Evidence-based colorectal cancer screening for the uninsured
The study will be conducted at John Peter Smith Health System (JPS). organized outreach will consist of a mailed invitation to approximately 20,000 eligible participants. The invitation letter will include information regarding importance of CRC screening, and a FiT kit. Screening participation will be promoted with automated phone reminders before and after invitation delivery, as well as [Quote]live[Quote] phone reminders. Guideline appropriate follow-up will delivered, including facilitation of colonoscopy for patients with abnormal FiTs, and annual repeat FiT invitation for 3 years for patients with normal FiTs.
To understand the impact of offering financial incentives on screening completion, a subset of 2,000 randomly assigned patients will be offered an additional modest $5 or $10 gift card for completing screening.
evaluation aim a) Determine screening rate improvement after expanding screening outreach to all unscreened patients. We predict the population screening rate will be [Greater Than]10% higher after outreach expansion compared to baseline.
evaluation aim B) Compare rates of initial and repeat screening completion among 1) Patients offered a modest financial incentive to complete screening, in addition to outreach invitations, vs. 2) Patients offered outreach invitations alone.
evaluation aim C) among patients receiving financial incentives to complete screening, compare rates of initial and repeat screening completion between patients receiving $5 vs. $10 incentives.
evaluation aim D) assess all CPRiT required outcomes, including increase in early stage cancer detection from baseline, as well as health system changes required to boost screening.
1. Patients who have identified the John Peter Smith Health System as their medical home by having one or more visits to a JPS primary care clinic within a year.
2. Age 50-64
3. Uninsured, but participants in JPS's medical assistance program for the uninsured.
4. Not up-to-date with colorectal cancer screening.