Live calls outperform texts for mailed FIT notifications
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Individuals who received live phone calls were more likely to complete a mailed fecal immunochemical test than those who received a text message, according to study results.
Gloria Coronado, PhD, of the Center for Health Research at Kaiser Permanente Northwest, and colleagues wrote that it is important to understand how to best optimize FIT outreach programs, because they have shown to help improve completion rates.
“While many previous mailed FIT programs have delivered advance notifications in the form of introductory letters, text messages or automated phone calls, relatively few programs have reported on their specific effectiveness,” they wrote. “We are unaware of any previous study that specifically evaluated live phone call or text message primers to a mailed FIT outreach program.”
Researchers conducted a randomized trial that included patients at a large, urban health center aged between 50 and 75 years who were due for colorectal cancer screening. They placed participants into groups that received either a live phone call primer (n = 1,203) or a text message primer (n = 1,622). Participants then received a mailed FIT kit followed by two automated calls and a live reminder from their care team.
The primary outcome of the study was the completion of FIT within 3 months of the group assignments.
Investigators were able to successfully reach 81% of individuals in the text group. Among individuals in the call groups, researchers reached 438 (36%) in a live discussion, left 386 (32%) a message and could not reach 379 (33%).
In adjusted intention to treat analysis (n = 2,825), FIT completion rates were higher among patients in the live call group compared with the text group (percentage point difference 3.3%; 95% CI, 0.4%-6.2%). The difference between the two groups increased to 7.3% (95% CI, 3.6%-11%) in the per-protocol analysis of individuals who had verified receipt of text message, live call or voice message)
Among individuals who were reached by the text message and those reached by live call, the difference between the two groups increased to 14.9% (95% CI, 9.6%-20.1%).
“Advance notification live phone calls outperformed text message notifications in a mailed FIT outreach program delivered by a large, Latino-serving health center to patients who had never completed a FIT,” Coronado and colleagues wrote. “Text message notifications led to no improvements in FIT completion. Our findings can inform efforts to optimize mailed FIT outreach programs.”
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