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Behavioral Interventions to Improve Breast Cancer Screening Outreach: Two Randomized Clinical Trials.

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Bulk ordering and text messaging significantly increased breast cancer screening mammogram completion rates. Clinician endorsement did not significantly impact screening rates, but text messaging did.

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Area of Science:

  • Public Health
  • Preventive Medicine
  • Oncology

Background:

  • Breast cancer screening rates remain below national goals despite public health initiatives.
  • Effective strategies are needed to improve mammogram completion rates.

Purpose of the Study:

  • To evaluate the effectiveness of bulk ordering, text messaging, and clinician endorsement in increasing breast cancer screening rates.
  • To assess the impact of these interventions on mammogram completion within three months.

Main Methods:

  • Two concurrent pragmatic randomized clinical trials with a 2x2 factorial design were conducted.
  • Participants included women aged 40-74 eligible for breast cancer screening.
  • Interventions included bulk mammogram orders, text message reminders, and clinician-endorsed messages.

Main Results:

  • Bulk ordering increased mammogram completion by 2.7% (P<.001).
  • Text messaging increased mammogram completion by 2.1% in Trial A (P<.001) and 2.5% in Trial B (P=.003).
  • Clinician endorsement did not significantly increase mammogram completion (1.1% difference, P=.18).

Conclusions:

  • Bulk ordering and text messaging are effective strategies to increase mammogram completion rates.
  • Text messaging, particularly after initial outreach, can improve screening adherence.
  • Further research may explore optimizing clinician endorsement strategies.