Financial Incentives to Increase Colorectal Cancer Screening in Priority Populations

NCT03080701 | Completed

• 2 other identifiers: 4RO1CA121125-09 REVISED4R01CA121125-09
• Study Type: interventional
• Target: 898
• Locations: 1 country
• Sites: 1

Brief Summary

The investigators propose to build on the success of the Systems of Support to Increase Colorectal Cancer trial (SOS, R01CA121125, Green) and focus on disparity groups who are less likely to be current for colorectal cancer (CRC) screening. We will test whether financial incentives increases screening uptake and decreases screening disparities. The investigators hypothesize that CRC screening rates will be higher in patients offered mailed fecal kits and financial incentives than those offered mailed fecal kits alone.

Conditions

Colorectal Cancer

Keywords

Behavioral: Automated Mailing

Outcome Measures

Primary Outcomes (1)

• CRC Screening Within 6 Months Following Randomization

  We will compare among the 3 arms (1) automated mailing; (2) Auto mailing plus $10; (3) Auto mailing plus $50 lottery for completion and the effect of each on CRC screening completion at 6 months (yes/no) within the following subgroups of each arm: 1. White and not Hispanic versus non-White or Hispanic. 2. Medicaid versus non-Medicaid (Medicare, employer-based, private) insurance. 3. History of prior versus no prior completion of CRC screening tests. 4. High school or less versus college or more education level.

  6 months

Study Arms (3)

Group 1 - Automated Mailing

NO INTERVENTION

The mailing process will be identical to those used in the SOS study. Mailing 1 includes an introductory letter on CRC screening and a pamphlet on CRC testing choices (colonoscopy every 10 years, FIT testing yearly, or flexible sigmoidoscopy every 10 years combined with interval FIT testing), and pros and cons of each. The letter will state that they will soon be receiving a FIT kit in the mail, and a number to call if they prefer another option. Mailing 2 includes a brief letter reaffirming the importance of screening, a FIT kit (the one used by Group Health), pictograph instructions, and a postage-paid return envelope. Mailing 3 a reminder letter, is sent to participants not completing the FIT kit after 3 weeks. The intervention for Group 1 includes no incentive.

Group 2 - Auto Mailing Plus Money

EXPERIMENTAL

Receives the same number of mailings and materials as group 1 with the following modifications. In Mailing 1 the letter will include the intervention notification that they will receive a monetary thank you gift for completing testing (FIT colonoscopy or flex sig within 6 months). Mailing 2 and mailing 3 (reminder letters for those still not returning kits) will include the same information about the monetary thank you gift for CRC screening completion. Mailing 4 will include the money with a thank you letter for those who complete the screening

Behavioral: Auto Mailing Plus Money

Group 3 - Auto Mailing Plus Lottery

EXPERIMENTAL

Receives the same number of mailings and materials as group 1 with the following modifications. In Mailing 1 the letter will include the intervention notification that they will have a 1 in 10 chance of winning money (FIT, colonoscopy or flex sig within 6 months). Mailing 2 and mailing 3 (reminder letters for those still not returning kits) will include the same information about the 1 in 10 chance of winning the lottery for CRC screening completion. Mailing 4 will include a thank you letter with money for those who complete their screening and win the lottery. Participants who do not win the lottery will receive a thank you letter.

Behavioral: Auto Mailing Plus Lottery

Interventions

Auto Mailing Plus Money BEHAVIORAL

Participant receives money as a thank you for completing CRC screening within 6 months.

Group 2 - Auto Mailing Plus Money

Auto Mailing Plus Lottery BEHAVIORAL

Participant has a 1 in 10 chance of winning money in a lottery for completing CRC screening within 6 months.

Group 3 - Auto Mailing Plus Lottery

Eligibility Criteria

• Age: 50 Years - 75 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• No evidence in electronic data of FIT screening in past year or a colonoscopy in the prior 9 years.
• Continuously enrolled in Group Health Cooperative (GHC) for at least one year.
• Patients who have Medicaid coverage or are non-white race or Hispanic any race.

You may not qualify if:

• Known high risk for CRC
• History of CRC
• History of inflammatory bowel disease
• Current anticoagulation therapy
• Organ failure
• Serious illness
• Debilitating disease
• Dementia
• Nursing home resident

Sponsors & Collaborators

• Kaiser Permanente: lead
• University of Michigan: collaborator
• University of Texas: collaborator

Study Sites (1)

Group Health Research Institute

Seattle, Washington, 98101, United States

Location

MeSH Terms

Conditions

Colorectal Neoplasms

Condition Hierarchy (Ancestors)

Intestinal Neoplasms; Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Colonic Diseases; Intestinal Diseases; Rectal Diseases

Study Officials

• Beverly B Green, MD, MPH

  Kaiser Permanente

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: The randomization sequence will be concealed to everyone except the study biostatistician.
• Purpose: SCREENING
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 31, 2017
• First Posted: March 15, 2017
• Study Start: March 23, 2017
• Primary Completion: November 2, 2018
• Study Completion: November 2, 2018
• Last Updated: November 5, 2019

Record last verified: 2019-11

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)