Wired For Colorectal Cancer Screening: An Mhealth Intervention


Colorectal cancer (CRC) is the third leading cause of cancer-related deaths in the United States. Medicallyunderserved populations experience a disproportionate burden of CRC mortality. Fecal occult blood test(FOBT) is a simple, easy to do, and widely accessible screening modality that helps to diminish CRCmortality disparities. The effectiveness of FOBT to reduce CRC mortality depends heavily on adherence toannual testing. Unfortunately, repeat FOBT screening ranges from 14% to 44%. A novel approach toencourage repeat annual FOBT is a technology-driven low cost mobile health (mHealth) educationalintervention. mHealth interventions have been shown to lead to behavior change in a variety diseases;however its use to facilitate annual CRC screening (CRCS) with FOBT has not been studied. There is atimely opportunity to promote repeat annual FOBT screening in an existing cohort of medically underservedmen and women enrolled in a trial to increase initial uptake of fecal immunochemical test (FIT), a type ofFOBT, at community based clinics. Assessment of repeat FIT is beyond the scope of the parent trial, butrepeat FIT uptake is expected to be low. The subject of this application is to explore the efficacy of aninnovative, low cost, educational, evidence-based and theory-based mHealth intervention to promoteadherence to annual FIT in a medically underserved population. During Phase I, a series of educational,targeted, and actionable mHealth messages will be developed and refined. This will be achieved by iterativefocus groups and mobile technology testing and troubleshooting with (n=35) patients seen in communityclinics. During Phase II, the feasibility, acceptability and preliminary efficacy of the Wired for CRCSintervention to educate and prompt patients to repeat CRCS with FIT will be assessed. To achieve this, 120members of the existing cohort of men and women who are not up to date on annual FIT will be recruitedand randomized to the Wired for CRCS intervention arm or usual care arm. Those randomized to the Wiredfor CRCS intervention will receive a series of educational, targeted, and actionable messages (refinedduring Phase I) on their cell phone. FIT uptake will be assessed four months after baseline. It is expectedthat the Wired for CRCS intervention will result in greater FIT uptake compared to usual care. Successful completion of this research will provide preliminary information on feasibility, acceptability, efficacy, usabilityand utility of a technology solution for promoting repeat annual FIT in a diverse sample of patients atcommunity clinics. With this evidence, the team will be poised for a larger trial expected to provide a moredefinitive test of educational mHealth interventions on adherence to CRCS with annual FIT.
Effective start/end date9/1/168/31/18


  • National Institutes of Health (NIH)


Occult Blood
Hematologic Tests
Early Detection of Cancer
Colorectal Neoplasms
Costs and Cost Analysis
Cell Phones
Vulnerable Populations