This trial tests how well electronic health record (EHR) based nudges for clinicians and patients work to improve screening for breast cancer. EHR based nudges include screening orders already placed in the patients chart, awaiting approval for clinicians and text message scheduling reminders for patients. There is a significant need to develop and scale low-cost interventions that increase breast cancer screening while simultaneously addressing the needs of high-risk patients and reducing disparities. Increasing breast cancer screening rates is challenging, in part, because it requires complementary decisions from clinicians and patients. EHR based nudges for clinicians and patients may improve screening for breast cancer.
Study sponsor and potential other locations can be found on ClinicalTrials.gov for NCT06177795.
PRIMARY OBJECTIVES:
I. To conduct a two-arm pragmatic cluster-randomized controlled trial to test the effectiveness of personalized electronic health record (EHR)-based nudges to clinicians and patients on increasing breast cancer screening rates.
II. To evaluate if EHR-based nudge interventions reduce disparities in breast cancer screening rates for high-risk subgroups.
III. To inform future design of tailored EHR interventions by examining heterogeneity of treatment response with respect to clinician and patient characteristics.
OUTLINE: Clinics are randomized to 1 of 2 arms.
ARM I: Patients receive usual care.
ARM II: Clinicians receive pending default orders for mammography within the EHR system prior to the primary care visit. Patients receive text message reminders at 4 and 14 days post primary care visit with information regarding scheduling a mammogram.
High risk patients within arm II are further randomized to 1 of 2 arms, not high risk patients are assigned to arm IIB.
ARM IIA: Patients receive text based chat nudges that they may interact with for further education regarding screening mammograms.
ARM IIB: Patients receive no further intervention.
Trial PhaseNo phase specified
Trial Typescreening
Lead OrganizationUniversity of Pennsylvania/Abramson Cancer Center
Principal InvestigatorAmol S. Navathe
