Colorectal Cancer
Conditions
Keywords
Behavioral: Automated Mailing
Brief summary
The investigators propose to build on the success of the Systems of Support to Increase Colorectal Cancer trial (SOS, R01CA121125, Green) and focus on disparity groups who are less likely to be current for colorectal cancer (CRC) screening. We will test whether financial incentives increases screening uptake and decreases screening disparities. The investigators hypothesize that CRC screening rates will be higher in patients offered mailed fecal kits and financial incentives than those offered mailed fecal kits alone.
Detailed description
Study staff will send invitation letters and a questionnaire to 5,000 patients aged 50-75 not current for CRC screening, two-thirds who are identified in the electronic data as being from a non-White race, ethnicity, or who have Medicaid coverage. Those returning the survey and remaining eligible (estimated N = 1150) will be randomized to either (1) Mailed fecal kit only, or mailed fecal kit plus one of 2 types of financial incentives for completing testing: (2) a guaranteed Monetary incentive or (3) a probabilistic Lottery incentive.
Interventions
BEHAVIORALAuto Mailing Plus Money
Participant receives money as a thank you for completing CRC screening within 6 months.
BEHAVIORALAuto Mailing Plus Lottery
Participant has a 1 in 10 chance of winning money in a lottery for completing CRC screening within 6 months.
Sponsors
University of Michigan
University of Texas
Kaiser Permanente
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SCREENING
Masking
SINGLE (Outcomes Assessor)
Masking description
The randomization sequence will be concealed to everyone except the study biostatistician.
Eligibility
Sex/Gender
ALL
Age
50 Years to 75 Years
Healthy volunteers
Yes
Inclusion criteria
* No evidence in electronic data of FIT screening in past year or a colonoscopy in the prior 9 years. * Continuously enrolled in Group Health Cooperative (GHC) for at least one year. * Patients who have Medicaid coverage or are non-white race or Hispanic any race.
Exclusion criteria
* Known high risk for CRC * History of CRC * History of inflammatory bowel disease * Current anticoagulation therapy * Organ failure * Serious illness * Debilitating disease * Dementia * Nursing home resident
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| CRC Screening Within 6 Months Following Randomization | 6 months | We will compare among the 3 arms (1) automated mailing; (2) Auto mailing plus $10; (3) Auto mailing plus $50 lottery for completion and the effect of each on CRC screening completion at 6 months (yes/no) within the following subgroups of each arm: 1. White and not Hispanic versus non-White or Hispanic. 2. Medicaid versus non-Medicaid (Medicare, employer-based, private) insurance. 3. History of prior versus no prior completion of CRC screening tests. 4. High school or less versus college or more education level. |
Countries
United States
Outcome results
None listed