Harnessing the Question-Behavior Effect to Enhance Colorectal Cancer Screening in an mHealth Experiment

To assess whether asking questions about a future behavior changes this behavior (i.e., the question-behavior effect) when applied to a population-level intervention to enhance colorectal cancer screening. In 2013, text-message reminders were sent to a national sample of 50 000 Israeli women and men...

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Bibliographic Details
Published in:American journal of public health (1971) 2016-11, Vol.106 (11), p.1998-2004
Main Authors: Hagoel, Lea, Neter, Efrat, Stein, Nili, Rennert, Gad
Format: Article
Language:English
Subjects:
Aged
AJPH Research
Blood
Blood & organ donations
Blood tests
Colonoscopy
Colorectal cancer
Colorectal carcinoma
Colorectal Neoplasms - diagnosis
Confidence intervals
Early Detection of Cancer - methods
Feces
Female
Health behavior
Health Promotion
Health Promotion - methods
Humans
Intervention
Israel
Male
Medical screening
Middle Aged
Models, Psychological
Occult Blood
Odds Ratio
Prevention
Public health
Public Health Practice
Reminder Systems
Screening
Socioeconomic Factors
Studies
Telemedicine
Text Messaging
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Summary:To assess whether asking questions about a future behavior changes this behavior (i.e., the question-behavior effect) when applied to a population-level intervention to enhance colorectal cancer screening. In 2013, text-message reminders were sent to a national sample of 50 000 Israeli women and men aged 50 to 74 years following a fecal occult blood test invitation. Participants were randomized into 4 intervention groups (2 interrogative reminders, with or without reference to social context; 2 noninterrogative reminders, with or without social context) and a no-intervention control group. The outcome was fecal occult blood test uptake (n = 48 091, following attrition). Performance of fecal occult blood test was higher in the interrogative-reminder groups than in the other 3 groups (odds ratio = 1.11; 95% confidence interval = 1.05, 1.19); the effect size was small, varying in the different group comparisons from 0.03 to 0.06. The question-behavior effect appears to be modestly effective in colorectal cancer screening, but the absolute number of potential screenees may translate into a clinically significant health promotion change.
ISSN:0090-0036
1541-0048
DOI:10.2105/AJPH.2016.303364