Lung Cancer
Conditions
Keywords
Lung Cancer Screening
Brief summary
The primary purpose of this study evaluate if different messaging impacts response rates to a brief survey (i.e., the simplified eligibility tool) that is designed to estimate pack-year eligibility for lung cancer screening (LCS). This will help inform the best way to increase response rates to the tool in future intervention studies designed to increase LCS, and expand upon survey methodology in general.
Detailed description
Despite growing evidence that lung cancer screening (LCS) reduces lung cancer-specific mortality, LCS across the United States is remarkably low. This is due in part to challenges with identifying adults who meet eligibility criteria for lifetime smoking intensity (i.e., 20 pack-years or greater), which is often missing from the electronic medical record. We have developed a simplified eligibility tool that has shown accuracy in estimating pack-years. But given the potential for low response rates, there is a great need to identify effective strategies to increasing response rates equitably prior to using it in practice or in future studies. The primary purpose of this study evaluate if different messaging impacts response rates to a brief survey (i.e., the simplified eligibility tool) that is designed to estimate pack-year eligibility for lung cancer screening (LCS). This will help to identify the best way to increase response rates to the tool in future intervention studies designed to increase LCS, and expand upon survey methodology in general.
Interventions
BEHAVIORALFramed Introductory Message A
Randomly assign patients to receive introductory message encouraging them to complete the survey (version A).
BEHAVIORALFramed Introductory Message B
Randomly assign patients to receive introductory message encouraging them to complete the survey (version B).
BEHAVIORALFramed Introductory Message C
Randomly assign patients to receive introductory message encouraging them to complete the survey (version C).
BEHAVIORALFramed Tobacco Use Message A
Randomly assign patients to receive norming message related to tobacco use (version A).
BEHAVIORALFramed Tobacco Use Message B
Randomly assign patients to receive norming message related to tobacco use (version B).
BEHAVIORALFinancial Incentive
Randomly assigned patients to be entered into a drawing to receive a $100 gift card.
Sponsors
National Institutes of Health (NIH)
National Cancer Institute (NCI)
Abramson Cancer Center at Penn Medicine
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Outcomes Assessor)
Intervention model description
We will use a randomized factorial design to test the effects of different types of messaging with or without incentives on response rates to an eligibility survey.
Eligibility
Sex/Gender
ALL
Age
50 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. meet age eligibility (50-80 years old) for LCS based on 2021 USPSTF guidelines; and 2. have completed at least one primary care visit at Penn Medicine in 2020-2025
Exclusion criteria
1. have a documented history of lung cancer; 2. have a documented history of completing LCS at Penn Medicine; 3. are listed as not wanting to be contacted or solicited for research; or 4. do not otherwise meet inclusion criteria.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Full Survey Completion | 7 days | The proportion of participants that answers all three survey questions via text message among all those randomized. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Partial Survey Completion | 7 days | The proportion of participants that answer at least one of three survey questions via text message among all those randomized. |
Countries
United States
Participant flow
Pre-assignment details
No significant events
Participants by arm
| Arm | Count |
|---|---|
| Arm 1 (Introductory Message A + Tobacco Use Message A + Incentive) Participants will receive two framed messages (AA) plus an incentive
Framed Introductory Message A: Randomly assign patients to receive introductory message encouraging them to complete the survey (version A).
Framed Tobacco Use Message A: Randomly assign patients to receive norming message related to tobacco use (version A).
Financial Incentive: Randomly assigned patients to be entered into a drawing to receive a $100 gift card. | 509 |
| Arm 2 (Introductory Message A + Tobacco Use Message A) Participants will receive two framed messages (AA)
Framed Introductory Message A: Randomly assign patients to receive introductory message encouraging them to complete the survey (version A).
Framed Tobacco Use Message A: Randomly assign patients to receive norming message related to tobacco use (version A). | 509 |
| Arm 3 (Introductory Message A + Tobacco Use Message B + Incentive) Participants will receive two framed messages (AB) plus an incentive
Framed Introductory Message A: Randomly assign patients to receive introductory message encouraging them to complete the survey (version A).
