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Increasing CRC Screening in Community Health Centers Through Mobile Messaging Optimization (CoSMMO)

2 czerwca 2026 zaktualizowane przez: University of Colorado, Denver

The goal of this interventional study is to create and test a comprehensive and low burden text message program within existing Community Health Centers (CHC) electronic records system to encourage patients to complete at home colorectal cancer (CRC) screening and to make sure they get follow-up care if their results are abnormal.

First, the investigators will learn from clinic staff and patients what their needs and preferences are in terms of use of technology. This information will be used to design the text messages program.

  • Clinic patients will participate in focus groups
  • Clinic staff will participate in interviews

Second, the investigators will test a series of different message versions in two batches (experiments):

  • Clinic patients with orders for an at-home colorectal cancer screening kit will receive the different message versions.
  • In the first batch, the messages that get the most engagement from patients will be selected to be used in the second experiment.
  • In the second batch, the investigators will test which messages lead to the most colorectal cancer screening completion.
  • This will be rolled-out within the clinics existing electronic record system. The study team will not receive any information that will identify individual patients.

Lastly, the investigators will check again with clinic staff to learn how the program performed, and what would be needed to continue using the text message program in the long run.

-Clinic staff will participate in interviews and surveys.

Przegląd badań

Szczegółowy opis

This trial is studying optimization of text messages and outreach approaches by community health centers to increase patients' completion of FIT colon cancer screening tests. Text message reminders are a low cost, scalable way to deliver patient reminders that are low burden for staff. The proposed work uses a creative, community-engaged, systems-level approach to improve completion of FIT testing and abnormal follow-up and program sustainment in CHCs.

The study design includes three parts. First, the text messages will be optimized to maximize patient engagement and outreach (Aims 1 & 2). The study will enroll patients from three partnering CHCs to participate in six focus groups to inform message design. The investigators will also conduct key informant interviews with 5-15 staff per CHC regarding the logistics of ensuring seamless integration into routine clinical operations and perspectives on the intervention activities. Then, a factorial experiment will be conducted, assigning 2,000 patients who have received a stool-based screening kit to different reminder messages. Engagement will be measured as replies or use of ≥1 links, to indicate interaction with the message. The experiment will compare: (1) personalization; (2) concern or negative emotions about screening; and (3) gain framing. In the factorial design patients will not be individually enrolled, this intervention will be tested within the workflows of usual practice. All data for the factorial experiment will be de-identified.

With those tools in place, the investigators will optimize outreach strategies for CRC screening completion. In a second factorial experiment with 5,100 patients, the investigators will optimize outreach strategy for primary screening outcomes of home-based stool screening test completion and screening completion by any guideline-recommended CRC screening test. Secondary outcomes include follow-up care for abnormal stool test results. In this factorial experiment, the investigators will test the impact of three outreach conditions on screening completion: increasing patient autonomy, providing information for accessing resources for impediments to care, and provision of live support. As in the first factorial test, for the second factorial test patients will not be individually enrolled, as the intervention will be tested within the workflows of usual practice. All data will be de-identified.

Finally, the study will assess implementation outcomes and sustainment of intervention components and effects. The investigators will conduct staff interviews and surveys to assess organizational capacity for sustaining the intervention elements being tested as well as the acceptability and feasibility of the text messages and screening tools. Sustainment of the text message outreach intervention elements will be assessed at post intervention and two 6-month intervals post-intervention.

Typ studiów

Interwencyjne

Zapisy (Szacowany)

7220

Faza

  • Nie dotyczy

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Kontakt w sprawie studiów

Lokalizacje studiów

    • Massachusetts
      • Boston, Massachusetts, Stany Zjednoczone, 02114
        • Massachusetts General Hospital
        • Kontakt:
        • Pod-śledczy:
          • Adjoa Anyane-Yeboa, MD, MPH
      • Boston, Massachusetts, Stany Zjednoczone, 02215
        • Dana Farber Cancer Institute
        • Kontakt:
        • Pod-śledczy:
          • Kasisomayajula Viswanath, PhD
      • Boston, Massachusetts, Stany Zjednoczone, 02108
        • The Massachusetts League of Community Health Center, Inc.
        • Kontakt:
        • Główny śledczy:
          • Susan Dargon-Hart
    • Texas
      • Dallas, Texas, Stany Zjednoczone, 75390
        • University of Texas Southwestern Medical Center
        • Kontakt:
        • Pod-śledczy:
          • Lynn Ibekwe-Agunanna, MPH, PhD

