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The Reach of Calls and Text Messages for Mailed FIT Outreach in the PROMPT Stepped-wedge Colorectal Cancer Screening Trial.

Gloria D CoronadoDenis B NyongesaAmanda F PetrikJamie H ThompsonAnne Laure EscaronTuan PhamMichael C Leo
Published in: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology (2024)
Background Mailed fecal immunochemical test (FIT) outreach can improve colorectal cancer screening participation. We assessed the reach and effectiveness of adding notifications to mailed FIT programs. Methods We conducted secondary analyses of a stepped-wedge evaluation of an enhanced mailed FIT program (n = 15 clinics). Patients were stratified by prior FIT completion. Those with prior FIT were sent a text message (Group 1); those without were randomized 1:1 to receive a text message (Group 2) or live phone call (Group 3). All groups were sent automated phone call reminders. In stratified analysis, we measured reach and effectiveness (FIT completion within 6 months) and assessed patient-level associations using generalized estimating equations. Results Patients (n = 16,934; 83% Latino; 72% completed prior FIT) were reached most often by text messages (78%), followed by live phone calls (71%), then automated phone calls (56%). FIT completion was higher in patients with prior FIT completion vs. without (44% (Group 1) vs. 19% (Group 2 + Group 3); p <.01). For patients without prior FIT, effectiveness was higher in those allocated to a live phone call (20% (Group 3) vs. 18% (Group 2) for text message; p = .04) and in those who personally answered the live call (28% vs. 9% no call completed; p < .01). Conclusion Text messages reached the most patients, yet effectiveness was highest in those who personally answered the live phone call. Impact Despite the broad reach and low cost of text messages, personalized approaches may more successfully boost FIT completion.
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