NCT03712553

Brief Summary

This project aims to evaluate different approaches to increase Hepatitis C screening among primary care patients at Penn Medicine through a centralized screening outreach program. In a pragmatic trial, we will evaluate different approaches to increase completion of screening among eligible patients, including changing the default from opt-in to opt-out and incorporating behavioral science principles into the outreach communication.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
21,493

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Mar 2019

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

October 16, 2018

Completed
3 days until next milestone

First Posted

Study publicly available on registry

October 19, 2018

Completed
5 months until next milestone

Study Start

First participant enrolled

March 15, 2019

Completed
1.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 15, 2020

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

October 15, 2020

Completed
Last Updated

December 1, 2020

Status Verified

November 1, 2020

Enrollment Period

1.6 years

First QC Date

October 16, 2018

Last Update Submit

November 30, 2020

Conditions

Keywords

Behavioral EconomicsScreeningOutreach

Outcome Measures

Primary Outcomes (1)

  • HCV Antibody Completion within 4 Months

    Percentage of patients who complete HCV antibody testing within 4 months of initial outreach

    4 months

Secondary Outcomes (4)

  • HCV Antibody Completion within 12 Months

    12 months

  • HCV Antibody Positive

    12 months

  • HCV Antibody Positive with Viral Loads

    12 months

  • Referred to Specialist

    12 months

Study Arms (8)

A1: Opt-In, UC Letter

ACTIVE COMPARATOR

Behavioral: Opt-In vs. Opt-Out The usual care (UC) letter consists of an opt-in message encouraging participants to contact their primary care provider for Hepatitis C screening.

Behavioral: LetterBehavioral: Usual Care Messaging

A2: Opt-Out, UC Letter

EXPERIMENTAL

Behavioral: Opt-In vs. Opt-Out The usual care (UC) letter consists of a message and a written laboratory order from primary care provider to complete Hepatitis C screening.

Behavioral: Opt-OutBehavioral: Usual Care Messaging

B1: Active MPM User, UC Letter

EXPERIMENTAL

Behavioral: Letter vs. Electronic Messaging Behavioral: Usual Care Messaging vs. Behavioral Economic Messaging Participants who are active MyPennMedicine (MPM) users receive a usual care (UC) letter consisting of a message encouraging them to contact their primary care provider for Hepatitis C screening.

Behavioral: Letter

B2: Active MPM User, BE Letter

EXPERIMENTAL

Behavioral: Letter vs. Electronic Messaging Behavioral: Usual Care Messaging vs. Behavioral Economic Messaging Participants who are active MyPennMedicine (MPM) users receive a letter with behavioral economic (BE) principles encouraging them to contact their primary care provider for Hepatitis C screening.

Behavioral: LetterBehavioral: Behavioral Economic Messaging

B3: Active MPM User, UC MPM Message

ACTIVE COMPARATOR

Behavioral: Letter vs. Electronic Messaging Behavioral: Usual Care Messaging vs. Behavioral Economic Messaging Participants who are active MyPennMedicine (MPM) users receive an electronic usual care (UC) message on the MyPennMedicine patient portal encouraging them to contact their primary care provider for Hepatitis C screening.

Behavioral: Usual Care Messaging

B4: Active MPM User, BE MPM Message

EXPERIMENTAL

Behavioral: Letter vs. Electronic Messaging Behavioral: Usual Care Messaging vs. Behavioral Economic Messaging Participants who are active MyPennMedicine (MPM) users receive an electronic message with behavioral economic principles on the MyPennMedicine patient portal encouraging them to contact their primary care provider for Hepatitis C screening.

Behavioral: Behavioral Economic Messaging

B5: Non-MPM User, UC Letter

ACTIVE COMPARATOR

Behavioral: Usual Care Messaging vs. Behavioral Economic Messaging Participants who are non-MyPennMedicine (non-MPM) users receive a usual care (UC) letter consisting of a message encouraging them to contact their primary care provider for Hepatitis C screening.

Behavioral: LetterBehavioral: Usual Care Messaging

B6: Non-MPM User, BE Letter

EXPERIMENTAL

Behavioral: Usual Care Messaging vs. Behavioral Economic Messaging Participants who are non-MyPennMedicine (non-MPM) users receive a letter with behavioral economic principles (BE) encouraging them to contact their primary care provider for Hepatitis C screening.

Behavioral: LetterBehavioral: Behavioral Economic Messaging

Interventions

Opt-OutBEHAVIORAL

Opt-In messaging prompts participants to contact their primary care provider to receive Hepatitis C screening whereas Opt-Out messaging includes a signed laboratory order for Hepatitis C screening.

A2: Opt-Out, UC Letter
LetterBEHAVIORAL

Participants receive messaging prompting them to contact their primary care provider to receive Hepatitis C screening, either as a letter or an electronic message on the MyPennMedicine patient portal.

A1: Opt-In, UC LetterB1: Active MPM User, UC LetterB2: Active MPM User, BE LetterB5: Non-MPM User, UC LetterB6: Non-MPM User, BE Letter

Participants receive standard messaging about HCV and ways to get screened and messaging that incorporates behavioral economic principles such as norms, reciprocity, anticipated regret, and pre-commitment to get screening.

B2: Active MPM User, BE LetterB4: Active MPM User, BE MPM MessageB6: Non-MPM User, BE Letter

Participants receive standard messaging about HCV and ways to get screening.

A1: Opt-In, UC LetterA2: Opt-Out, UC LetterB3: Active MPM User, UC MPM MessageB5: Non-MPM User, UC Letter

Eligibility Criteria

Age53 Years - 73 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • at least 2 visits to primary care provider within 2 years
  • born between 1945 and 1965

You may not qualify if:

  • have had 1 HCV antibody test, viral load test or are considered up-to-date on HCV screening by health maintenance

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania, 19104, United States

Location

Related Publications (1)

  • Mehta SJ, Day SC, Norris AH, Sung J, Reitz C, Wollack C, Snider CK, Shaw PA, Asch DA. Behavioral interventions to improve population health outreach for hepatitis C screening: randomized clinical trial. BMJ. 2021 May 18;373:n1022. doi: 10.1136/bmj.n1022.

MeSH Terms

Conditions

Hepatitis C

Interventions

College Fraternities and Sororities

Condition Hierarchy (Ancestors)

Blood-Borne InfectionsCommunicable DiseasesInfectionsHepatitis, Viral, HumanVirus DiseasesFlaviviridae InfectionsRNA Virus InfectionsHepatitisLiver DiseasesDigestive System Diseases

Intervention Hierarchy (Ancestors)

OrganizationsHealth Care Economics and Organizations

Study Officials

  • Shivan Mehta, MD, MBA

    University of Pennsylvania

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
SCREENING
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Assistant Professor of Medicine

Study Record Dates

First Submitted

October 16, 2018

First Posted

October 19, 2018

Study Start

March 15, 2019

Primary Completion

October 15, 2020

Study Completion

October 15, 2020

Last Updated

December 1, 2020

Record last verified: 2020-11

Data Sharing

IPD Sharing
Will not share

Locations