Behavioral Economic Incentives and Cancer Health Risk Assessment

Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. Despite effective screening and treatment strategies, screening rates remain at 59-65%. UPHS employees have similarly limited rates of CRC screening despite having awareness, access, and insurance coverage. There is a need to identify those who are not up-to-date on screening and eligible for outreach in this population. Financial incentives informed by behavioral economic principles could be used to encourage self-report about screening status and completion of CRC screening. This research utilizes a digital health platform, Way to Health, to evaluate the feasibility of a cancer health risk assessment. This is a single-center RCT among UPHS employees between ages 50-64 that will randomize eligible participants into one of two study arms: (1) no incentive to complete cancer health risk assessment (no incentive) or (2) loss-framed incentive to complete cancer health risk assessment (incentive). Those that are eligible for screening will receive a direct access phone number to schedule colonoscopy, with an additional unconditional incentive for those in incentive arm. The primary outcome is completion of screening colonoscopy, with secondary outcomes of colonoscopy scheduling and completion of risk assessment.