Effectiveness and Acceptability of Targeted Text Message Reminders in Colorectal Cancer Screening: M-TICS Study
Background
Mobile phone-based SMS text message reminders have the potential to improve colorectal cancer screening participation rates.
Objective
This study aimed to assess the effectiveness and acceptability of adding targeted SMS text message reminders to the standard procedure for individuals who picked up but did not return their screening kit at the pharmacy within 14 days in a colorectal cancer screening program in Catalonia, Spain.
Methods
A randomized control trial was conducted among individuals who picked up a fecal immunochemical test (FIT) kit for colorectal cancer screening at the pharmacy but did not return it within 14 days. The intervention group (n=4563) received an SMS text message reminder on the 14th day of kit pick up, while the control group (n=4806) received no reminder. Both groups received a 30-day reminder letter if necessary. The main primary outcome was the FIT completion rate within 30, 60, and 126 days from FIT kit pick up (intention-to-treat analysis). A telephone survey assessed the acceptability and appropriateness of the intervention. The cost-effectiveness of adding an SMS text message reminder to FIT completion was also evaluated.
Results
The intervention group had higher FIT completion rates than the control group at 30 (64.2% vs 53.7%; P<.001), 60 (78.6% vs 72.0%; P<.001), and 126 (82.6% vs 77.7%; P<.001) days. Participation rates were higher in the intervention arm independent of sex, age, socioeconomic level, and previous screening behavior. A total of 339 (89.2%) interviewees considered it important and useful to receive SMS text message reminders for FIT completion, and 355 (93.4%) preferred SMS text messages to postal letters. The study observed a reduction of US $2.4 per participant gained in the intervention arm for invitation costs compared to the control arm.
Conclusions
Adding an SMS text message reminder to the standard procedure significantly increased FIT kit return rates and was a cost-effective strategy. SMS text messages also proved to be an acceptable and appropriate communication channel for cancer screening programs.
TRIAL REGISTRATION: ClinicalTrials.gov NCT04343950; https://www.clinicaltrials.gov/study/NCT04343950.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1371/journal.pone.0245806.
PMID:39083331 | DOI:10.2196/57959
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