Text message reminders cannot replace but can improve the effect of postal reminders to increase participation in colorectal cancer screening: a randomized controlled trial

Background: Mobile phone SMS text message reminders have shown moderate effects in improving participation rates in ongoing colorectal cancer screening programs. Objective: This study aimed to assess the effectiveness of SMS text messages as a replacement for routine postal reminders in a fecal immu...

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Autores: Vives, Núria, Binefa i Rodríguez, Gemma, Travier, Noemie, Farre, Albert, Panera, Jon Aritz, Casas, Berta, Vidal, Carmen, Ibáñez Sanz, Gemma, Garcia, Montse, M-tics Research Group
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/219438
Acceso en línea:https://hdl.handle.net/2445/219438
Access Level:acceso abierto
Palabra clave:Càncer colorectal
Servei de missatges curts
Cribratge
Colorectal cancer
Text messages (Telephone systems)
Medical screening
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spelling Text message reminders cannot replace but can improve the effect of postal reminders to increase participation in colorectal cancer screening: a randomized controlled trialVives, NúriaBinefa i Rodríguez, GemmaTravier, NoemieFarre, AlbertPanera, Jon AritzCasas, BertaVidal, CarmenIbáñez Sanz, GemmaGarcia, MontseM-tics Research GroupCàncer colorectalServei de missatges curtsCribratgeColorectal cancerText messages (Telephone systems)Medical screeningBackground: Mobile phone SMS text message reminders have shown moderate effects in improving participation rates in ongoing colorectal cancer screening programs. Objective: This study aimed to assess the effectiveness of SMS text messages as a replacement for routine postal reminders in a fecal immunochemical test-based colorectal cancer screening program in Catalonia, Spain. Methods: We conducted a randomized controlled trial among individuals aged 50 to 69 years who were invited to screening but had not completed their fecal immunochemical test within 6 weeks. The intervention group (n=12,167) received an SMS text message reminder, while the control group (n=12,221) followed the standard procedure of receiving a reminder letter. The primary outcome was participation within 18 weeks of the invitation. The trial was stopped early, and a recovery strategy was implemented for nonparticipants in the intervention group. We performed a final analysis to evaluate the impact of the recovery strategy on the main outcome of the trial. Participation was assessed using a logistic regression model adjusting for potential confounders (sex, age, and deprivation score index) globally and by screening behavior. Results: The trial was discontinued early in September 2022 due to the results of the interim analysis. The interim analysis included 5570 individuals who had completed 18 weeks of follow-up (intention-to-treat). The SMS text message group had a participation rate of 17.2% (477/2781), whereas the control group had a participation rate of 21.9% (610/2789; odds ratio 0.71, 95% CI 0.62-0.82; P<.001). As a recovery strategy, 7591 (72.7%) out of 10,442 nonparticipants in the SMS text message group had an open screening episode and received a second reminder by letter, reaching a participation rate of 23% (1748/7591). The final analysis (N=24,388) showed a participation rate of 29.3% (3561/12,167) in the intervention group, which received 2 reminders, while the participation rate was 26.5% (3235/12,221) in the control group (odds ratio 1.16, 95% CI 1.09-1.23; P<.001). Conclusions: Replacing SMS text messages with reminder letters did not increase the participation rate but also led to a decline in participation among nonparticipants 6 weeks after the invitation. However, sending a second reminder by letter significantly increased participation rates among nonparticipants within 6 weeks in the SMS text message group compared with those who received 1 postal reminder (control group). Additional research is essential to determine the best timing and frequency of reminders to boost participation without being intrusive in their choice of participation. Trial Registration: ClinicalTrials.gov NCT04343950; https://www.clinicaltrials.gov/study/NCT04343950JMIR Publications Inc.2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/219438Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.2196/64243JMIR mHealth and uHealth, 2025, vol. 13https://doi.org/10.2196/64243cc-by (c) Vives, Núria, et al., 2025http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/2194382026-05-27T06:46:51Z
dc.title.none.fl_str_mv Text message reminders cannot replace but can improve the effect of postal reminders to increase participation in colorectal cancer screening: a randomized controlled trial
title Text message reminders cannot replace but can improve the effect of postal reminders to increase participation in colorectal cancer screening: a randomized controlled trial
spellingShingle Text message reminders cannot replace but can improve the effect of postal reminders to increase participation in colorectal cancer screening: a randomized controlled trial
Vives, Núria
Càncer colorectal
Servei de missatges curts
Cribratge
Colorectal cancer
Text messages (Telephone systems)
