ASPO Abstracts

Live Phone Calls More Effective than Automated Reminders for a Direct-Mail Fecal Testing Program in Community Health Centers

Authors: Coronado GD, Thompson JH, Petrik AF, Leo MC, Nyongesa DB, Davis MM, Younger BM, Castillo ML, Escaron AL

Category: Cancer Health Disparities
Conference Year: 2019

Abstract Body:
Purpose: Our study seeks to raise rates of colon cancer screening in a Latino-serving community health center. Using patient-refined materials, we examined FIT completion rates following automated and live approaches in a 3-arm pilot pragmatic trial.Methods: Eligible participants were ages 50 — 75 years, not up-to-date with colon cancer screening, and had a clinic visit in each of the previous two years at either of two health center clinics. A total of 1,767 participants were randomized (1:1:1) to receive: a text alert, mailed FIT, and two automated phone call reminders (automated); a mailed FIT and up to three live call reminders (live); or the combination of text alert, mailed FIT, two automated call reminders, and up to three live call reminders (automated plus live). The format and content of the messages were selected using a patient-engagement approach, boot camp translation. We assessed FIT return rates in the three arms.Results: Among randomized participants (n=1,767), 553 (31.3%) completed a FIT within 6 months. Participants had a mean age of 59 years and 57% were female. FIT completion rates were 26.0% (automated), 32.3% (live), and 35.7% (automated plus live). Controlling for clinic, adults allocated to the live condition had a significantly higher FIT completion rate than those in the automated condition (Adjusted Difference = 6.3 percentage points, 95% CI [1.1, 11.4]), as did adults allocated to the automated plus live condition (Adjusted Difference=9.7 percentage points, 95% CI [4.4, 14.9]). FIT completion rates differed significantly by preferred language (English: 25.5%; Spanish 35.1%; Other 39.7%; p < .01); number of clinic visits in the past year (Yes: 33.9% vs. No: 21.2%; p < .01); and prior FIT testing (Yes: 45.1% vs. No: 17.1%; p < .01). No significant interactions were observed between treatment conditions and language, number of clinic visits, or prior FIT testing.Conclusion: Live call reminders, either alone or with automated alerts and reminders, outperformed automated approaches alone. Using multiple touchpoints and communication modes might have the greatest impact on FIT completion rates.

Keywords: colon cancer screening, Latino,