Breast Cancer
Conditions
Keywords
Mammography, Preventive Screening, Population Health
Brief summary
This project aims to evaluate different approaches to increase breast cancer screening among primary care patients at Penn Medicine through a centralized screening outreach program. In a pragmatic trial, the investigators will evaluate different approaches to increase completion of screening among eligible patients, including ordering mammograms in bulk prior to outreach, sending personalized text reminders, and endorsing of the communication by the primary care provider.
Detailed description
While mammograms are recommended by guidelines for early detection of breast cancer, mammogram rates are significantly lower now than they were prior to the initial COVID-19 pandemic surge in early 2020. In this project, the investigators will evaluate different ways of reaching out to eligible patients to encourage them to participate in breast cancer screening. Through letters, texting, and the electronic health record portal (MyPennMedicine (MPM)), the investigators will compare mammogram bulk orders, text messaging, and primary care provider endorsement to traditional outreach messaging with the goal of increasing breast cancer screening uptake.
Interventions
BEHAVIORALBulk Order
A mammogram order will be placed using bulk order technology in the EHR in advance of outreach for all patients.
BEHAVIORALTexting
In addition to outreach, patients will receive text messaging with information regarding the importance of screening, how to schedule a mammogram, and locations available for mammography.
BEHAVIORALClinician Endorsement
Outreach informing patients that they are overdue for a mammogram will be signed by the patient's primary care provider.
BEHAVIORALNo Bulk Order
The outreach will ask patients to contact their PCP's office in order to have a mammogram order placed on their behalf.
BEHAVIORALStandard Endorsement
Patient's will receive outreach from the practice informing them that they are overdue for a mammogram.
Sponsors
Abramson Cancer Center at Penn Medicine
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
SCREENING
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
FEMALE
Age
40 Years to 74 Years
Healthy volunteers
No
Inclusion criteria
1. Women ages 40-74 2. Followed by Primary Care with a Penn Medicine PCP listed and at least one visit in the last 2 years 3. Health Maintenance due (default biannual screening starting at age 50 or edit modifier based on input by clinician)
Exclusion criteria
1. Currently scheduled for a mammogram 2. History of bilateral mastectomy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mammogram Completion in 3 months | 3 months | Percent of patients that complete a mammogram |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mammogram Completion in 6 months | 6 months | Percent of patients that complete a mammogram |
Other
| Measure | Time frame | Description |
|---|---|---|
| Mammogram Positivity Rate | 3 months | Percent of mammograms that have positive results |
| Mammogram Completion by Age Groups | 3 months | Percent of patients that complete a mammogram by age groups |
| Mammogram Completion by Median Household Income by Zip Code | 3 months | Percent of patients that complete a mammogram by Median Household Income by zip code |
| Mammogram Completion by Insurance Type | 3 months | Percent of patients that complete a mammogram by insurance type |
| Mammogram Completion by Electronic Patient Portal Status | 3 months | Percent of patients that complete a mammogram by electronic patient portal status |
| Mammogram Completion by Race/Ethnicity | 3 months | Percent of patients that complete a mammogram by race/ethnicity |
| Positive Mammograms Resulting in Subsequent Care | 3 months | Percent of patients with a positive mammogram that receive subsequent care |
Countries
United States
Outcome results
None listed