A Patient Reminder and Self-Referral Via Online Patient Portals and Text Messaging to Improve Adherence to Breast Cancer Screening

Patient Reminders and Self-Referrals Via Online Patient Portals and Text Messaging (PReVenT) to Improve Adherence to Breast Cancer Screening

This clinical trial evaluates the patient reminders and self-referrals via online patient portals and text messaging (PReVenT) intervention for improving adherence to breast cancer screening. Though no doctor referral is required for mammography, adherence to screening mammograms remains low. Barriers to screening mammography can include things like forgetfulness, low motivation, high cost, or lack of knowledge. Patient reminders and self-scheduling assistance may overcome some of these barriers by increasing patients' awareness, motivating them to schedule their mammogram, and improving access by removing the need for a healthcare provider to order the exam. The PReVenT intervention uses online and text-message based patient-reminders and self-referral assistance to increase adherence to breast cancer screening.

PRIMARY OBJECTIVES; I. Compare the screening mammogram (SM) completion rates between PReVenT and enhanced usual care (EUC) arms at 6 months.

II. Describe patient's experience with the PReVenT intervention using mixed methods stratified by completion of SM.

OUTLINE: Participants are randomized to 1 of 2 arms.

ARM I: Participants receive usual care as well as a portal message reminder to schedule a SM and a callback link if they need assistance. Participants who have not or do not schedule their SM at the time of the first reminder receive a reminder text-message one week later with a link to receive assistance with scheduling.

ARM II: Participants receive usual care as well as portal and text messages one week apart with educational materials about healthy eating.

After completion of study, patients are followed up at 6 months.

Inclusion Criteria:

• Women aged 50-74 years
• Active online patient portal account
• Mobile phone number listed in the electronic medical record (EMR)
• At least one primary care visit in our healthcare system between 2015 and 2021
• No screening mammography performed in our healthcare system in the last 2 years

Exclusion Criteria:

• Because of limited research team and patient portal language at this time, non-English speaking patient will be excluded
• Personal history of breast cancer or prior mastectomy
• Participants who already have an upcoming SM scheduled within or outside of Emory Healthcare
• Patients who had a screening mammography at an outside facility within the prior 2 years
• Patients with severe comorbidities at the time of the study (in palliative care or hospitalized at the time of the study)
• Participants who are cognitively impaired or have with history of Alzheimer's disease or dementia