ASPO Abstracts
The Acceptability of Text Messaging to Reach Racially Diverse Adults Eligible for Colorectal Cancer Screening
Category: Cancer Health Disparities
Conference Year: 2021
Abstract Body:
Purpose. Healthcare organizations increasingly are looking for ways to support shared decision making (SDM). Patient portals enable secure messaging and integration with medical records, but their use leads to racial inequities in program reach. We explored perceptions of and willingness to engage with three types of text message content for SDM in colorectal cancer (CRC) screening. Methods. We identified adults aged 50-75 years via an online panel. Sampling quotas ensured no more than half the sample was White and 27% had not previously screened for CRC. Participants were allocated randomly to three message conditions: general support (if you think colon cancer affects only a certain type of person, you are not alone), doctor's office support (your doctor's office is here to help you take control of your health), and standard (some colon cancers run in families, but most don't). Participants viewed messages on their phones and responded to questions using 5-point Likert scales to indicate salience, worry and willingness to receive future messages. Results. Participants (N=291) on average were aged 60 years (6.6 SD), 69% female, and 10% Asian/51% Black/38% White. Almost half had a college degree (48%), and 40% reported household income <$50,000. Regardless of condition, over half (57%) reported initial message salience (grabbed their attention quite a bit/very much), few reported worried feelings (<9% quite a bit/very much), and 74% expressed a willingness (agreed/strongly agreed) to get similar messages from their doctor's office. Whites expressed less salience (50%) and less worry (4%) compared to Blacks (61%/12%) and Asians (62%/14%). Blacks were substantially more willing to sign up for future messages (82% vs. 69% Asians/63% Whites). Among Blacks, general support and doctor's office support messages outperformed standard messages; general support and standard messages outperformed doctor's office support among Whites. Conclusions. Among an online sample, we found support for text messaging to engage racially diverse adults in CRC screening decisions. Blacks reported a willingness to use text messaging to learn about CRC screening, particularly if messaging contained supportive language. Further testing among primary care patient populations is ongoing.
Keywords: Colorectal cancer screening, test messages, and shared decision making