Text messaging and lottery incentive to improve colorectal cancer screening outreach at a community health center: A randomized controlled trial
Efforts to boost colorectal cancer (CRC) screening rates in underserved populations have been limited by effectiveness and scalability. We evaluate the impact of adding a lottery-based financial incentive to a text messaging program that asks patients to opt-in to receive mailed fecal immunochemical...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-09-01
|
| Series: | Preventive Medicine Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211335520300747 |
| _version_ | 1818037437518053376 |
|---|---|
| author | Shivan J. Mehta Akinbowale Oyalowo Catherine Reitz Owen Dean Timothy McAuliffe David A. Asch Chyke A. Doubeni |
| author_facet | Shivan J. Mehta Akinbowale Oyalowo Catherine Reitz Owen Dean Timothy McAuliffe David A. Asch Chyke A. Doubeni |
| author_sort | Shivan J. Mehta |
| collection | DOAJ |
| description | Efforts to boost colorectal cancer (CRC) screening rates in underserved populations have been limited by effectiveness and scalability. We evaluate the impact of adding a lottery-based financial incentive to a text messaging program that asks patients to opt-in to receive mailed fecal immunochemical testing (FIT).This is a two-arm pragmatic randomized controlled trial at a community health center in Southwest Philadelphia from April to July 2017. We included CRC screening-eligible patients between ages 50–74 years who had a mobile phone, active health insurance, and at least one visit to the clinic in the past 12 months. Patients received a text message about CRC screening with the opportunity to opt-in to receive mailed FIT. They were randomized 1:1 to the following: (1) text messaging outreach alone (text), or (2) text messaging with lottery for a 1-in-5 chance of winning $100 after FIT completion (text + lottery). The primary outcome was the percentage of patients completing the mailed FIT within 3 months of initial outreach.281 patients were included in the intent-to-treat analysis. The FIT completion rate was 12.1% (95% CI, 6.7%–17.5%) in the text message arm and 12.1% (95% CI, 6.7%–17.5%) in the lottery arm, with no statistical difference between arms. The majority of post-intervention interview respondents found text messaging to be acceptable and convenient.Opt-in text messaging is a feasible option to promote the uptake of mailed FIT screening, but the addition of a lottery-based incentive did not improve completion rates.Trial Registration: clinicaltrials.gov (NCT03072095). |
| first_indexed | 2024-12-10T07:26:50Z |
| format | Article |
| id | doaj.art-e3fe67d641734cdb8dcf58498f96b218 |
| institution | Directory Open Access Journal |
| issn | 2211-3355 |
| language | English |
| last_indexed | 2024-12-10T07:26:50Z |
| publishDate | 2020-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Preventive Medicine Reports |
| spelling | doaj.art-e3fe67d641734cdb8dcf58498f96b2182022-12-22T01:57:41ZengElsevierPreventive Medicine Reports2211-33552020-09-0119101114Text messaging and lottery incentive to improve colorectal cancer screening outreach at a community health center: A randomized controlled trialShivan J. Mehta0Akinbowale Oyalowo1Catherine Reitz2Owen Dean3Timothy McAuliffe4David A. Asch5Chyke A. Doubeni6Department of Medicine, Perelman School of Medicine, University of Pennsylvania, United States; Center for Health Care Innovation, University of Pennsylvania, United States; Corresponding author at: 14-174 PCAM South Tower, 3400 Civic Center Blvd., Philadelphia, PA 19104, United States.Department of Medicine, Perelman School of Medicine, University of Pennsylvania, United StatesDepartment of Medicine, Perelman School of Medicine, University of Pennsylvania, United States; Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, United StatesDepartment of Medicine, Perelman School of Medicine, University of Pennsylvania, United States; Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, United StatesDepartment of Medicine, Perelman School of Medicine, University of Pennsylvania, United States; Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, United StatesDepartment of Medicine, Perelman School of Medicine, University of Pennsylvania, United States; Center for Health Care Innovation, University of Pennsylvania, United States; Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, United StatesCenter for Health Equity and Community Engagement Research, Mayo Clinic, United StatesEfforts to boost colorectal cancer (CRC) screening rates in underserved populations have been limited by effectiveness and scalability. We evaluate the impact of adding a lottery-based financial incentive to a text messaging program that asks patients to opt-in to receive mailed fecal immunochemical testing (FIT).This is a two-arm pragmatic randomized controlled trial at a community health center in Southwest Philadelphia from April to July 2017. We included CRC screening-eligible patients between ages 50–74 years who had a mobile phone, active health insurance, and at least one visit to the clinic in the past 12 months. Patients received a text message about CRC screening with the opportunity to opt-in to receive mailed FIT. They were randomized 1:1 to the following: (1) text messaging outreach alone (text), or (2) text messaging with lottery for a 1-in-5 chance of winning $100 after FIT completion (text + lottery). The primary outcome was the percentage of patients completing the mailed FIT within 3 months of initial outreach.281 patients were included in the intent-to-treat analysis. The FIT completion rate was 12.1% (95% CI, 6.7%–17.5%) in the text message arm and 12.1% (95% CI, 6.7%–17.5%) in the lottery arm, with no statistical difference between arms. The majority of post-intervention interview respondents found text messaging to be acceptable and convenient.Opt-in text messaging is a feasible option to promote the uptake of mailed FIT screening, but the addition of a lottery-based incentive did not improve completion rates.Trial Registration: clinicaltrials.gov (NCT03072095).http://www.sciencedirect.com/science/article/pii/S2211335520300747Colorectal cancerScreeningText messagingIncentives |
| spellingShingle | Shivan J. Mehta Akinbowale Oyalowo Catherine Reitz Owen Dean Timothy McAuliffe David A. Asch Chyke A. Doubeni Text messaging and lottery incentive to improve colorectal cancer screening outreach at a community health center: A randomized controlled trial Preventive Medicine Reports Colorectal cancer Screening Text messaging Incentives |
| title | Text messaging and lottery incentive to improve colorectal cancer screening outreach at a community health center: A randomized controlled trial |
| title_full | Text messaging and lottery incentive to improve colorectal cancer screening outreach at a community health center: A randomized controlled trial |
| title_fullStr | Text messaging and lottery incentive to improve colorectal cancer screening outreach at a community health center: A randomized controlled trial |
| title_full_unstemmed | Text messaging and lottery incentive to improve colorectal cancer screening outreach at a community health center: A randomized controlled trial |
| title_short | Text messaging and lottery incentive to improve colorectal cancer screening outreach at a community health center: A randomized controlled trial |
| title_sort | text messaging and lottery incentive to improve colorectal cancer screening outreach at a community health center a randomized controlled trial |
| topic | Colorectal cancer Screening Text messaging Incentives |
| url | http://www.sciencedirect.com/science/article/pii/S2211335520300747 |
| work_keys_str_mv | AT shivanjmehta textmessagingandlotteryincentivetoimprovecolorectalcancerscreeningoutreachatacommunityhealthcenterarandomizedcontrolledtrial AT akinbowaleoyalowo textmessagingandlotteryincentivetoimprovecolorectalcancerscreeningoutreachatacommunityhealthcenterarandomizedcontrolledtrial AT catherinereitz textmessagingandlotteryincentivetoimprovecolorectalcancerscreeningoutreachatacommunityhealthcenterarandomizedcontrolledtrial AT owendean textmessagingandlotteryincentivetoimprovecolorectalcancerscreeningoutreachatacommunityhealthcenterarandomizedcontrolledtrial AT timothymcauliffe textmessagingandlotteryincentivetoimprovecolorectalcancerscreeningoutreachatacommunityhealthcenterarandomizedcontrolledtrial AT davidaasch textmessagingandlotteryincentivetoimprovecolorectalcancerscreeningoutreachatacommunityhealthcenterarandomizedcontrolledtrial AT chykeadoubeni textmessagingandlotteryincentivetoimprovecolorectalcancerscreeningoutreachatacommunityhealthcenterarandomizedcontrolledtrial |