NCT05693649

Behavioral Economic Approaches for Population-Based Colorectal Cancer Screening

• Status: Active Not Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 20,000 (estimated)
• Sponsor: Abramson Cancer Center at Penn Medicine · Academic / Other
• Sex: All
• Age: 50 Years – 72 Years
• Healthy volunteers: Not accepted

Summary

This is a 3-year pragmatic, randomized clinical trial among average-risk patients at diverse primary care practices who are overdue for colorectal (CRC) screening. This project aims to evaluate the effect of a centralized program that includes direct outreach to patients and visit-based, clinician directed nudges facilitated by the electronic health record (EHR) with follow-up text messaging on the uptake of CRC screening. The primary outcome is CRC screening completion at 3 years. Patient and clinician factors impacting the experience and effectiveness of the intervention will be explored through surveys and qualitative interviews.

Detailed description

Despite effective strategies for prevention, early detection, and treatment, colorectal cancer (CRC) remains the second leading cause of cancer death in the United States (US). While there have been considerable policy and system-level efforts to increase CRC screening rates, uptake remains well below national goals of 80% participation. Members of racial and ethnic minorities are even further behind. Approaches to increase population-based screening can consider \[1\] how screening is encouraged by targeting the clinicians who typically order or recommend the procedure or the patient who completes it; and \[2\] the kind of screening offered (e.g., colonoscopy or fecal immunochemical testing \[FIT\]). This project simultaneously tests interventions along both of these dimensions.

Conditions

• Colorectal Cancer

Interventions

Type	Name	Description
BEHAVIORAL	No Direct Patient Outreach	Patient will not receive direct outreach prompting them to schedule and/or complete colorectal cancer screening.
BEHAVIORAL	Direct Patient Outreach: Colonoscopy Only	Patient will receive direct outreach including an order to schedule and complete colonoscopy.
BEHAVIORAL	Direct Patient Outreach: Sequential Choice	Patient will receive direct outreach including an order to schedule and complete colonoscopy then an at-home fecal immunochemical test (FIT) if colonoscopy is not completed.
BEHAVIORAL	Visit-Based Nudge/Text	Patient's clinician will receive an alert prompting them to discuss colorectal cancer screening with their patient upon visit. Patient will also receive a text message 3 days after visit reminding them to complete colorectal cancer screening.
BEHAVIORAL	No Nudge/Text	Patient's clinician will not receive an alert prompting them to discuss colorectal cancer screening with their patient upon visit. Patient will not receive a text message 3 days after visit reminding them to complete colorectal cancer screening.

Timeline

• Start date: 2023-06-07
• Primary completion: 2026-12-21
• Completion: 2026-12-21
• First posted: 2023-01-23
• Last updated: 2025-09-05

Locations

1 site across 1 country: United States