Clinical trial · Interventional
Behavioral Economic Approaches for Population-Based Colorectal Cancer Screening
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
This is a 3-year pragmatic, randomized clinical trial among average-risk patients at diverse primary care practices who are overdue for colorectal (CRC) screening. This project aims to evaluate the effect of a centralized program that includes direct outreach to patients and visit-based, clinician directed nudges facilitated by the electronic health record (EHR) with follow-up text messaging on the uptake of CRC screening. The primary outcome is CRC screening completion at 3 years. Patient and clinician factors impacting the experience and effectiveness of the intervention will be explored through surveys and qualitative interviews.
Conditions
Conditions (1)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Colorectal Cancer | Malignant Colorectal Neoplasm | CURATED_BROADER | 0.80 |
Interventions
Interventions (5)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| Direct Patient Outreach: Colonoscopy Only | Behavioral | — | UNRESOLVED |
| Direct Patient Outreach: Sequential Choice | Behavioral | — | UNRESOLVED |
| No Direct Patient Outreach | Behavioral | — | UNRESOLVED |
| No Nudge/Text | Behavioral | — | UNRESOLVED |
| Visit-Based Nudge/Text | Behavioral | — | UNRESOLVED |
Design
Arms and outcomes
Arms (5)
- type
- EXPERIMENTAL
- label
- Arm 1A: Usual Care
- description
- Patients assigned to the Usual Care arm will receive current usual care and will not receive direct patient outreach or any visit-based interventions from this trial.
- interventionNames
- Behavioral: No Direct Patient Outreach
- Behavioral: No Nudge/Text
- type
- EXPERIMENTAL
- label
- Arm 2A: Colonoscopy Only and No Nudge/Text
- description
- Using bulk ordering, patients assigned to this arm will receive an order for colonoscopy and direct outreach (via text message and either the electronic patient portal or mailed letter, depending on their patient portal status) informing them they are overdue for CRC screening. Patients randomized to this arm will not receive visit-based interventions.
- interventionNames
- Behavioral: Direct Patient Outreach: Colonoscopy Only
- Behavioral: No Nudge/Text
Eligibility
Eligibility (as posted)
- Sex
- All
- Minimum age
- 50 Years
- Maximum age
- 72 Years
Show eligibility criteria text
Inclusion Criteria: * Patients ages 50-72 * Followed by Primary Care with a participating Penn Medicine PCP listed and at least one visit in the last 2 years * Not up to date on colorectal cancer screening per Health Maintenance (no colonoscopy in the last 10 years, stool testing in the last year, flexible sigmoidoscopy in the last 5 years, MT-sDNA in the last 3 years). Exclusion Criteria: * Personal or significant family history of CRC, colonic polyps, hereditary nonpolyposis colorectal cancer syndrome, familial adenomatous polyposis syndrome, other gastrointestinal cancer, gastrointestinal bleeding, iron-deficiency anemia, or inflammatory bowel disease * History of total colectomy, dementia or metastatic cancer * Currently on hospice or receiving palliative care * Uninsured or self-pay patients * Currently scheduled for a colonoscopy or sigmoidoscopy * Active order for multitarget stool DNA testing (MT-sDNA) * History of paraplegia or quadriplegia * Elevated chance of mortality within 3 years according to mortality risk algorithm * Active order for Fecal Immunochemical Test (FIT) in the last 60 days * Positive stool test (FIT or MT-sDNA) result in the last 5 years
References
Publications (1)
- DERIVEDMehta SJ, Shaw PA, Reitz C, Brophy C, Okorie E, Williams K, Segura A, Tao J, Snider CK, Wollack C, Friday S, Rendle KA, Klaiman T, Glanz K, Rhodes C, Asch DA. Sequential choice vs colonoscopy outreach for colorectal cancer screening: Design and rationale of a pragmatic randomized clinical trial. Contemp Clin Trials. 2026 Feb;161:108188. doi: 10.1016/j.cct.2025.108188. Epub 2025 Dec 16. PMID 41412475