Medical screening
title_short Text message reminders cannot replace but can improve the effect of postal reminders to increase participation in colorectal cancer screening: a randomized controlled trial
title_full Text message reminders cannot replace but can improve the effect of postal reminders to increase participation in colorectal cancer screening: a randomized controlled trial
title_fullStr Text message reminders cannot replace but can improve the effect of postal reminders to increase participation in colorectal cancer screening: a randomized controlled trial
title_full_unstemmed Text message reminders cannot replace but can improve the effect of postal reminders to increase participation in colorectal cancer screening: a randomized controlled trial
title_sort Text message reminders cannot replace but can improve the effect of postal reminders to increase participation in colorectal cancer screening: a randomized controlled trial
dc.creator.none.fl_str_mv Vives, Núria
Binefa i Rodríguez, Gemma
Travier, Noemie
Farre, Albert
Panera, Jon Aritz
Casas, Berta
Vidal, Carmen
Ibáñez Sanz, Gemma
Garcia, Montse
M-tics Research Group
author Vives, Núria
author_facet Vives, Núria
Binefa i Rodríguez, Gemma
Travier, Noemie
Farre, Albert
Panera, Jon Aritz
Casas, Berta
Vidal, Carmen
Ibáñez Sanz, Gemma
Garcia, Montse
M-tics Research Group
author_role author
author2 Binefa i Rodríguez, Gemma
Travier, Noemie
Farre, Albert
Panera, Jon Aritz
Casas, Berta
Vidal, Carmen
Ibáñez Sanz, Gemma
Garcia, Montse
M-tics Research Group
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Càncer colorectal
Servei de missatges curts
Cribratge
Colorectal cancer
Text messages (Telephone systems)
Medical screening
topic Càncer colorectal
Servei de missatges curts
Cribratge
Colorectal cancer
Text messages (Telephone systems)
Medical screening
description Background: Mobile phone SMS text message reminders have shown moderate effects in improving participation rates in ongoing colorectal cancer screening programs. Objective: This study aimed to assess the effectiveness of SMS text messages as a replacement for routine postal reminders in a fecal immunochemical test-based colorectal cancer screening program in Catalonia, Spain. Methods: We conducted a randomized controlled trial among individuals aged 50 to 69 years who were invited to screening but had not completed their fecal immunochemical test within 6 weeks. The intervention group (n=12,167) received an SMS text message reminder, while the control group (n=12,221) followed the standard procedure of receiving a reminder letter. The primary outcome was participation within 18 weeks of the invitation. The trial was stopped early, and a recovery strategy was implemented for nonparticipants in the intervention group. We performed a final analysis to evaluate the impact of the recovery strategy on the main outcome of the trial. Participation was assessed using a logistic regression model adjusting for potential confounders (sex, age, and deprivation score index) globally and by screening behavior. Results: The trial was discontinued early in September 2022 due to the results of the interim analysis. The interim analysis included 5570 individuals who had completed 18 weeks of follow-up (intention-to-treat). The SMS text message group had a participation rate of 17.2% (477/2781), whereas the control group had a participation rate of 21.9% (610/2789; odds ratio 0.71, 95% CI 0.62-0.82; P<.001). As a recovery strategy, 7591 (72.7%) out of 10,442 nonparticipants in the SMS text message group had an open screening episode and received a second reminder by letter, reaching a participation rate of 23% (1748/7591). The final analysis (N=24,388) showed a participation rate of 29.3% (3561/12,167) in the intervention group, which received 2 reminders, while the participation rate was 26.5% (3235/12,221) in the control group (odds ratio 1.16, 95% CI 1.09-1.23; P<.001). Conclusions: Replacing SMS text messages with reminder letters did not increase the participation rate but also led to a decline in participation among nonparticipants 6 weeks after the invitation. However, sending a second reminder by letter significantly increased participation rates among nonparticipants within 6 weeks in the SMS text message group compared with those who received 1 postal reminder (control group). Additional research is essential to determine the best timing and frequency of reminders to boost participation without being intrusive in their choice of participation. Trial Registration: ClinicalTrials.gov NCT04343950; https://www.clinicaltrials.gov/study/NCT04343950
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/219438
url https://hdl.handle.net/2445/219438
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.2196/64243
JMIR mHealth and uHealth, 2025, vol. 13
https://doi.org/10.2196/64243
dc.rights.none.fl_str_mv cc-by (c) Vives, Núria, et al., 2025
http://creativecommons.org/licenses/by/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Vives, Núria, et al., 2025
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv JMIR Publications Inc.
publisher.none.fl_str_mv JMIR Publications Inc.
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.812455

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