Framed Tobacco Use Message B: Randomly assign patients to receive norming message related to tobacco use (version B).
Financial Incentive: Randomly assigned patients to be entered into a drawing to receive a $100 gift card. | 515 |
| Arm 4 (Introductory Message A + Tobacco Use Message B) Participants will receive two framed messages (AB)
Framed Introductory Message A: Randomly assign patients to receive introductory message encouraging them to complete the survey (version A).
Framed Tobacco Use Message B: Randomly assign patients to receive norming message related to tobacco use (version B). | 509 |
| Arm 5 (Introductory Message B + Tobacco Use Message A + Incentive) Participants will receive two framed messages (BA) plus an incentive
Framed Introductory Message B: Randomly assign patients to receive introductory message encouraging them to complete the survey (version B).
Framed Tobacco Use Message A: Randomly assign patients to receive norming message related to tobacco use (version A).
Financial Incentive: Randomly assigned patients to be entered into a drawing to receive a $100 gift card. | 510 |
| Arm 6 (Introductory Message B + Tobacco Use Message A) Participants will receive two framed messages (BA)
Framed Introductory Message B: Randomly assign patients to receive introductory message encouraging them to complete the survey (version B).
Framed Tobacco Use Message A: Randomly assign patients to receive norming message related to tobacco use (version A). | 510 |
| Arm 7 (Introductory Message B + Tobacco Use Message B + Incentive) Participants will receive two framed messages (BB) plus an incentive
Framed Introductory Message B: Randomly assign patients to receive introductory message encouraging them to complete the survey (version B).
Framed Tobacco Use Message B: Randomly assign patients to receive norming message related to tobacco use (version B).
Financial Incentive: Randomly assigned patients to be entered into a drawing to receive a $100 gift card. | 512 |
| Arm 8 (Introductory Message B + Tobacco Use Message B) Participants will receive two framed messages (BB)
Framed Introductory Message B: Randomly assign patients to receive introductory message encouraging them to complete the survey (version B).
Framed Tobacco Use Message B: Randomly assign patients to receive norming message related to tobacco use (version B). | 509 |
| Arm 9 (Introductory Message C + Tobacco Use Message A + Incentive) Participants will receive two framed messages (CA) plus an incentive
Framed Introductory Message C: Randomly assign patients to receive introductory message encouraging them to complete the survey (version C).
Framed Tobacco Use Message A: Randomly assign patients to receive norming message related to tobacco use (version A).
Financial Incentive: Randomly assigned patients to be entered into a drawing to receive a $100 gift card. | 511 |
| Arm 10 (Introductory Message C + Tobacco Use Message A) Participants will receive two framed message (CA)
Framed Introductory Message C: Randomly assign patients to receive introductory message encouraging them to complete the survey (version C).
Framed Tobacco Use Message A: Randomly assign patients to receive norming message related to tobacco use (version A). | 511 |
| Arm 11 (Introductory Message C + Tobacco Use Message B + Incentive) Participants will receive two framed messages (CB) plus an incentive
Framed Introductory Message C: Randomly assign patients to receive introductory message encouraging them to complete the survey (version C).
Framed Tobacco Use Message B: Randomly assign patients to receive norming message related to tobacco use (version B).
Financial Incentive: Randomly assigned patients to be entered into a drawing to receive a $100 gift card. | 509 |
| Arm 12 (Introductory Message C + Tobacco Use Message B) Participants will receive two framed messages (CB)
Framed Introductory Message C: Randomly assign patients to receive introductory message encouraging them to complete the survey (version C).
