Health Promotion, Prevention, Risk Reduction Behavior
Conditions
Brief summary
The goal of this study is to determine the most effective messages for encouraging patients with chronic conditions, who have not seen their doctor in at least one year, to return to the clinic. Study participants will receive postcards or letters encouraging them to make an appointment. Researchers will assess whether messages increase appointment scheduling (and attendance).
Detailed description
About 18,500 Geisinger patients, Geisinger Health Plan members, and Medicaid patients with chronic illness have not been seen in a clinic for at least one year, which is concerning because regular appointments are necessary for chronic disease management. Geisinger is therefore working to encourage those with chronic illness and overdue appointments to return to the clinic. In the present study, patients will either receive a mailer (with a message encouraging them to schedule an appointment with their physician), or no mailer. The purpose of the study is to compare three different mailers to assess which is most effective at encouraging patients to schedule and attend an appointment. The three mailers include (1) a standard outreach postcard (emphasizing that we are checking in with the patient), and, informed by behavioral science research, (2) a postcard with a cartoon and humorous messages and (3) a letter signed by a physician. The study will compare the effectiveness of the three experimental mailer arms to each other and to a no-contact control arm.
Interventions
BEHAVIORALOutreach mailer
Postcard or letter
BEHAVIORALHumor/Salience
Funny cartoon
BEHAVIORALDoctor's authority
Letter from a doctor
BEHAVIORALInformation
Information about benefits of the appointment
Sponsors
Geisinger Clinic
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE (Subject, Caregiver)
Masking description
Participants will not be informed specifically of their assignment to different arms throughout the study. Providers who conduct appointments will not be randomized to study arms or informed of patient assignment.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Geisinger patient, Geisinger Health Plan member or Medicaid patient * Chronic illness * No appointment for \> 1 year
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patients - Appointment scheduling | 30 days | Proportion of Geisinger patients who schedule an appointment |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patients - Appointment scheduling - Comparing mailers | 30 days | Proportion of Geisinger patients who schedule an appointment, comparing relative efficacy of the mailers |
| Patients - Attendance at scheduled appointments within 180 days of mailer | 180 days | Proportion of appointments (from the primary outcome) that were attended. This outcome focuses on attendance at appointments that were scheduled within 30 days of the mailer drop date. It is possible to schedule an appointment months in advance, so the Time Frame needs to be long to capture attendance at any appointment scheduled within 30 days of the mailer. 180 days should be sufficient to capture all scheduled appointments. |
| Patients, Members & Medicaid - Attendance at any appointment | 30 days | Attendance at any appointment within 30 days of drop date |
| Patients, Members & Medicaid - Timing of appointment | 30 days | Number of days between the drop date and any appointment captured in Secondary Outcome 3 |
Other
| Measure | Time frame | Description |
|---|---|---|
| Patients - Appointment scheduling - Comparing mailers | 14 days | Proportion of Geisinger patients who schedule an appointment, comparing relative efficacy of the interventions. Note: this analysis will inform internal operations but will not be reported in publication. |
| Patients - Calls to scheduling line | 30 days | Proportion of Geisinger patients who call the appointment scheduling line. |
Countries
United States
Outcome results
None listed