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Comparative Effectiveness of Text + Video vs Text Alone to Prompt Stool-Based Testing for Colorectal Cancer

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|October 3, 2025
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Summary
This summary is machine-generated.

Adding instructional videos to text message reminders for colorectal cancer (CRC) screening did not significantly increase fecal immunochemical test (FIT) return rates. Further research is needed to optimize text message outreach for CRC screening effectiveness.

Keywords:
colorectal cancerstool-based testingtextvideo-text

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Area of Science:

  • Public Health
  • Preventive Medicine
  • Health Communication

Background:

  • Colorectal cancer (CRC) remains a leading cause of cancer mortality in the US.
  • Mailed fecal immunochemical testing (FIT) outreach is a key CRC screening method.
  • Text message reminders improve FIT return, but the impact of instructional videos is unknown.

Purpose of the Study:

  • To evaluate if adding instructional videos to text messages enhances FIT return rates for CRC screening.
  • To compare the effectiveness of text-only reminders versus text-plus-video reminders.

Main Methods:

  • A randomized study at Kaiser Permanente Northwest included 12,346 patients aged 45-75 due for CRC screening.
  • Participants were assigned to receive either text-only reminders or text reminders with a link to an instructional video.
  • Cox regression analysis compared FIT completion rates at 90 and 180 days post-randomization.

Main Results:

  • No significant difference in FIT return rates was observed between the text-alone group and the text-plus-video group at 90 days (HR, 1.02; P=.54) or 180 days (HR, 1.00; P=.78).
  • Patient demographics were similar across both study groups.
  • The addition of instructional videos did not boost FIT return rates compared to text messages alone.

Conclusions:

  • Instructional videos, when added to text message reminders, did not improve fecal immunochemical test return rates for colorectal cancer screening in this study population.
  • Future research should explore methods to assess message receipt and optimize the effectiveness of text-based outreach strategies for CRC screening.