Financial Incentives to Increase Colorectal Cancer Screening in Priority Populations

Kaiser Permanente898 enrolled

Overview

The investigators propose to build on the success of the Systems of Support to Increase Colorectal Cancer trial (SOS, R01CA121125, Green) and focus on disparity groups who are less likely to be current for colorectal cancer (CRC) screening. We will test whether financial incentives increases screening uptake and decreases screening disparities. The investigators hypothesize that CRC screening rates will be higher in patients offered mailed fecal kits and financial incentives than those offered mailed fecal kits alone.

Study staff will send invitation letters and a questionnaire to 5,000 patients aged 50-75 not current for CRC screening, two-thirds who are identified in the electronic data as being from a non-White race, ethnicity, or who have Medicaid coverage. Those returning the survey and remaining eligible (estimated N = 1150) will be randomized to either (1) Mailed fecal kit only, or mailed fecal kit plus one of 2 types of financial incentives for completing testing: (2) a guaranteed Monetary incentive or (3) a probabilistic Lottery incentive.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SCREENING

Masking

SINGLE

Enrollment

898

Conditions

Colorectal Cancer

Interventions

Auto Mailing Plus MoneyBEHAVIORAL

Participant receives money as a thank you for completing CRC screening within 6 months.

Auto Mailing Plus LotteryBEHAVIORAL

Participant has a 1 in 10 chance of winning money in a lottery for completing CRC screening within 6 months.

Eligibility

Sex: ALLMin age: 50 YearsMax age: 75 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * No evidence in electronic data of FIT screening in past year or a colonoscopy in the prior 9 years. * Continuously enrolled in Group Health Cooperative (GHC) for at least one year. * Patients who have Medicaid coverage or are non-white race or Hispanic any race. Exclusion Criteria: * Known high risk for CRC * History of CRC * History of inflammatory bowel disease * Current anticoagulation therapy * Organ failure * Serious illness * Debilitating disease * Dementia * Nursing home resident

Locations (1)

Group Health Research Institute

Seattle, Washington, United States

Outcomes

Primary Outcomes

CRC Screening Within 6 Months Following Randomization

We will compare among the 3 arms (1) automated mailing; (2) Auto mailing plus $10; (3) Auto mailing plus $50 lottery for completion and the effect of each on CRC screening completion at 6 months (yes/no) within the following subgroups of each arm: 1. White and not Hispanic versus non-White or Hispanic. 2. Medicaid versus non-Medicaid (Medicare, employer-based, private) insurance. 3. History of prior versus no prior completion of CRC screening tests. 4. High school or less versus college or more education level.

Time frame: 6 months

Data from ClinicalTrials.gov

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