Framed Tobacco Use Message B: Randomly assign patients to receive norming message related to tobacco use (version B). | 511 |
| Total | 6,125 |
Baseline characteristics
| Characteristic | Arm 1 (Introductory Message A + Tobacco Use Message A + Incentive) | Arm 2 (Introductory Message A + Tobacco Use Message A) | Arm 3 (Introductory Message A + Tobacco Use Message B + Incentive) | Arm 4 (Introductory Message A + Tobacco Use Message B) | Arm 5 (Introductory Message B + Tobacco Use Message A + Incentive) | Arm 6 (Introductory Message B + Tobacco Use Message A) | Arm 7 (Introductory Message B + Tobacco Use Message B + Incentive) | Arm 8 (Introductory Message B + Tobacco Use Message B) | Arm 9 (Introductory Message C + Tobacco Use Message A + Incentive) | Arm 10 (Introductory Message C + Tobacco Use Message A) | Arm 11 (Introductory Message C + Tobacco Use Message B + Incentive) | Arm 12 (Introductory Message C + Tobacco Use Message B) | Total |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | 65.02 years STANDARD_DEVIATION 0.35 | 64.33 years STANDARD_DEVIATION 0.33 | 64.50 years STANDARD_DEVIATION 0.33 | 64.48 years STANDARD_DEVIATION 0.34 | 64.15 years STANDARD_DEVIATION 0.33 | 64.67 years STANDARD_DEVIATION 0.34 | 64.21 years STANDARD_DEVIATION 0.33 | 63.33 years STANDARD_DEVIATION 0.35 | 64.56 years STANDARD_DEVIATION 0.33 | 64.28 years STANDARD_DEVIATION 0.36 | 64.40 years STANDARD_DEVIATION 0.33 | 63.89 years STANDARD_DEVIATION 0.32 | 64.32 years STANDARD_DEVIATION 0.1 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 7 Participants | 14 Participants | 15 Participants | 11 Participants | 16 Participants | 10 Participants | 8 Participants | 15 Participants | 16 Participants | 9 Participants | 9 Participants | 6 Participants | 136 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 502 Participants | 495 Participants | 500 Participants | 498 Participants | 494 Participants | 500 Participants | 504 Participants | 494 Participants | 495 Participants | 502 Participants | 500 Participants | 505 Participants | 5989 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 1 Participants | 1 Participants | 2 Participants | 0 Participants | 2 Participants | 2 Participants | 0 Participants | 1 Participants | 1 Participants | 4 Participants | 3 Participants | 4 Participants | 21 Participants |
| Race (NIH/OMB) Asian | 6 Participants | 6 Participants | 6 Participants | 12 Participants | 8 Participants | 8 Participants | 10 Participants | 8 Participants | 5 Participants | 7 Participants | 14 Participants | 7 Participants | 97 Participants |
| Race (NIH/OMB) Black or African American | 94 Participants | 94 Participants | 95 Participants | 93 Participants | 95 Participants | 95 Participants | 95 Participants | 94 Participants | 94 Participants | 94 Participants | 94 Participants | 94 Participants | 1131 Participants |
| Race (NIH/OMB) More than one race | 12 Participants | 13 Participants | 10 Participants | 11 Participants | 11 Participants | 12 Participants | 13 Participants | 14 Participants | 15 Participants | 9 Participants | 13 Participants | 14 Participants | 147 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 1 Participants | 0 Participants | 0 Participants | 0 Participants | 1 Participants | 0 Participants | 0 Participants | 0 Participants | 1 Participants | 0 Participants | 0 Participants | 0 Participants | 3 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 26 Participants | 23 Participants | 37 Participants | 33 Participants | 32 Participants | 31 Participants | 27 Participants | 34 Participants | 32 Participants | 28 Participants | 26 Participants | 39 Participants | 368 Participants |
| Race (NIH/OMB) White | 369 Participants | 372 Participants | 365 Participants | 360 Participants | 361 Participants | 362 Participants | 367 Participants | 358 Participants | 363 Participants | 369 Participants | 359 Participants | 353 Participants | 4358 Participants |
| Sex: Female, Male Female | 259 Participants | 260 Participants | 261 Participants | 258 Participants | 259 Participants | 259 Participants | 261 Participants | 258 Participants | 260 Participants | 259 Participants | 258 Participants | 260 Participants | 3112 Participants |
| Sex: Female, Male Male | 250 Participants | 249 Participants | 254 Participants | 251 Participants | 251 Participants | 251 Participants | 251 Participants | 251 Participants | 251 Participants | 252 Participants | 251 Participants | 251 Participants | 3013 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk | EG004 affected / at risk | EG005 affected / at risk | EG006 affected / at risk | EG007 affected / at risk | EG008 affected / at risk | EG009 affected / at risk | EG010 affected / at risk | EG011 affected / at risk |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 509 | 0 / 509 | 0 / 515 | 0 / 509 | 0 / 510 | 0 / 510 | 0 / 512 | 0 / 509 | 0 / 511 | 0 / 511 | 0 / 509 | 0 / 511 |
| other Total, other adverse events | 0 / 509 | 0 / 509 | 0 / 515 | 0 / 509 | 0 / 510 | 0 / 510 | 0 / 512 | 0 / 509 | 0 / 511 | 0 / 511 | 0 / 509 | 0 / 511 |
| serious Total, serious adverse events | 0 / 509 | 0 / 509 | 0 / 515 | 0 / 509 | 0 / 510 | 0 / 510 | 0 / 512 | 0 / 509 | 0 / 511 | 0 / 511 | 0 / 509 | 0 / 511 |
Outcome results
Primary
Full Survey Completion
The proportion of participants that answers all three survey questions via text message among all those randomized.
