Increasing CRC Screening in Community Health Centers Through Mobile Messaging Optimization
CoSMMO
2 other identifiers
interventional
7,220
1 country
4
Brief Summary
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, we will learn from clinic staff and patients what their needs and preferences are in terms of use of technology. We will use this information to design the text messages program.
- Clinic patients will participate in focus groups
- Clinic staff will participate in interviews Second, we 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, we 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, we 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.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable colorectal-cancer
Started Dec 2026
Longer than P75 for not_applicable colorectal-cancer
4 active sites
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
April 29, 2026
CompletedFirst Posted
Study publicly available on registry
May 6, 2026
CompletedStudy Start
First participant enrolled
December 1, 2026
ExpectedPrimary Completion
Last participant's last visit for primary outcome
October 1, 2031
Study Completion
Last participant's last visit for all outcomes
January 1, 2032
May 6, 2026
April 1, 2026
4.8 years
April 29, 2026
April 29, 2026
Conditions
Keywords
Outcome Measures
Primary Outcomes (2)
Text message engagement
Interaction with CRC screening reminder messages by reply
14 days after reminder message delivery
Stool-based CRC screening completion
Stool-based CRC screening test resulted in electronic health record
3 months after reminder message delivery
Secondary Outcomes (2)
Time to follow-up care after abnormal stool-based screening test
3 months after date of abnormal result
Invalid test results
3 months after reminder message delivery
Study Arms (16)
Standard Message - Gain Frame
EXPERIMENTALNo personalization, no concerns/negative emotion, gain-framed message.
Concern Message - Gain Frame
EXPERIMENTALNo personalization, screening concerns/negative emotions, gain-framed message.
Concern Message - No Gain Frame
EXPERIMENTALNo personalization, screening concerns/negative emotions, no gain-framed message.
Standard Message - No Gain Frame
EXPERIMENTALNo personalization, no screening concerns/negative emotions, no gain-framed message.
Personalized Message - Gain Frame
EXPERIMENTALPersonalization included, no screening concerns/negative emotions, gain-framed message.
Personalized Message - No Gain Frame
EXPERIMENTALPersonalization included, no screening concerns/negative emotions, no gain-framed message.
Personalized - Concern Message - Gain Frame
EXPERIMENTALPersonalization and screening concerns/negative emotions, gain framed message.
Personalized - Concern Message - No Gain Frame
EXPERIMENTALPersonalization and screening concerns/negative emotions, no gain-framed message.
Basic Outreach Only
EXPERIMENTALNo autonomy support, no impediments support, no live support.
Outreach + Impediments Support
EXPERIMENTALNo autonomy support, no live support. Impediment support.
Outreach + Impediments + Live Support
EXPERIMENTALNo autonomy support. Impediment support and live support included.
Outreach + Live Support
EXPERIMENTALLive support included. No autonomy or impediments support.
Autonomy Outreach Support
EXPERIMENTALAutonomy support included, no impediments or live support.
Autonomy + Live Support
EXPERIMENTALAutonomy and live support with impediments support.
Autonomy + Impediments Support
EXPERIMENTALAutonomy and impediments support included. No live support included.
Autonomy + Impediments + Live Support
EXPERIMENTALAutonomy, impediments, and live support included.
Interventions
Message includes personalized content.
Emotional concerns or barriers related to CRC screening.
Use gain-framed language to influence motivation.
Provide patients with choices or options to increase sense of control.
Offer access to live assistance.
Include information or resources to help overcome barriers to care.
Electronic alerts, dashboards, and tracking systems used to identify and follow up with patients due for CRC screening or abnormal results.
Eligibility Criteria
You may qualify if:
- 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)
You may not qualify if:
- 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)
- Adult employees of participating CHCs
- Job responsibilities include activities related to CRC screening
- None
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- National Institutes of Health (NIH)collaborator
- Massachusetts League of Community Health Centerscollaborator
- Dana-Farber Cancer Institutecollaborator
- University of Texas Southwestern Medical Centercollaborator
- Massachusetts General Hospitalcollaborator
- University of Colorado, Denverlead
- National Cancer Institute (NCI)collaborator
Study Sites (4)
The Massachusetts League of Community Health Center, Inc.
Boston, Massachusetts, 02108, United States
Massachusetts General Hospital
Boston, Massachusetts, 02114, United States
Dana Farber Cancer Institute
Boston, Massachusetts, 02215, United States
University of Texas Southwestern Medical Center
Dallas, Texas, 75390, United States
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Gina Kruse, MD
University of Colorado, Denver
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- NONE
- Purpose
- HEALTH SERVICES RESEARCH
- Intervention Model
- FACTORIAL
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
April 29, 2026
First Posted
May 6, 2026
Study Start (Estimated)
December 1, 2026
Primary Completion (Estimated)
October 1, 2031
Study Completion (Estimated)
January 1, 2032
Last Updated
May 6, 2026
Record last verified: 2026-04
Data Sharing
- IPD Sharing
- Will share
- Shared Documents
- STUDY PROTOCOL, SAP
- Time Frame
- 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.
- Access Criteria
- 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.
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.