scholarly journals Testing Behavior Change Techniques to Encourage Primary Care Physicians to Access Cancer Screening Audit and Feedback Reports: Protocol for a Factorial Randomized Experiment of Email Content

2018 ◽  
Vol 7 (2) ◽  
pp. e11 ◽  
Author(s):  
Gratianne Vaisson ◽  
Holly O Witteman ◽  
Zachary Bouck ◽  
Caroline A Bravo ◽  
Laura Desveaux ◽  
...  
Author(s):  
Gratianne Vaisson ◽  
Holly O Witteman ◽  
Zachary Bouck ◽  
Caroline A Bravo ◽  
Laura Desveaux ◽  
...  

BACKGROUND Cancer Care Ontario’s Screening Activity Report (SAR) is an online audit and feedback tool designed to help primary care physicians in Ontario, Canada, identify patients who are overdue for cancer screening or have abnormal results requiring follow-up. Use of the SAR is associated with increased screening rates. To encourage SAR use, Cancer Care Ontario sends monthly emails to registered primary care physicians announcing that updated data are available. However, analytics reveal that 50% of email recipients do not open the email and less than 7% click the embedded link to log in to their report. OBJECTIVE The goal of the study is to determine whether rewritten emails result in increased log-ins. This manuscript describes how different user- and theory-informed messages intended to improve the impact of the monthly emails will be experimentally tested and how a process evaluation will explore why and how any effects observed were (or were not) achieved. METHODS A user-centered approach was used to rewrite the content of the monthly email, including messages operationalizing 3 behavior change techniques: anticipated regret, material incentive (behavior), and problem solving. A pragmatic, 2x2x2 factorial experiment within a multiphase optimization strategy will test the redesigned emails with an embedded qualitative process evaluation to understand how and why the emails may or may not have worked. Trial outcomes will be ascertained using routinely collected administrative data. Physicians will be recruited for semistructured interviews using convenience and snowball sampling. RESULTS As of April 2017, 5576 primary care physicians across the province of Ontario, Canada, had voluntarily registered for the SAR, and in so doing, signed up to receive the monthly email updates. From May to August 2017 participants received the redesigned monthly emails with content specific to their allocated experimental condition prompting use of the SAR. We have not yet begun analyses. CONCLUSIONS This study will inform how to communicate effectively with primary care providers by email and identify which behavior change techniques tested are most effective at encouraging engagement with an audit and feedback report. CLINICALTRIAL ClinicalTrials.gov NCT03124316; https://clinicaltrials.gov/ct2/show/NCT03124316 (Archived by WebCite at http://www.webcitation.org/6w2MqDWGu)


2019 ◽  
Vol 26 (3) ◽  
Author(s):  
G. Vaisson ◽  
H. O. Witteman ◽  
S. Chipenda-Dansokho ◽  
M. Saragosa ◽  
Z. Bouck ◽  
...  

Background In Ontario, an online audit and feedback tool that provides primary care physicians with detailed information about patients who are overdue for cancer screening is underused. In the present study, we aimed to examine the effect of messages operationalizing 3 behaviour change techniques on access to the audit and feedback tool and on cancer screening rates.Methods During May–September 2017, a pragmatic 2×2×2 factorial experiment tested 3 behaviour change techniques: anticipated regret, material incentive, and problem-solving. Outcomes were assessed using routinely collected administrative data. A qualitative process evaluation explored how and why the e-mail messages did or did not support Screening Activity Report access.Results Of 5449 primary care physicians randomly allocated to 1 of 8 e-mail messages, fewer than half opened the messages and fewer than 1 in 10 clicked through the messages. Messages with problem-solving content were associated with a 12.9% relative reduction in access to the tool (risk ratio: 0.871; 95% confidence interval: 0.791 to 0.958; p = 0.005), but a 0.3% increase in cervical cancer screening (rate ratio: 1.003; 95% confidence interval: 1.001 to 1.006; p = 0.003). If true, that association would represent 7568 more patients being screened. No other significant effects were observed.Conclusions For audit and feedback to work, recipients must engage with the data; for e-mail messages to prompt activity, recipients must open and review the message content. This large factorial experiment demonstrated that small changes in the content of such e-mail messages might influence clinical behaviour. Future research should focus on strategies to make cancer screening more user-centred.


2021 ◽  
Author(s):  
Sujha Subramanian ◽  
Regi Jose ◽  
Anoop Lal ◽  
Paul Augustine ◽  
Madeleine Jones ◽  
...  

2012 ◽  
Vol 27 (4) ◽  
pp. 687-694 ◽  
Author(s):  
Kathryn Chapman ◽  
Keith Nicholls ◽  
Margaret M. Sullivan ◽  
Susan Crutchfield ◽  
Thomas Shaw ◽  
...  

2012 ◽  
Vol 48 (1) ◽  
pp. 95-113 ◽  
Author(s):  
Ashwani K. Singal ◽  
Yu-Li Lin ◽  
Yong-Fang Kuo ◽  
Taylor Riall ◽  
James S. Goodwin

2011 ◽  
Vol 140 (5) ◽  
pp. S-576
Author(s):  
Jesse Nodora ◽  
William D. Martz ◽  
Erin Ashbeck ◽  
Elizabeth T. Jacobs ◽  
Patricia A. Thompson ◽  
...  

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