Increasing CRC Screening in Community Health Centers Through Mobile Messaging Optimization

Summary

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, we will learn from clinic staff and patients what their needs and preferences are in terms of use of technology. We will use this information to design the text messages program.

* Clinic patients will participate in focus groups
* Clinic staff will participate in interviews

Second, we 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, we 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, we 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.

Conditions

• Colorectal Cancer

Interventions

BEHAVIORAL

Personalized Text Message

Message includes personalized content.

BEHAVIORAL

Screening Concerns Text Message

Emotional concerns or barriers related to CRC screening.

BEHAVIORAL

Message Framing Text Message

Use gain-framed language to influence motivation.

BEHAVIORAL

Autonomy Support Outreach

Provide patients with choices or options to increase sense of control.

BEHAVIORAL

Impediments Support Outreach

Include information or resources to help overcome barriers to care.

BEHAVIORAL

Live Support Outreach

Offer access to live assistance.

OTHER

Data Reporting and Visualization System Tools

Electronic alerts, dashboards, and tracking systems used to identify and follow up with patients due for CRC screening or abnormal results.

Sponsors & Collaborators

• National Institutes of Health (NIH)

  collaborator NIH

• National Cancer Institute (NCI)

  collaborator NIH

• Massachusetts League of Community Health Centers

  collaborator OTHER

• Dana-Farber Cancer Institute

  collaborator OTHER

• University of Texas Southwestern Medical Center

  collaborator OTHER

• Massachusetts General Hospital

  collaborator OTHER

• University of Colorado, Denver

  lead OTHER

Principal Investigators

• Gina Kruse, MD · University of Colorado, Denver

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

FACTORIAL

Eligibility

Min Age

45 Years

Max Age

75 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2026-12-31

Primary Completion

2031-10-31

Completion

2032-01-31

Countries

• United States

Study Locations