Which Is More Effective at Improving Uptake of Bowel Cancer Screening: Text Message Reminders or Patient Navigation? Results from a three-arm RCT
1
Epidemiology and Public Health, UCL, London, United Kingdom
2
St Mark's Bowel Cancer Screening Centre, St Mark's Hospital, Harrow, United Kingdom
3
Wolfson Institute of Population Health, Queen Mary's University London, London, United Kingdom
4
Surrey University, School of Health sciences, Cape Town, United Kingdom
5
University of Birmingham, Birmingham, United Kingdom
6
NHS England, London, United Kingdom
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
ABSTRACT:
Background. Text message reminders (TMRs) and patient navigation (PN) have the increase bowel cancer screening uptake. Few studies have compared these interventions with one another. Methods. A three-arm randomised controlled trial allocated individuals who had not completed bowel cancer screening within 18 weeks of invitation to no reminder (usual care), TMRs at 19, 21, 23 & 25 weeks, or a text-message reminder at 19 weeks, with telephone PN at 21, 23 and 25 weeks. The primary outcome was participation within 26 weeks of invitation. Differences were assessed using logistic regression. Results. On an intention-to-treat basis (n=3,129), uptake was higher in TMR and PN groups, compared with UC (2.0% vs. 6.5%, p<0.001; 2.0% vs, 7.5%, p<0.001). There was no difference between TMR and PN groups On a per-protocol basis (n=2,294), the difference in uptake between UC and TMR and PN became even larger (2.0% vs. 8.6%, p<0.001; 2.0% vs, 12.6%, p<0.001) as did the difference between the two intervention groups with uptake being significantly higher in the PN vs TMR group respectively (12.6% vs 8.6, p<0.025). Conclusions. PN is more efficacious than text-message reminders on a per-protocol basis but require better reach to optimise effectiveness.
Background. Text message reminders (TMRs) and patient navigation (PN) have the increase bowel cancer screening uptake. Few studies have compared these interventions with one another. Methods. A three-arm randomised controlled trial allocated individuals who had not completed bowel cancer screening within 18 weeks of invitation to no reminder (usual care), TMRs at 19, 21, 23 & 25 weeks, or a text-message reminder at 19 weeks, with telephone PN at 21, 23 and 25 weeks. The primary outcome was participation within 26 weeks of invitation. Differences were assessed using logistic regression. Results. On an intention-to-treat basis (n=3,129), uptake was higher in TMR and PN groups, compared with UC (2.0% vs. 6.5%, p<0.001; 2.0% vs, 7.5%, p<0.001). There was no difference between TMR and PN groups On a per-protocol basis (n=2,294), the difference in uptake between UC and TMR and PN became even larger (2.0% vs. 8.6%, p<0.001; 2.0% vs, 12.6%, p<0.001) as did the difference between the two intervention groups with uptake being significantly higher in the PN vs TMR group respectively (12.6% vs 8.6, p<0.025). Conclusions. PN is more efficacious than text-message reminders on a per-protocol basis but require better reach to optimise effectiveness.
| eISSN: | 2654-1459 |
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