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

Abstract

<div>AbstractBackground:<p>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.</p>Methods:<p>We conducted secondary analyses of a stepped-wedge evaluation of an enhanced mailed FIT program (<i>n</i> = 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.</p>Results:<p>Patients (<i>n</i> = 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 versus without [44% (Group 1) vs. 19% (Group 2 + Group 3); <i>P</i> < 0.01]. 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; <i>P</i> = 0.04] and in those who personally answered the live call (28% vs. 9% no call completed; <i>P</i> < 0.01).</p>Conclusions:<p>Text messages reached the most patients, yet effectiveness was highest in those who personally answered the live phone call.</p>Impact:<p>Despite the broad reach and low cost of text messages, personalized approaches may more successfully boost FIT completion.</p></div>