Study published in JMIR Cancer finds interactive texting program addresses SDoH barriers to help more people complete screenings on time
mPulse Mobile, a leader in conversational AI and digital engagement solutions, partnered with AltaMed Health Services, one of the largest nonprofit federally qualified health centers (FQHC) in the U.S., to publish a research study in JMIR Cancer. The study found that automated, bidirectional texting using Natural Language Understanding (NLU) and fotonovelas can increase screenings for colorectal cancer, particularly among populations facing Social Determinants of Health (SDoH) barriers.
While colorectal cancer is the second most deadly type of cancer in the United States, it is also highly preventable with regular screening, as rates of survival are high when caught early. The California member population served by AltaMed, which is majority Hispanic or Latin American, is less likely to be screened for colorectal cancer and more likely to be diagnosed with advanced disease than non-Hispanic white patients due to a variety of SDoH barriers to care. AltaMed partnered with mPulse Mobile to research ways to address these barriers by delivering culturally-tailored mobile content, in the familiar fotonovela format, aimed at overcoming lack of awareness around CRC screenings and other cultural and behavioral barriers.
Along with mailing at-home fecal immunochemical tests, or FIT kits, to members due for screenings, the randomized controlled trial used an automated texting program for two-way communication to identify barriers to getting screened and to educate members around the importance of screening. Among 5,241 members who had not completed their FIT kit after 12 weeks, an intervention group received an additional 4-week series of automated text messages monitored using a program developed by mPulse Mobile. In combination with the text messages, participants were sent a link to a fotonovela in either English or Spanish, containing a comic about someone encouraging a friend to complete their FIT kit and explaining why the screening is important.
The intervention resulted in a significant quality improvement among participating members:
- 40% of members in the intervention group engaged with the text messages. Of those, 31% clicked on the link to view the fotonovela.
- The intervention group had a screening rate of 18.8%, while the group that did not receive the texts and fotonovela had a screening rate of 11.7%.
- Screening rates were higher among members who engaged with the text messages than among those who did not.
“Addressing Social Determinants of Health barriers among hard-to-reach populations is a core facet of mPulse Mobile’s mission,” said Bob Farrell, CEO of mPulse Mobile. “We’re thrilled to have partnered with an organization like AltaMed to demonstrate how innovative digital engagement approaches can address the challenges people face completing important health actions. Understanding the needs of individuals at scale and then tailoring touchpoints to address these needs is a crucial part of improving health outcomes across diverse populations.”
mPulse Mobile, the leader in Conversational AI solutions for the healthcare industry, drives improved health outcomes and business efficiencies by engaging individuals with tailored and meaningful dialogue. mPulse Mobile combines behavioral science, analytics, and industry expertise to help healthcare organizations move their consumers to adopt healthy behaviors.
“Our program used tailored conversations and personalized stories to engage different segments and drive behavior change. Conversational AI helped us to uncover the reasons why people weren’t completing their screenings and to address these barriers in real time. The results show that we were able to reach and influence some of the most vulnerable populations and this is very encouraging,” said Rena Brar Prayaga, Behavioral Data Scientist and co-author of the study.
AltaMed Health Services, serving primarily Latinx patients in Southern California, has a history of leading innovative, culturally-tailored member engagement programs that improve care outcomes and overcome social determinant barriers among their member population.
Evaluators at the Center for Community Health and Evaluation (CCHE), part of the Kaiser Permanente Washington Health Research Institute, independently evaluated the intervention. The full study, “Using Text Messages and Fotonovelas to Increase Return of Home-Mailed Colorectal Cancer Screening Tests: Mixed Methods Evaluation” was a collaboration between AltaMed, mPulse Mobile and CCHE and published in JMIR Cancer. Authors of the study are Carly E Levitz and Elena Kuo from the Center for Community Health and Evaluation, Monica Guo, Esmeralda Ruiz, Evelyn Torres-Ozadali and Anne Escaron from AltaMed, and Rena Brar Prayaga from mPulse Mobile.