Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jul 12, 2024
Open Peer Review Period: Jul 22, 2024 - Sep 16, 2024
Date Accepted: Nov 5, 2024
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Text message reminders cannot replace but can improve the effect of postal reminders to increase participation in colorectal cancer screening: a randomized controlled trial
ABSTRACT
Background:
Mobile phone text message reminders to increase colorectal cancer (CRC) screening participation have shown moderate effects.
Objective:
We assessed the effectiveness of text messages as a replacement for routine postal reminders in a fecal immunochemical test (FIT) based colorectal cancer screening program in Catalonia.
Methods:
We conducted a randomized controlled trial among individuals aged 50 to 69 invited to screening who had not completed FIT within six weeks. The intervention group (n=12,167) received a text message reminder, and the control group (n=12,221) used the standard procedure (reminder letter). The primary outcome was a participation rate within 18 weeks of the invitation. The trial was discontinued, and a recovery strategy was implemented by sending a reminder letter to non-participant individuals from the intervention group. We performed a final analysis to determine the impact of the recovery strategy.
Results:
Interim analysis (n=7095) showed a lower participation rate among non-participants within six weeks in the text message group compared to the control group (16.4% vs. 20.9%, OR 0.71, 95% CI 0.63–0.81). A total of 7591 non-participants in the text message group received a second reminder by letter, reaching a participation rate of 23%. Final analysis (n=24,388) showed that the intervention group, which received two reminders, had higher participation than the control group (29.3% vs. 26.5%, OR 1.16, 95% CI 1.09–1.23).
Conclusions:
Our attempt to replace reminder letters with text messages was unsuccessful, but receiving two reminders significantly increased participation rates among non-participants within six weeks compared to one postal reminder. Additional research is essential to determine the best timing and frequency of reminders to boost participation without being intrusive in their choice of participation. Clinical Trial: Clinicaltrials.gov NCT04343950, https://www.clinicaltrials.gov/study/NCT04343950 (04/09/2020).
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