A Practical Strategy of Informatics, Geospatial Mapping, Geodemographic Segmentation, and Regression Analyses to...

Geodemographic segmentation (GDS) is a business-based methodology that groups customers into "segments" based on similarities and designs directed marketing campaigns. GDS is an underutilized resource in medicine but holds much potential to encourage patients to follow evidence-based guidelines.

Our strategy highlights the use of informatics, Geographic Information Systems, regression, and GDS methodologies to solve the problem of nonadherence to cancer screening. We examined adherence to colorectal cancer screening by fecal immunochemical test in a cohort (N = 15,944) of average-risk US veterans at a mid-sized healthcare system. Processes included a priori covariate selection, data query, Geographic Information System, GDS, and regression analyses. Specifically, GDS software linked adherence and addresses to GDS database neighborhood "portraits."

More than half (56%) of all subjects were nonadherent. Hot spot geospatial analysis revealed clusters of low adherence. Using individual-level data and the 23 GDS portraits, regression analysis showed significantly lower adherence in subjects of younger age, Hispanic ethnicity, and/or living in one of seven portraits. GDS provided rich, contextual knowledge about the neighborhoods of our nonadherent patients, including how residents seek out information (e.g., television, social media).

This work demonstrated an approach revealing "who" within our clientele were at risk for nonadherence, "where" these patients live, and "how" adherent screening behavior might be promoted to them.

This strategy advocates for GDS resource utilization to motivate adherence in patient subsets in the same way businesses successfully deliver persuasive messages tailored to different segments of their clientele.