Clinical trial NCT06640426: Messaging Intervention to Increase Medicare Annual Wellness Visits -- the NUDGE AWV Clinical Trial
Official title: Messaging Intervention to Increase Medicare Annual Wellness Visits: the MIMA Randomized Clinical Trial
Study type: INTERVENTIONAL
Overall status: ACTIVE_NOT_RECRUITING
Phase: NA
Conditions: Annual Wellness Visit
Breast Cancer Screening
Colon Cancer Screening
Lead sponsor: Ascension Health
Sponsor class: INDUSTRY
First posted: 2024-10-15
Enrollment: 50000
Sex: ALL
Minimum age (years): 65
Standard ages: OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: This study will use a randomized controlled trial to evaluate a health system initiative to improve Medicare Annual Wellness Visit (AWV) completion. Investigators will randomly assign Ascension Health patients who are eligible for an AWV to one of three conditions. Patients in Treatment Condition #1 will receive a set of up to five email and text messages over the course of eight days, while also receiving usual care which could include messaging from their practice or the electronic health record. Patients in Treatment Condition #2 will receive a set of two email and text messages on a single day. Patients in the Control Condition will receive no messages as part of this campaign, but will be receiving usual care, which could include messages related to AWV's from their primary care practice or from the electronic health record.
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: Medicare Annual Wellness Visits (AWVs) are critical for addressing preventive care needs among older adults, yet the most recent estimates from the Center for Medicare Services suggest less than 50% of eligible patients take advantage of this free healthcare benefit. Behavioral science-informed messaging interventions offer a promising strategy to increase AWV participation by guiding patient behavior. In this study, investigators will evaluate a health system initiative that utilizes personalized email and text messages to encourage Medicare beneficiaries to schedule and attend their AWVs. This approach aims to boost patient engagement in preventive health services, ultimately improving care outcomes for older adult populations

Detailed description: The Centers for Medicare \& Medicaid Services (CMS) recommends Annual Wellness Visits (AWVs) to encourage preventive care and improve long-term health outcomes for Medicare beneficiaries. These visits are designed to provide a proactive approach to healthcare by focusing on identifying risk factors, updating medical histories, and developing personalized prevention plans that promote early detection of diseases. By prioritizing prevention over treatment, AWVs help reduce the overall cost burden on the healthcare system while enhancing patient engagement and empowering individuals to take a more active role in managing their health. Yet despite these benefits, most Medicare members who are eligible for an AWV - at no cost to them - do not complete one.

Behavioral science research suggests that personalized messages, designed to facilitate action, can have significant impacts on health behavior. Studies have found these messaging interventions can increase vaccination rates, cancer screening rates, and other care gap closure.

Eligibility criteria: Inclusion Criteria:

* Age 65 or older
* Have either a mobile phone number or an email address on file with the health system
* Included in and non-compliant on the Ascension AWV Clinical Priority Goal measure
* Have consented to receive electronic communications from the health system

Exclusion Criteria:

* Patients whose primary care providers are exempted from the campaign by the health system
* Completed MAWV appointment in previous 30 days
* Has an upcoming AWV appointment scheduled
* Have received a nudge campaign from the Clinical Transformation team in the past 90 days
* Patients who have previously opted out of receiving electronic communications from the health system in our message delivery platform (Salesforce)

Primary outcomes:
measure: Annual Wellness Visit scheduling
timeFrame: 14 days
Secondary outcomes:
measure: Completed Annual Wellness Visit
timeFrame: 90 Days
measure: Days to Annual Wellness Visit Completion
timeFrame: 90 days
Other outcomes:
measure: Breast cancer screening
timeFrame: 180 days
measure: Colon Cancer Screening
timeFrame: 180 days
measure: Ordering of tests for breast cancer screening
timeFrame: 90 days
measure: Ordering of tests for colon cancer screening
timeFrame: 90 days
Locations:
city: St. Louis
country: United States
facility: Ascension Health
state: Missouri
Study officials:
References: