Question-Behavior-Effect: impact of interviews and mHealth methods on colorectal cancer screening

Abstract

Background: Examine the effectiveness QBE in increasing cancer screening in two delivery modes: telephone interview and text-messaging. Methods: Study I: 14,472 participants were randomly assigned to a telephone interview or control. Study 2: Following an invitation letter, text-message reminders were sent to 50,000 participants, randomized into five groups: four experimental, one control. Messages were interrogative or declarative, each with/without reference to social context. Findings: Uptake was higher in the experimental groups than in the controls in both studies. In study I, uptake was higher the interview group than in the control's in all analyses and at all-time points, with effect size range 0.05 to 0.19. In study 2, all versions but one (the declarative) had a significant effect compared to the control; participation was the highest in the interrogative and interrogative-with-social-reference conditions with effect size of 0.05-0.06. Discussion: The routine use of the inexpensive text-messaging mode is recommended. Though increased screening was modest, absolute numbers in population-level translate into a clinically significant change.