Behavioral Nudges for Colon Cancer Screening

(PROMPT-CRC Trial)

No longer recruiting at 2 trial locations

Overseen By Emily Rosenzweig, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Emily Rosenzweig

Disqualifiers: Other screening, Recent nudge, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if personalized messages (three messaging nudges) can encourage more people to complete their at-home colon cancer screening using a stool test kit. Early detection of colon cancer through screening can significantly improve survival rates, but many people don't complete their tests. Participants will either receive these nudging messages or not, to assess their impact. This trial suits individuals aged 45 to 75 who have been ordered a stool test by their doctor but haven't returned their kit yet. As an unphased trial, this study offers a unique opportunity to contribute to innovative research that could improve health outcomes for many.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on increasing the return rates of stool testing kits through behavioral nudges, so it's unlikely that your medications would be affected.

What prior data suggests that these behavioral nudges are safe for increasing stool testing kit return rates?

Studies have shown that gentle reminders can safely increase participation in cancer screening programs. Research indicates that personalized messages effectively remind and encourage people to complete their screenings. For example, one study examined digital reminders for high-risk individuals and found them effective in encouraging participation without any reported harm.

Testing these messaging strategies has revealed no significant safety issues. The process involves sending reminders or motivational messages, which participants tolerate well and pose minimal risk. Overall, gentle reminders are considered a safe way to boost engagement in colon cancer screening. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these messaging nudges for colon cancer screening because they offer a fresh approach compared to traditional screening reminders. Unlike standard methods that often rely on direct reminders or invitations for screenings, these nudges aim to subtly influence behavior by leveraging psychological insights to encourage people to get screened. This technique could potentially increase screening rates by gently prompting individuals without the need for more intrusive reminders. The innovative use of behavioral psychology in healthcare could lead to higher participation rates and earlier detection, making this approach a promising tool in cancer prevention.

What evidence suggests that these behavioral nudges are effective for increasing stool testing kit return rates?

This trial will evaluate the effectiveness of behavioral nudges, specifically three messaging nudges, to increase participation in colon cancer screening. Research has shown that simple reminders or prompts can help more people participate in cancer screening. For instance, one study found that digital reminders significantly increased screening among people at high risk. Another review found that these prompts effectively encourage people to follow screening guidelines. Interventions based on behavioral economics have also boosted participation in colorectal cancer screening. Additionally, a real-world experiment showed that setting a deadline for completing an at-home test increased the number of people who did it. These findings suggest that reminder messages could help more people complete stool tests for colon cancer screening. Participants in the experimental group of this trial will receive these messages, while the control group will not. ^{1 6 7 8 9}

Who Is on the Research Team?

Emily Rosenzweig

Principal Investigator

Ascension Health

Are You a Good Fit for This Trial?

This trial is for people aged 45 to 75 who are due for colorectal cancer screening. It's designed to help those who may face barriers to traditional colonoscopy by using stool testing kits, which can be done at home.

Inclusion Criteria

Included in and non-compliant on the Ascension Colon Cancer Screening Clinical Priority Goal measure

Have consented to receive electronic communications from the health system

No record of Cologuard stool testing lab results returned within 60 days of the order being placed

Exclusion Criteria

Have received a nudge campaign from the Clinical Transformation team in the past 90 days

Patients who have previously opted out of receiving electronic communications from the health system in our message delivery platform (Salesforce)

Patients whose primary care providers are exempted from the campaign by the health system

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive behavioral nudges to increase stool testing kit return rates

12 weeks

Messages sent periodically

Follow-up

Participants are monitored for kit return rates and lab results

12 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Three Messaging Nudges

Trial Overview The study tests if three different types of personalized reminder messages (behavioral nudges) can encourage patients to return their mail-in stool testing kits, which screen for colon cancer.

How Is the Trial Designed?

Group I: Experimental Group Experimental Treatment 1 Intervention

Group receiving the messages

Group II: Control Group Active Control 1 Intervention

Group not receiving the messages

Who Is Running the Clinical Trial?

Emily Rosenzweig

Lead Sponsor

Trials

2

Recruited

52,400+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11995504/

Evaluating digital nudge interventions for the promotion of ... This study aims to synthesize the effects of digital nudge interventions on promoting cancer screening behaviors in high-risk individuals.

2. journals.plos.org journals.plos.org/plosone/article?id=10.1371/journal.pone.0290424

A systematic review of evidence and meta-analysis? | PLOS One In another review, the authors found compelling evidence that nudges are effective in promoting adherence to guidelines [78].

3. sciencedirect.com sciencedirect.com/science/article/pii/S2211335522000547

Review article Effectiveness of behavioural economics ... Effectiveness of behavioural economics-based interventions to improve colorectal cancer screening participation: A rapid systematic review of randomised ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10843112/

Are behavioral economics interventions effective in ... It means behavioral economics-based interventions are effective in encouraging the demand for colorectal cancer screening. In another review, ...

5. anderson-review.ucla.edu anderson-review.ucla.edu/cancer-screening-procrastination-can-be-deadly-a-nudge-lifts-compliance/

Cancer-Screening Procrastination Can Be Deadly A real-word experiment that offered screening to more than 7,700 participants found that giving people a deadline to complete an at-home test ...

6. clinicaltrials.gov clinicaltrials.gov/study/NCT06796049

Behavioral Nudge in Colorectal Cancer Screening Also called a data safety and monitoring board, or DSMB. Early Phase 1 (formerly listed as Phase 0). A phase of research used to describe exploratory trials ...

7. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0091743523001950

Testing behavioral economics messages to increase non- ... This study aimed to evaluate the impact of behavioral economic-inspired messages on participation in colorectal cancer (CRC) screening programs.

8. journals.plos.org journals.plos.org/plosone/article/file?type=printable&id=10.1371/journal.pone.0290424

Are behavioral economics interventions effective in increasing ... Studies using behavioral eco- nomics interventions to promote colorectal screening have reported heterogeneous results. In a rapid review, ...

9. anderson-review.ucla.edu anderson-review.ucla.edu/colon-cancer/

Carefully Crafted Messaging Boosts Uptake in Cancer ... Researchers spanning the medical and behavioral psychology fields have been exploring potential ways to boost colon cancer screening.