Patient Reminders and Self-referrals Via Online Patient Portals and Text Messaging (PReVenT) to Improve Adherence to Breast Cancer Screening – A Pilot Randomized Controlled Trial Open Access

Abstract

Background: Despite evidence that screening mammography (SM) reduces breast cancer mortality, SM adherence rates still fall short of national goals. The aim of this study was to evaluate the impact of Patient Reminders and Self-referrals Via Online Patient Portals and Text Messaging (PReVenT) intervention on SM scheduling and completion rates compared to enhanced usual care (EUC) at 6 months.

 

Methods: This randomized controlled trial was conducted at a single large, urban, academic healthcare system from September 2022 to June 2023. A baseline survey was conducted to confirm eligibility and collect sociodemographic data. Eligible participants were then randomized to the PReVenT or EUC arm. EUC was enhanced by online portal and text messaging about healthy lifestyle. A follow-up survey was sent 6 months post-randomization to assess their scheduling and completion of SM. Intention-to-treat analysis was conducted. Inclusion criteria was females aged 50-74 years, with an active online patient portal account, at least one primary care visit in the healthcare system in 2021, no prior history of breast cancer, and have not had a SM in the past 2 years. The intervention consisted of online portal and SMS reminders to schedule their overdue SM (PReVenT). Our outcome measures were scheduling and completion of SM within 6 months after enrollment.

 

Results: Of 140 consented and randomized participants, 90% completed the 6-month follow-up survey (63 PReVenT and 63 EUC). There were no significant differences in the SM scheduling rates (PReVenT: 44.4% versus EUC: 42.9%; p-value= 0.857) or completion rates (PReVenT: 34.9% versus EUC: 28.6%; p-value= 0.444) by study arm during the 6-month follow-up period. There was no significant association between scheduling or completion rate of SM and study arm, race, income, marital status, or education level (p-value>0.05).

 

Conclusion: In women overdue for SM, over 6 months, targeted online portal and SMS reminders did not result in greater scheduling or completion of SM.

Table of Contents

Chapter 1. Background Literature Review - Page 1

Student Contribution - Page 8

Chapter 2. Journal Article

Title Page - Page 9 Blinded Title Page - Page 11 Key Points - Page 12 Abstract - Page 13 Introduction - Page 15 Methods - Page 16 Results - Page 20 Discussion - Page 21 Conclusion - Page 24 Tables and Figures - Page 25 Appendix - Page 30

Chapter 3. Future Directions/Public Health Implications - Page 36

Bibliography - Page 40

About this Master's Thesis

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School	Rollins School of Public Health
Department	Executive Masters of Public Health - MPH
Subfield / Discipline	Applied Epidemiology
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Medicine and Surgery
Keyword	text messaging screening mammography patient reminders online patient portal
Committee Chair / Thesis Advisor	Mohammed K. Ali, MD, MSc, MBA, Emory University
Committee Members	Ilana Graetz, PhD, Emory University

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