Mammogram Mail- and Phone-based Interventions

Study Overview
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Brief Summary
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The project aims to evaluate four different versions and modalities of interventions encouraging mammogram screening among all eligible women due or overdue for screening. The evaluation will compare among the following forms of outreach to help determine whether (a) live calls are more effective at increasing mammogram screening than other forms of outreach and (b) each form of outreach is more effective than no outreach: (1) a postcard, (2) a letter, (3) an auto-dialer phone message, and (4) a live call from a care gaps team. The interventions will be rolled out over many months, allowing for comparisons of effectiveness against those who have not yet been contacted.

Official Title
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Randomized Comparison of Mail- and Phone-based Interventions Promoting Mammogram Screening

Conditions
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Breast Cancer

Intervention / Treatment
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* Behavioral: Postcard
* Behavioral: Letter
* Behavioral: Auto-dialer
* Behavioral: Live call


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Female Geisinger Health Plan members between ages 52 and 74 as of December 31, 2023 Overdue for annual mammogram Continuously enrolled with the Geisinger Health Plan as of October 1, 2021 Can be contacted via both phone and mail Exclusion Criteria: Geisinger Health Plan members on a do-not-contact list Had a mammogram as of October 1, 2021 In hospice, using hospice services, or receiving palliative care as of January 1, 2023 Medicare members 66 years of age or above at time of outreach, who are institutionalized or have both frailty and advanced illness Had a bilateral mastectomy at any time

Ages Eligible for Study
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Minimum Age: 51 Years
Maximum Age: 74 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Screening
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Each intervention will be rolled out to only a subset of the total population each month, such that all patients will receive one of the interventions over the course of 7 months. Active arms will be compared contemporaneously against a passive control group consisting of active arm participants for whom the intervention has not yet begun, as well as a random subset of participants who are excluded before the future intervention begins.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Standard postcard<br>Patients in this arm will receive a postcard with words and an image, typical of outreach in prior years, encouraging them to schedule their annual mammograms. | Behavioral: Postcard<br>* Postcard with phone number to call for help scheduling a mammogram.<br>|
| Experimental: Formal letter<br>Patients in this arm will receive a letter from the Geisinger Health Plan (on Geisinger letterhead) noting that they're overdue for a mammogram and encouraging them to schedule. | Behavioral: Letter<br>* Letter with phone number to call for help scheduling a mammogram.<br>|
| Experimental: Auto-dialer<br>Patients in this arm will receive a call from an auto-dialer with a message noting that they're overdue for a mammogram and encouraging them to schedule. | Behavioral: Auto-dialer<br>* Auto-dialer with option to press button for help scheduling a mammogram.<br>|
| Experimental: Live call<br>Patients in this arm will receive a call from a Geisinger Health Plan representative noting that they're overdue for a mammogram and encouraging them to schedule (and helping them schedule if they are interested). | Behavioral: Live call<br>* Live call offering help scheduling a mammogram.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mammogram completed | Record of completed mammogram (yes/no), for comparing postcards, letters, and auto-dialer messages with live calls | In the 180 days following the patient's intervention send date | 
| Mammogram completed | Record of completed mammogram (yes/no), for comparing postcards, letters, auto-dialer messages, and live calls with controls | In the 120 days following the patient's intervention send date | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Economics, Behavioral, Mammography, Risk Reduction Behavior, Communication