Time frame: 7 days
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Arm 1 (Introductory Message A + Tobacco Use Message A + Incentive) | Full Survey Completion | 358 Participants |
| Arm 2 (Introductory Message A + Tobacco Use Message A) | Full Survey Completion | 381 Participants |
| Arm 3 (Introductory Message A + Tobacco Use Message B + Incentive) | Full Survey Completion | 383 Participants |
| Arm 4 (Introductory Message A + Tobacco Use Message B) | Full Survey Completion | 389 Participants |
| Arm 5 (Introductory Message B + Tobacco Use Message A + Incentive) | Full Survey Completion | 372 Participants |
| Arm 6 (Introductory Message B + Tobacco Use Message A) | Full Survey Completion | 399 Participants |
| Arm 7 (Introductory Message B + Tobacco Use Message B + Incentive) | Full Survey Completion | 386 Participants |
| Arm 8 (Introductory Message B + Tobacco Use Message B) | Full Survey Completion | 402 Participants |
| Arm 9 (Introductory Message C + Tobacco Use Message A + Incentive) | Full Survey Completion | 335 Participants |
| Arm 10 (Introductory Message C + Tobacco Use Message A) | Full Survey Completion | 397 Participants |
| Arm 11 (Introductory Message C + Tobacco Use Message B + Incentive) | Full Survey Completion | 373 Participants |
| Arm 12 (Introductory Message C + Tobacco Use Message B) | Full Survey Completion | 366 Participants |
Secondary
Partial Survey Completion
The proportion of participants that answer at least one of three survey questions via text message among all those randomized.
Time frame: 7 days
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Arm 1 (Introductory Message A + Tobacco Use Message A + Incentive) | Partial Survey Completion | 377 Participants |
| Arm 2 (Introductory Message A + Tobacco Use Message A) | Partial Survey Completion | 405 Participants |
| Arm 3 (Introductory Message A + Tobacco Use Message B + Incentive) | Partial Survey Completion | 394 Participants |
| Arm 4 (Introductory Message A + Tobacco Use Message B) | Partial Survey Completion | 403 Participants |
| Arm 5 (Introductory Message B + Tobacco Use Message A + Incentive) | Partial Survey Completion | 381 Participants |
| Arm 6 (Introductory Message B + Tobacco Use Message A) | Partial Survey Completion | 414 Participants |
| Arm 7 (Introductory Message B + Tobacco Use Message B + Incentive) | Partial Survey Completion | 403 Participants |
| Arm 8 (Introductory Message B + Tobacco Use Message B) | Partial Survey Completion | 408 Participants |
| Arm 9 (Introductory Message C + Tobacco Use Message A + Incentive) | Partial Survey Completion | 345 Participants |
| Arm 10 (Introductory Message C + Tobacco Use Message A) | Partial Survey Completion | 413 Participants |
| Arm 11 (Introductory Message C + Tobacco Use Message B + Incentive) | Partial Survey Completion | 383 Participants |
| Arm 12 (Introductory Message C + Tobacco Use Message B) | Partial Survey Completion | 385 Participants |