).
Sections du résumé
BACKGROUND
Routine screening reduces colorectal cancer mortality, but screening rates fall below national targets and are particularly low in underserved populations.
OBJECTIVE
To compare the effectiveness of a single text message outreach to serial text messaging and mailed fecal home test kits on colorectal cancer screening rates.
DESIGN
A two-armed randomized clinical trial.
PARTICIPANTS
An urban community health center in Philadelphia. Adults aged 50-74 who were due for colorectal cancer screening had at least one visit to the practice in the previously year, and had a cell phone number recorded.
INTERVENTIONS
Participants were randomized (1:1 ratio). Individuals in the control arm were sent a simple text message reminder as per usual practice. Those in the intervention arm were sent a pre-alert text message offering the options to opt-out of receiving a mailed fecal immunochemical test (FIT) kit, followed by up to three behaviorally informed text message reminders.
MAIN MEASURES
The primary outcome was participation in colorectal cancer screening at 12 weeks. The secondary outcome was the FIT kit return rate at 12 weeks.
KEY RESULTS
Four hundred forty participants were included. The mean age was 57.4 years (SD ± 6.1). 63.4% were women, 87.7% were Black, 19.1% were uninsured, and 49.6% were Medicaid beneficiaries. At 12 weeks, there was an absolute 17.3 percentage point increase in colorectal cancer screening in the intervention arm (19.6%), compared to the control arm (2.3%, p < 0.001). There was an absolute 17.7 percentage point increase in FIT kit return in the intervention arm (19.1%) compared to the control arm (1.4%, p < 0.001).
CONCLUSIONS
Serial text messaging with opt-out mailed FIT kit outreach can substantially improve colorectal cancer screening rates in an underserved population.
TRIAL REGISTRATION
clinicaltrials.gov ( https://clinicaltrials.gov/ct2/show/NCT03479645 ).
Identifiants
pubmed: 33511567
doi: 10.1007/s11606-020-06415-8
pii: 10.1007/s11606-020-06415-8
pmc: PMC8298623
doi:
Banques de données
ClinicalTrials.gov
['NCT03479645']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1958-1964Subventions
Organisme : NCI NIH HHS
ID : K08 CA234326
Pays : United States
Informations de copyright
© 2020. Society of General Internal Medicine.
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