Encouraging Overdue Healthcare Appointment Scheduling Among Patients With Chronic Diseases

The goal of this study is to determine the most effective messages for encouraging patients with chronic conditions, who have not seen their doctor in at least one year, to return to the clinic. Study participants will receive postcards or letters encouraging them to make an appointment. Researchers will assess whether messages increase appointment scheduling (and attendance).

Study Overview

• Status: Completed
• Conditions: Health Promotion; Prevention; Risk Reduction Behavior
• Intervention / Treatment: Behavioral: Outreach mailer; Behavioral: Humor/Salience; Behavioral: Information; Behavioral: Doctor's authority

Detailed Description

About 18,500 Geisinger patients, Geisinger Health Plan members, and Medicaid patients with chronic illness have not been seen in a clinic for at least one year, which is concerning because regular appointments are necessary for chronic disease management. Geisinger is therefore working to encourage those with chronic illness and overdue appointments to return to the clinic.

In the present study, patients will either receive a mailer (with a message encouraging them to schedule an appointment with their physician), or no mailer. The purpose of the study is to compare three different mailers to assess which is most effective at encouraging patients to schedule and attend an appointment. The three mailers include (1) a standard outreach postcard (emphasizing that we are "checking in" with the patient), and, informed by behavioral science research, (2) a postcard with a cartoon and humorous messages and (3) a letter signed by a physician. The study will compare the effectiveness of the three experimental mailer arms to each other and to a no-contact control arm.

• Study Type: Interventional
• Enrollment (Actual): 21562
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Pennsylvania
    • Danville, Pennsylvania, United States, 17822
      • Geisinger

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Geisinger patient, Geisinger Health Plan member or Medicaid patient
• Chronic illness
• No appointment for > 1 year

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Outreach Postcard; This group receives a postcard with a stock image on the front and a message encouraging regular visits to manage health on the back.	Behavioral: Outreach mailer; Postcard or letter
Experimental: Humorous Postcard; This group receives a postcard with with a cartoon image and a visit-related joke on the front and a humorous message on the back, with additional information about why visits are important, and what to expect at the appointment.	Behavioral: Outreach mailer; Postcard or letter; Behavioral: Humor/Salience; Funny cartoon; Behavioral: Information; Information about benefits of the appointment
Experimental: Physician Letter; This group receives a personalized letter signed by a physician with information about why visits are important, and what to expect at the appointment.	Behavioral: Outreach mailer; Postcard or letter; Behavioral: Information; Information about benefits of the appointment; Behavioral: Doctor's authority; Letter from a doctor
No Intervention: No-contact Control; This group will not receive a study mailer during the trial.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patients - Appointment scheduling	Proportion of Geisinger patients who schedule an appointment	30 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patients - Appointment scheduling - Comparing mailers	Proportion of Geisinger patients who schedule an appointment, comparing relative efficacy of the mailers	30 days
Patients - Attendance at scheduled appointments within 180 days of mailer	Proportion of appointments (from the primary outcome) that were attended. This outcome focuses on attendance at appointments that were scheduled within 30 days of the mailer drop date. It is possible to schedule an appointment months in advance, so the Time Frame needs to be long to capture attendance at any appointment scheduled within 30 days of the mailer. 180 days should be sufficient to capture all scheduled appointments.	180 days
Patients, Members & Medicaid - Attendance at any appointment	Attendance at any appointment within 30 days of drop date	30 days
Patients, Members & Medicaid - Attendance at any appointment	Attendance at any appointment within 90 days of drop date	90 days
Patients, Members & Medicaid - Attendance at any appointment	Attendance at any appointment within 180 days of drop date	180 days
Patients, Members & Medicaid - Timing of appointment	Number of days between the drop date and any appointment captured in Secondary Outcome 3	30 days
Patients, Members & Medicaid - Timing of appointment	Number of days between the drop date and any appointment captured in Secondary Outcome 4	90 days
Patients, Members & Medicaid - Timing of appointment	Number of days between the drop date and any appointment captured in Secondary Outcome 5	180 days

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patients - Appointment scheduling - Comparing mailers	Proportion of Geisinger patients who schedule an appointment, comparing relative efficacy of the interventions. Note: this analysis will inform internal operations but will not be reported in publication.	14 days
Patients - Calls to scheduling line	Proportion of Geisinger patients who call the appointment scheduling line.	30 days

Collaborators and Investigators

• Sponsor: Geisinger Clinic

Study record dates

Study Major Dates

• Study Start (Actual): July 12, 2021
• Primary Completion (Actual): August 26, 2021
• Study Completion (Actual): August 26, 2022

Study Registration Dates

• First Submitted: August 2, 2021
• First Submitted That Met QC Criteria: August 9, 2021
• First Posted (Actual): August 11, 2021

Study Record Updates

• Last Update Posted (Actual): December 1, 2022
• Last Update Submitted That Met QC Criteria: November 29, 2022
• Last Verified: November 1, 2022

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Chronic Disease
• Other Study ID Numbers: 2021-0442

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Data with no personally identifiable information will be made available to other researchers on the Open Science Framework for transparency.
• IPD Sharing Time Frame: The data will become available after publication of study results in a scientific journal and will be available as long as the Open Science Framework hosts the data.
• IPD Sharing Access Criteria: The data on the Open Science Framework will be open to anyone requesting that information.
• IPD Sharing Supporting Information Type: SAP; ANALYTIC_CODE

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No