Evaluation of Letters Enhanced With Behavioral Nudges to Promote Colorectal Cancer Testing Through Fecal Immunochemical Tests or Colonoscopies
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 14,644
- 试验地点
- 1
- 主要终点
- FIT Kit Return at 6 months
研究概览
简要总结
In this evaluation, 4 different versions of letters are being sent with mailers promoting colorectal cancer screening with an at-home test. The researchers hypothesize that the use of behavioral nudges in the message should lead to increased colorectal cancer screening (either with the at-home test or a colonoscopy).
详细描述
Colorectal cancer (CRC) is the third most common cancer diagnosed in the US. Mailing fecal immunochemical (FIT) kits to at-risk patients is an effective way of increasing CRC testing uptake, as this test can be done at home and is less intrusive compared to colonoscopies. As part of an existing program, the health system mails FIT kits to eligible patients each year. Although this test needs to be conducted annually, not everyone who receives the test kit returns the kits for processing. In this study, the researchers aim to test different letters with the goal of encouraging the use of FIT kits or scheduling a colonoscopy.
As part of this study, the kits are mailed with everything the patient will need to conduct the test at home and mail a sample back to the hospital. It also includes an introductory letter informing the patient about the program and inviting them to use the kit. The researchers are comparing a standard version of the introductory letter against 3 versions that include different combinations of behavioral nudges, specifically framing effects (loss, default, decoy) and fear appeals.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Factorial
- 主要目的
- Screening
- 盲法
- Double (Participant, Care Provider)
盲法说明
Participants and providers are not aware of the different letter versions.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Enrollment in Medicare Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO; age 65 and older) or Commercial HMO in one large employer's group
- •Has a flag indicating that the person is due for a colon cancer screening
排除标准
- •Members who are on the do not contact list at Geisinger Health Plan
研究组 & 干预措施
Standard Letter
The standard letter describes the importance of getting screened and instructs recipients how to use the FIT kit for screening at home.
干预措施: Letter (Behavioral)
Letter with Risks
The standard letter is enhanced with language that further emphasizes the risks but also clearly describes how early detection with a test can reduce those risks; it also explains why test kits are being sent to disarm skepticism about the program.
干预措施: Letter (Behavioral)
Letter with Risks
The standard letter is enhanced with language that further emphasizes the risks but also clearly describes how early detection with a test can reduce those risks; it also explains why test kits are being sent to disarm skepticism about the program.
干预措施: Loss Frame and Fear Appeals (Behavioral)
Letter with Risks
The standard letter is enhanced with language that further emphasizes the risks but also clearly describes how early detection with a test can reduce those risks; it also explains why test kits are being sent to disarm skepticism about the program.
干预措施: Transparency (Behavioral)
Letter with Risks and Options
In addition to the enhancements added by the letter with risks, the letter also includes a table comparing FIT kit and colonoscopy. Presenting different screening options allows recipients to make the choice that best suits them. In addition, presenting multiple options increases the chance that recipients get screened in one way or another.
干预措施: Letter (Behavioral)
Letter with Risks and Options
In addition to the enhancements added by the letter with risks, the letter also includes a table comparing FIT kit and colonoscopy. Presenting different screening options allows recipients to make the choice that best suits them. In addition, presenting multiple options increases the chance that recipients get screened in one way or another.
干预措施: Loss Frame and Fear Appeals (Behavioral)
Letter with Risks and Options
In addition to the enhancements added by the letter with risks, the letter also includes a table comparing FIT kit and colonoscopy. Presenting different screening options allows recipients to make the choice that best suits them. In addition, presenting multiple options increases the chance that recipients get screened in one way or another.
干预措施: Default Effect and Presentation of Alternatives (Behavioral)
Letter with Risks and Options
In addition to the enhancements added by the letter with risks, the letter also includes a table comparing FIT kit and colonoscopy. Presenting different screening options allows recipients to make the choice that best suits them. In addition, presenting multiple options increases the chance that recipients get screened in one way or another.
干预措施: Enhanced Fear Appeals and Decoy Effect (Behavioral)
Letter with Risks, Options, and Consequences for Inaction
In addition to the enhancements added by the letter with risk, the comparison table includes comparisons of the consequences of getting screened vs. waiting for symptoms to appear.
干预措施: Letter (Behavioral)
Letter with Risks, Options, and Consequences for Inaction
In addition to the enhancements added by the letter with risk, the comparison table includes comparisons of the consequences of getting screened vs. waiting for symptoms to appear.
干预措施: Loss Frame and Fear Appeals (Behavioral)
Letter with Risks, Options, and Consequences for Inaction
In addition to the enhancements added by the letter with risk, the comparison table includes comparisons of the consequences of getting screened vs. waiting for symptoms to appear.
干预措施: Enhanced Fear Appeals and Decoy Effect (Behavioral)
结局指标
主要结局
FIT Kit Return at 6 months
时间窗: 6 months from intervention start date
Binary variable indicating whether a valid FIT kit was returned for testing
Colonoscopy Ordered at 6 months
时间窗: 6 months from intervention start date
Binary variable indicating whether a colonoscopy was ordered
次要结局
- FIT Kit Return at 12 months(12 months from intervention start date)
- FIT Kit Result(12 months from intervention start date)
- Colonoscopy Result(12 months from intervention start date)
- Colonoscopy Completed(12 months from intervention start date)
- Colonoscopy Ordered at 12 months(12 months from intervention start date)
研究者
Amir Goren
Program Director, Behavioral Insights Team
Geisinger Clinic