Evaluation of Mailers Promoting Mammogram Screening

Not Applicable

Completed

• Conditions: Breast Cancer
• Interventions: Behavioral: Postcard; Behavioral: Small Gift; Behavioral: Loss Frame and Fear Appeals

• Registration Number: NCT04555902
• Lead Sponsor: Geisinger Clinic

Brief Summary

In this evaluation, 3 different versions of mailers promoting annual mammograms are being sent to women on the month of their 50th and 64th birthdays. The researchers hypothesize that the use of behavioral nudges in the mailers should lead to increased uptake in mammogram screening.

Detailed Description

Mammogram screening for women, starting at age 50, can significantly reduce the risk of complications due to breast cancer. As part of an existing outreach campaign, the health system mails a postcard and small gift (pink socks) to women on the month of their 50th and 64th birthdays to promote annual mammogram screening.

The researchers are evaluating two new versions of the mailers against a standard mailer to see which version leads to greater uptake in mammograms. The new mailers have content that applies behavioral nudge theory - specifically, loss frames and fear appeals - to encourage taking action. One of the two new versions does not include the small gift, to test whether its inclusion or exclusion has any effect on mammogram screening.

Study Timeline

• Study First Submitted: 2020-09-04
• Study First Submitted QC: 2020-09-14
• Study First Posted: 2020-09-21
• Study Start: 2020-10-02
• Primary Completion: 2021-10-05
• Study Completion: 2021-10-05
• Status Verified: 2021-11
• Last Update Submitted: 2021-11-12
• Last Update Posted: 2021-11-15

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 1342

Inclusion Criteria

• Female Geisinger Health Plan members turning 50 and 64 in that month
• For the 2020 campaign, birthdays from June 2020 (as opposed to August 2020) will be included due to a temporary suspension of the outreach program due to the COVID-19 pandemic since June
• For the pre-post examination of the 2019 campaign, all months in that year will be included

Exclusion Criteria

• Members who are on the do not contact list at Geisinger Health Plan

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: FACTORIAL

Arm && Interventions

Group	Intervention	Description
Mailer with Loss Frame, Risks, and Small Gift	Postcard	The postcard is enhanced with language that further emphasizes the risks but also clearly describes how early detection with a test can reduce those risks; a small gift is included.
Mailer with Loss Frame, Risks, and Small Gift	Small Gift	The postcard is enhanced with language that further emphasizes the risks but also clearly describes how early detection with a test can reduce those risks; a small gift is included.
Standard Mailer and Small Gift	Postcard	A postcard encourages mammograms and includes a small gift.
Mailer with Loss Frame, Risks, and Small Gift	Loss Frame and Fear Appeals	The postcard is enhanced with language that further emphasizes the risks but also clearly describes how early detection with a test can reduce those risks; a small gift is included.
Standard Mailer and Small Gift	Small Gift	A postcard encourages mammograms and includes a small gift.
Mailer with Loss Frame, Risks, and No Gift	Postcard	The postcard is enhanced with language that further emphasizes the risks but also clearly describes how early detection with a test can reduce those risks; the small gift is not included.
Mailer with Loss Frame, Risks, and No Gift	Loss Frame and Fear Appeals	The postcard is enhanced with language that further emphasizes the risks but also clearly describes how early detection with a test can reduce those risks; the small gift is not included.

Primary Outcome Measures

Name	Time	Method
Mammogram Completion at 6 months (2020)	6 months from intervention start date	Binary variable indicating whether a mammogram was completed

Secondary Outcome Measures

Name	Time	Method
Mammogram Completion at 12 months (2020)	12 months from intervention start date	Binary variable indicating whether a mammogram was completed (a longer time frame allows for late responses)
Breast Cancer Diagnosis at 6 months (2020)	6 months from intervention start date	Binary variable indicating whether the recipient was diagnosed with breast cancer
Breast Cancer Diagnosis at 12 months (2020)	12 months from intervention start date	Binary variable indicating whether the recipient was diagnosed with breast cancer
Emergency Department Visits at 12 months (2020)	12 months from intervention start date	Number of Emergency Department Visits (proxy for increased costly utilization of health system resources)
Obstetrician-Gynecologist Visits at 12 months (2020)	12 months from intervention start date	Number of visits (proxy for increased preventative health care)
Emergency Department Visits at 6 months (2020)	6 months from intervention start date	Number of Emergency Department Visits (proxy for increased costly utilization of health system resources)
Primary Care Provider Visits at 12 months (2020)	12 months from intervention start date	Number of visits (proxy for increased preventative health care)
Primary Care Provider Visits at 6 months (2020)	6 months from intervention start date	Number of visits (proxy for increased preventative health care)
Obstetrician-Gynecologist Visits at 6 months (2020)	6 months from intervention start date	Number of visits (proxy for increased preventative health care)

Trial Locations

Locations (1)

Geisinger; 🇺🇸 Danville, Pennsylvania, United States