Breast Cancer
Conditions
Keywords
Mass Screening, Communication, Mammography, Risk Reduction Behavior, Economics, Behavioral, Psychology, Loss Frame, Fear Appeals, Reciprocity
Brief summary
In this evaluation, 3 different versions of mailers promoting annual mammograms are being sent to women on the month of their 50th and 64th birthdays. The researchers hypothesize that the use of behavioral nudges in the mailers should lead to increased uptake in mammogram screening.
Detailed description
Mammogram screening for women, starting at age 50, can significantly reduce the risk of complications due to breast cancer. As part of an existing outreach campaign, the health system mails a postcard and small gift (pink socks) to women on the month of their 50th and 64th birthdays to promote annual mammogram screening. The researchers are evaluating two new versions of the mailers against a standard mailer to see which version leads to greater uptake in mammograms. The new mailers have content that applies behavioral nudge theory - specifically, loss frames and fear appeals - to encourage taking action. One of the two new versions does not include the small gift, to test whether its inclusion or exclusion has any effect on mammogram screening.
Interventions
BEHAVIORALPostcard
The postcard includes appeals to get annual mammograms and provides information for ordering a mammogram.
BEHAVIORALSmall Gift
Pink socks are included in the mailer. The gift increases salience of the mailer and it potentially promotes reciprocation from the recipient in the form of ordering a mammogram.
BEHAVIORALLoss Frame and Fear Appeals
The postcard is enhanced with language that frames the situation in terms of losses. It also uses fear appeals by stating the risks of breast cancer, while also stating that a mammogram screening is an accessible way to address those risks.
Sponsors
Geisinger Clinic
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
SCREENING
Masking
DOUBLE (Subject, Caregiver)
Masking description
Participants and providers are not aware of the different mailer versions.
Intervention model description
1 x 3 design
Eligibility
Sex/Gender
FEMALE
Age
50 Years to 64 Years
Healthy volunteers
Yes
Inclusion criteria
* Female Geisinger Health Plan members turning 50 and 64 in that month * For the 2020 campaign, birthdays from June 2020 (as opposed to August 2020) will be included due to a temporary suspension of the outreach program due to the COVID-19 pandemic since June * For the pre-post examination of the 2019 campaign, all months in that year will be included
Exclusion criteria
\- Members who are on the do not contact list at Geisinger Health Plan
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mammogram Completion at 6 months (2020) | 6 months from intervention start date | Binary variable indicating whether a mammogram was completed |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Obstetrician-Gynecologist Visits at 6 months (2020) | 6 months from intervention start date | Number of visits (proxy for increased preventative health care) |
| Breast Cancer Diagnosis at 6 months (2020) | 6 months from intervention start date | Binary variable indicating whether the recipient was diagnosed with breast cancer |
| Breast Cancer Diagnosis at 12 months (2020) | 12 months from intervention start date | Binary variable indicating whether the recipient was diagnosed with breast cancer |
| Emergency Department Visits at 6 months (2020) | 6 months from intervention start date | Number of Emergency Department Visits (proxy for increased costly utilization of health system resources) |
| Emergency Department Visits at 12 months (2020) | 12 months from intervention start date | Number of Emergency Department Visits (proxy for increased costly utilization of health system resources) |
| Mammogram Completion at 12 months (2020) | 12 months from intervention start date | Binary variable indicating whether a mammogram was completed (a longer time frame allows for late responses) |
| Primary Care Provider Visits at 6 months (2020) | 6 months from intervention start date | Number of visits (proxy for increased preventative health care) |
| Primary Care Provider Visits at 12 months (2020) | 12 months from intervention start date | Number of visits (proxy for increased preventative health care) |
| Obstetrician-Gynecologist Visits at 12 months (2020) | 12 months from intervention start date | Number of visits (proxy for increased preventative health care) |
Other
| Measure | Time frame | Description |
|---|---|---|
| Breast Cancer Diagnosis at 12 months (2019) | 12 months from 2019 intervention start date | Binary variable indicating whether the woman was diagnosed with breast cancer |
| Emergency Department Visits at 12 months (2019) | 12 months from 2019 intervention start date | Number of Emergency Department Visits (proxy for increased costly utilization of health system resources) |
| Primary Care Provider Visits at 12 months (2019) | 12 months from 2019 intervention start date | Number of visits to be used for exploratory pre-post comparisons (proxy for increased preventative health care) |
| Mammogram Completion at 12 months (2019) | 12 months from 2019 intervention start date | Binary variable indicating whether a mammogram was completed to be used for exploratory pre-post comparisons |
Countries
United States
Outcome results
None listed