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Cancer. 2017 Apr 15;123(8):1382-1389. doi: 10.1002/cncr.30499. Epub 2016 Dec 21.

Text message reminders increased colorectal cancer screening in a randomized trial with Alaska Native and American Indian people.

Author information

1
Partnerships for Native Health, Washington State University, Seattle, Washington.
2
Southcentral Foundation, Anchorage, Alaska.
3
United States Public Health Service, Indian Health Service, Region X, Southcentral Foundation.

Abstract

BACKGROUND:

Alaska Native and American Indian people (AN/AIs) have a high incidence of colorectal cancer (CRC) and CRC-related mortality. Screening can prevent death from CRC, but screening rates are low in racially and ethnically diverse populations. The authors conducted a randomized controlled trial using text messaging to increase CRC screening among unscreened AN/AIs in a tribal health care system in Anchorage, Alaska.

METHODS:

The intervention entailed up to 3 text messages sent 1 month apart. The authors randomized 2386 AN/AIs aged 40 to 75 years who were eligible for CRC screening to the intervention or usual-care control conditions. Screening status was ascertained from electronic health records 3 months and 6 months after the last text message. Hazard ratios (HRs) were estimated to evaluate the effectiveness of the intervention, stratified by age and sex.

RESULTS:

The intervention increased CRC screening for AN/AIs aged 50 to 75 years (HR, 1.42; 95% confidence interval [95% CI], 0.97-2.09) and aged 40 to 49 years (HR, 1.24; 95% CI, 0.95-1.62). Within both age groups, the HRs were higher for women (HR, 1.69 [95% CI, 1.02-2.80] and HR, 1.37 [95% CI, 1.01-1.88]) compared with men (HR, 1.09 [95% CI, 0.59-1.99] and HR, 0.90 [95% CI, 0.54-1.53]). Interaction analysis yielded P values of .55 and .09, respectively, for age and sex.

CONCLUSIONS:

A simple text messaging intervention was found to increase CRC screening rates in AN/AIs, a group with high CRC morbidity and mortality. Text messaging may be a cost-effective means of reducing CRC screening disparities in AN/AIs and other populations. Cancer 2017;123:1382-1389. © 2016 American Cancer Society.

KEYWORDS:

Alaska Natives; American Indians; Native Americans; cancer screening; colorectal cancer; randomized controlled trial; text messaging

PMID:
28001304
PMCID:
PMC5384860
DOI:
10.1002/cncr.30499
[Indexed for MEDLINE]
Free PMC Article

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