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

  • Dorosły
  • Starszy dorosły

Akceptuje zdrowych ochotników

Tak

Opis

Eligibility Criteria for CHC Patients Cohorts

Inclusion Criteria (CHC Patients):

  • Adults 45-75 years old
  • Receive care in partner CHCs
  • Are of average risk for colorectal cancer
  • Received a stool-based testing order at their CHC
  • Have a mobile phone and can receive text messages (Aim 1 quantitative cohort only)
  • Fluent in English, Spanish, or another predominant language to be identified by the PI (applicable to patients focus groups cohort only)

Exclusion Criteria (CHC Patients):

  • Personal or family history of CRC or colorectal polyps
  • History of inflammatory bowel disease
  • Heritable conditions that put them at above average risk for colorectal cancer (e.g., familial adenomatous polyposis)

Eligibility Criteria for CHC Staff Cohorts Inclusion Criteria (CHC Staff)

  • Adult employees of participating CHCs
  • Job responsibilities include activities related to CRC screening

Exclusion Criteria (CHC Staff)

  • None

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Badania usług zdrowotnych
  • Przydział: Randomizowane
  • Model interwencyjny: Przypisanie czynnikowe
  • Maskowanie: Brak (otwarta etykieta)

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Eksperymentalny: Standard Message - Gain Frame
No personalization, no concerns/negative emotion, gain-framed message.
Use gain-framed language to influence motivation.
Electronic alerts, dashboards, and tracking systems used to identify and follow up with patients due for CRC screening or abnormal results.
Eksperymentalny: Concern Message - Gain Frame
No personalization, screening concerns/negative emotions, gain-framed message.
Use gain-framed language to influence motivation.
Electronic alerts, dashboards, and tracking systems used to identify and follow up with patients due for CRC screening or abnormal results.
Emotional concerns or barriers related to CRC screening.
Eksperymentalny: Concern Message - No Gain Frame
No personalization, screening concerns/negative emotions, no gain-framed message.
Use gain-framed language to influence motivation.
Electronic alerts, dashboards, and tracking systems used to identify and follow up with patients due for CRC screening or abnormal results.
Emotional concerns or barriers related to CRC screening.
Eksperymentalny: Standard Message - No Gain Frame
No personalization, no screening concerns/negative emotions, no gain-framed message.
Use gain-framed language to influence motivation.
Electronic alerts, dashboards, and tracking systems used to identify and follow up with patients due for CRC screening or abnormal results.
Eksperymentalny: Personalized Message - Gain Frame
Personalization included, no screening concerns/negative emotions, gain-framed message.
Use gain-framed language to influence motivation.
Electronic alerts, dashboards, and tracking systems used to identify and follow up with patients due for CRC screening or abnormal results.
Message includes personalized content.
Eksperymentalny: Personalized Message - No Gain Frame
Personalization included, no screening concerns/negative emotions, no gain-framed message.
Use gain-framed language to influence motivation.
Electronic alerts, dashboards, and tracking systems used to identify and follow up with patients due for CRC screening or abnormal results.
Message includes personalized content.
Eksperymentalny: Personalized - Concern Message - Gain Frame
Personalization and screening concerns/negative emotions, gain framed message.
Use gain-framed language to influence motivation.
Electronic alerts, dashboards, and tracking systems used to identify and follow up with patients due for CRC screening or abnormal results.
Emotional concerns or barriers related to CRC screening.
Eksperymentalny: Personalized - Concern Message - No Gain Frame
Personalization and screening concerns/negative emotions, no gain-framed message.
Use gain-framed language to influence motivation.
Electronic alerts, dashboards, and tracking systems used to identify and follow up with patients due for CRC screening or abnormal results.
Emotional concerns or barriers related to CRC screening.
Eksperymentalny: Basic Outreach Only
No autonomy support, no impediments support, no live support.
Electronic alerts, dashboards, and tracking systems used to identify and follow up with patients due for CRC screening or abnormal results.
Offer access to live assistance.
Eksperymentalny: Outreach + Impediments Support
No autonomy support, no live support. Impediment support.
Electronic alerts, dashboards, and tracking systems used to identify and follow up with patients due for CRC screening or abnormal results.
Include information or resources to help overcome barriers to care.
Eksperymentalny: Outreach + Impediments + Live Support
No autonomy support. Impediment support and live support included.
Electronic alerts, dashboards, and tracking systems used to identify and follow up with patients due for CRC screening or abnormal results.
Offer access to live assistance.
Include information or resources to help overcome barriers to care.
Eksperymentalny: Outreach + Live Support
Live support included. No autonomy or impediments support.
Electronic alerts, dashboards, and tracking systems used to identify and follow up with patients due for CRC screening or abnormal results.
Offer access to live assistance.
Eksperymentalny: Autonomy Outreach Support
Autonomy support included, no impediments or live support.
Electronic alerts, dashboards, and tracking systems used to identify and follow up with patients due for CRC screening or abnormal results.
Provide patients with choices or options to increase sense of control.
Eksperymentalny: Autonomy + Live Support
Autonomy and live support with impediments support.
Electronic alerts, dashboards, and tracking systems used to identify and follow up with patients due for CRC screening or abnormal results.
Offer access to live assistance.
Provide patients with choices or options to increase sense of control.
Eksperymentalny: Autonomy + Impediments Support
Autonomy and impediments support included. No live support included.
Electronic alerts, dashboards, and tracking systems used to identify and follow up with patients due for CRC screening or abnormal results.
Include information or resources to help overcome barriers to care.
Provide patients with choices or options to increase sense of control.
Eksperymentalny: Autonomy + Impediments + Live Support
Autonomy, impediments, and live support included.
Electronic alerts, dashboards, and tracking systems used to identify and follow up with patients due for CRC screening or abnormal results.
Offer access to live assistance.
Include information or resources to help overcome barriers to care.
Provide patients with choices or options to increase sense of control.

