Colorectal Cancer
Conditions
Keywords
screening, colon cancer, incentives, behavioral economics
Brief summary
This is a 4-arm cluster randomized controlled trial to evaluate whether patient financial incentives directly integrated into primary care can improve fecal occult blood test (FOBT) completion rates. We will recruit primary care patients at the Philadelphia Veterans Affairs Medical Center (PVAMC) in 2 stages. In stage 1, we hypothesize that, compared to usual care, $5, $10, $20 incentives will each lead to a statistically significant increase in the rate of FOBT completion. We also hypothesize that there will be a direct dose-response relationship between the incentive amount and rates of FOBT completion. In stage 2, we hypothesize that a lottery-based incentive and a raffle-based incentive will both lead to a statistically significant increase in the rate of FOBT completion compared to a fixed payment incentive with an equivalent dollar per patient value.
Interventions
BEHAVIORALStage 1
Patients who are prescribed an FOBT kit in one of the PVAMC Primary Care clinics (i.e., Module B or C) will be randomly assigned by day to one of 4 study arms. All FOBT kits will include a card with a description of the arm that the patient has been randomized to.
BEHAVIORALStage 2
Patients who are prescribed an FOBT kit in one of the PVAMC Primary Care clinics (i.e., Module B or C) will be randomly assigned by day to one of 4 study arms. All FOBT kits will include a card with a description of the arm that the patient has been randomized to. The exact dollar amounts for the Voucher-Based Incentive, Lottery-Based Incentive, and Raffle-Based Incentive arms will be based on the results of Stage 1.
Sponsors
VA Pittsburgh Healthcare System
Corporal Michael J. Crescenz VA Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
MALE
Healthy volunteers
No
Inclusion criteria
* PVAMC outpatients who are prescribed an FOBT kit in Module B or C during the study period.
Exclusion criteria
* None. All PVAMC outpatients who are prescribed an FOBT kit in Module B or C during the study period will be eligible.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| FOBT completion and return | 30 days |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| FOBT completion rate among previously non-adherent patients and FOBT kit return time by arm | 30 days | There are 2 secondary outcomes. First, we will compare time to FOBT kit return by arm. Second, we will compare 30 day FOBT completion rates among previously non-adherent patients (i.e., individuals who had failed to complete a prescribed FOBT kit in the year prior to the start of the study) by arm. |
Countries
United States
Outcome results
None listed