The goal of this interventional study is to create and test a comprehensive and low burden text message program within existing Community Health Centers (CHC) electronic records system to encourage patients to complete at home colorectal cancer (CRC) screening and to make sure they get follow-up care if their results are abnormal.
First, the investigators will learn from clinic staff and patients what their needs and preferences are in terms of use of technology. This information will be used to design the text messages program.
* Clinic patients will participate in focus groups * Clinic staff will participate in interviews
Second, the investigators will test a series of different message versions in two batches (experiments):
* Clinic patients with orders for an at-home colorectal cancer screening kit will receive the different message versions. * In the first batch, the messages that get the most engagement from patients will be selected to be used in the second experiment. * In the second batch, the investigators will test which messages lead to the most colorectal cancer screening completion. * This will be rolled-out within the clinics existing electronic record system. The study team will not receive any information that will identify individual patients.
Lastly, the investigators will check again with clinic staff to learn how the program performed, and what would be needed to continue using the text message program in the long run.
-Clinic staff will participate in interviews and surveys.
Adults 45-75 years old
Receive care in partner CHCs
Are of average risk for colorectal cancer
Received a stool-based testing order at their CHC
Personal or family history of CRC or colorectal polyps
History of inflammatory bowel disease
Heritable conditions that put them at above average risk for colorectal cancer (e.g., familial adenomatous polyposis)
Adult employees of participating CHCs
Factorial
Personalized Text Message
BehavioralMessage includes personalized content.
Screening Concerns Text Message
BehavioralEmotional concerns or barriers related to CRC screening.
Message Framing Text Message
BehavioralUse gain-framed language to influence motivation.
Autonomy Support Outreach
BehavioralProvide patients with choices or options to increase sense of control.
Impediments Support Outreach
BehavioralInclude information or resources to help overcome barriers to care.
Live Support Outreach
BehavioralOffer access to live assistance.
Data Reporting and Visualization System Tools
Other interventionElectronic alerts, dashboards, and tracking systems used to identify and follow up with patients due for CRC screening or abnormal results.
16
Treatment groupsSee each treatment group below.
Text message engagement
Proportion of message recipients who interact with CRC screening reminder messages by reply
Stool-based CRC screening completion
Proportion of message recipients with stool-based CRC screening tests resulted in electronic health record
Time to follow-up care after abnormal stool-based screening test
Time (days) to follow-up care after abnormal stool-based screening test
Invalid test results
Proportion of message recipients with invalid stool-based screening test result
Click on the lead sponsor to view all of their trials.
University of Colorado, Denver
Lead sponsor
National Institutes of Health (NIH)
Collaborator
National Cancer Institute (NCI)
Collaborator
Massachusetts League of Community Health Centers
Collaborator
Dana-Farber Cancer Institute
Collaborator
University of Texas Southwestern Medical Center
Collaborator
Massachusetts General Hospital
Collaborator
