Reducing Urban Cervical Cancer Disparities Using a Tailored MHealth Intervention to Enhance Colposcopy Attendance
Fox Chase Cancer Center
Summary
This study uses a hybrid Type 1 effectiveness-implementation trial to operationalize and assess the efficacy of the Health Enhancement Resource System (HERS) intervention. HERS aims to increase patient follow-up after abnormal test results through text message-based barriers counseling for women and supplemental telephone-based Health Coaching for women who miss their appointment.
Description
Invasive cervical cancer is preventable with well-established screening and diagnostic tests. However, there is a large and persistent disparity gap in cervical cancer mortality rates among urban, underserved populations that continues to intensify. This gap is largely due to low follow-up after an abnormal test result leading to continued disease risk. The study team developed an efficacious, tailored telephone counseling intervention delivered by a health coach \[Tailored Communication for Cervical Cancer Risk (TC3)\] that increased attendance at follow-up appointments for initial colposcop…
Eligibility
- Age range
- 18–90 years
- Sex
- Female
- Healthy volunteers
- Yes
Inclusion Criteria: * 18 to 90 years of age (screening is still recommended for some women over 65-depending on screening and medical history and proceeds until age 90 in the study's clinic recruitment sites), * referral for colposcopic evaluation at the clinic sites, * able to communicate with ease in English, * have a cell phone with texting ability, and * competent to give consent. Exclusion Criteria: * are pregnant at the time of recruitment, * display current evidence or have a history of positive invasive carcinoma of the cervix, or * require follow-up but not a colposcopy.
Interventions
- BehavioralStage 1 SOC
Participants will receive high Standard Care, consisting of a telephone call approximately one month before the appointment to confirm the appointment date for the baseline colposcopy appointment, followed by a notification letter including scheduled appointment date and clinic contact information should the clinic be unable to reach the patient by telephone.
- BehavioralStage 1 HERS
Participants will receive text message appointment reminders and barriers messages. Text messages will be sent on a prescheduled basis over the course of 2 weeks preceding the scheduled target appointment.
- BehavioralStage 2 HERS
Participants will receive another barriers assessment and another round of text message appointment reminders and barriers messages.
- BehavioralStage 2 HERS+HC
Participants will receive another barriers assessment and another round of text message barriers counseling as well as health coaching (HC) after their missed appointment. Participants that miss their scheduled appointment will receive a HC call within 2 business days. HC calls will be flexibly scheduled based on the preference of the patients and limited to 15 minutes or less.
- BehavioralStage 3 SOC
Locations (3)
- Rutgers, The State University of New JerseyNew Brunswick, New Jersey
- Thomas Jefferson UniversityPhiladelphia, Pennsylvania
- Fox Chase Cancer CenterPhiladelphia, Pennsylvania