Text Messaging and Opt-out Mailed Outreach in Colorectal Cancer Screening: a Randomized Clinical Trial

Summary

This study tested an opt-out outreach model for colorectal cancer screening in an FQHC. Patients received a series of text messages via CareMessage combined with a mailed test kit. This approach boosted screening rates from 2.3% to 19.6%, proving highly effective in an underserved population.

Key Findings

• The screening rate for patients receiving mailed test kits and sequential messaging was 19.6%, a nearly nine-fold increase over the 2.3% rate in the control group which received a single message.
• This represents a 17.3 percentage point increase in screening, a massive improvement.
• The program was highly successful in engaging a diverse, underserved population (primarily Black patients with Medicaid or no insurance) who often face barriers to preventive care.
• The entire automated text messaging sequence, from the initial alert to the follow-up reminders, was powered by the CareMessage platform.

Clinical Significance

Colorectal cancer screening rates are persistently low in underserved communities. This study provides a powerful, low-cost, and scalable model to overcome this challenge. By combining proactive, automated outreach using CareMessage with mailed FIT kits, health centers can move from simple reminders to an effective system that dramatically boosts screening completion. This approach removes significant barriers for patients, improving early cancer detection and health equity.

CareMessage Product Feature(s)

Outreach

Citation

Huf, S. W., Asch, D. A., Volpp, K. G., Reitz, C., & Mehta, S. J. (2021). Text Messaging and Opt-out Mailed Outreach in Colorectal Cancer Screening: a Randomized Clinical Trial. Journal of General Internal Medicine, 36(7), 1958–1964.