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Text message engagement
Ramy czasowe: 14 days after reminder message delivery
Proportion of message recipients who interact with CRC screening reminder messages by reply
14 days after reminder message delivery
Stool-based CRC screening completion
Ramy czasowe: 3 months after reminder message delivery
Proportion of message recipients with stool-based CRC screening tests resulted in electronic health record
3 months after reminder message delivery

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Time to follow-up care after abnormal stool-based screening test
Ramy czasowe: 3 months after date of abnormal result
Time (days) to follow-up care after abnormal stool-based screening test
3 months after date of abnormal result
Invalid test results
Ramy czasowe: 3 months after reminder message delivery
Proportion of message recipients with invalid stool-based screening test result
3 months after reminder message delivery

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Szacowany)

1 grudnia 2026

Zakończenie podstawowe (Szacowany)

1 października 2031

Ukończenie studiów (Szacowany)

1 stycznia 2032

Daty rejestracji na studia

Pierwszy przesłany

29 kwietnia 2026

Pierwszy przesłany, który spełnia kryteria kontroli jakości

29 kwietnia 2026

Pierwszy wysłany (Rzeczywisty)

6 maja 2026

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

4 czerwca 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

2 czerwca 2026

Ostatnia weryfikacja

1 czerwca 2026

Więcej informacji

Terminy związane z tym badaniem

Plan dla danych uczestnika indywidualnego (IPD)

Planujesz udostępniać dane poszczególnych uczestników (IPD)?

TAK

Opis planu IPD

All EHR derived data or data on text message intervention interactions, and any descriptive quality improvement data that we receive from the CHCs are de-identified. If qualitative data is shared, transcripts would be stripped of all identifiers.

Ramy czasowe udostępniania IPD

The data will be available when the project is complete. The data will be maintained for 7 years on our servers, per our standard practice.

Kryteria dostępu do udostępniania IPD

The primary restriction will be approval of data use requests by the participating community health centers' leadership. We will share the data with potential users who have a legitimate and appropriate use for data of this nature. Because the data is owned by the participating health centers, data use requests will be reviewed and approved by the health centers' leadership committee. Since the data is owned by the participating community health centers, a data use agreement will be created to allow for use and analysis by the collaborating researchers. All data use requests will be made to Dr. Kruse, who will discuss them with the study team and with CHC leadership, before any data use agreements are made and data is released.

Typ informacji pomocniczych dotyczących udostępniania IPD

  • PROTOKÓŁ BADANIA
  • SOK ROŚLINNY

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Nie

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

produkt wyprodukowany i wyeksportowany z USA

Nie

Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .

Badania kliniczne na Rak jelita grubego

Badania kliniczne na Message Framing Text Message

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