@Article{info:doi/10.2196/mhealth.9351,
author="Hagoel, Lea
and Stein, Nili
and Rennert, Gad
and Neter, Efrat",
title="Better Ask Than Tell: Responses to mHealth Interrogative Reminders and Associations With Colorectal Cancer Screening Subsequent Uptake in a Prospective Cohort Intervention",
journal="JMIR Mhealth Uhealth",
year="2019",
month="Jan",
day="21",
volume="7",
number="1",
pages="e9351",
keywords="adherence; colorectal cancer; cancer screening; health behaviors; interrogative reminders; short message service text messages",
abstract="Background: Text message (short message service, SMS) interrogative reminders were adopted in population screening for the early detection of colorectal cancer (CRC). Objective: This study aims to examine responses to text message (SMS) reminders and associate responses with senders' characteristics, message type (interrogative/declarative), and subsequent screening uptake. Methods: We conducted a prospective cohort intervention. Text message (SMS) reminders to undergo CRC screening, randomized into interrogative and declarative phrasing, were sent to nonadherent 40,000 women and men (age 50-74 years) at CRC average risk. We analyzed recipient responses by message phrasing, recipient characteristics, and for content, the latter predicting subsequent CRC screening per program database. Results: While interrogative text message (SMS) reminders elicited 7.67{\%} (1475/19,227) responses, declarative ones elicited 0.76{\%} (146/19,262) responses. Text message (SMS) responses were content analyzed and grouped into attitudes toward CRC screening (1237/1512, 81.8{\%} positive) and intention to screen (1004/1512, 62.6{\%}). Text message (SMS) respondents screened significantly more than nonrespondents after 6 months (415/1621, 25.6{\%} vs 3322/36,868, 9.0{\%}; $\chi$12=487.5, P<.001); 1 year (340/1621, 21.0{\%} vs 4711/36,868; $\chi$12=91.5, P<.001); and 2 years (225/1621, 13.9{\%} vs 3924/36,868; $\chi$12=16.9, P<.001) following the reminders. In a multivariable logistic regression among text message (SMS) respondents, screening after 6 months was significantly predicted by older age, past sporadic screening, attitudes, and intentions. Conclusions: Interrogative text message (SMS) reminders reached previously uninvolved sectors in the CRC target population---men, sporadic-screenees, and the ``never-tested'' before. This novel application resulted in a population-level, incrementally enhanced screening. Asking patients about their future health behavior may be relevant for enhancing other health behaviors in preventive medicine and clinical settings. ",
issn="2291-5222",
doi="10.2196/mhealth.9351",
url="https://mhealth.jmir.org/2019/1/e9351/",
url="https://doi.org/10.2196/mhealth.9351",
url="http://www.ncbi.nlm.nih.gov/pubmed/30664486"
}