%0 Journal Article
%@ 2291-5222
%I JMIR Publications
%V 7
%N 1
%P e9351
%T Better Ask Than Tell: Responses to mHealth Interrogative Reminders and Associations With Colorectal Cancer Screening Subsequent Uptake in a Prospective Cohort Intervention
%A Hagoel,Lea
%A Stein,Nili
%A Rennert,Gad
%A Neter,Efrat
%+ Department of Behavioral Sciences, Ruppin Academic Center, Beit 3, Emeq Hefer, 4025000, Israel, 972 45 646 2678, neter@ruppin.ac.il
%K adherence
%K colorectal cancer
%K cancer screening
%K health behaviors
%K interrogative reminders
%K short message service text messages
%D 2019
%7 21.01.2019
%9 Original Paper
%J JMIR Mhealth Uhealth
%G English
%X 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%; χ12=487.5, P<.001); 1 year (340/1621, 21.0% vs 4711/36,868; χ12=91.5, P<.001); and 2 years (225/1621, 13.9% vs 3924/36,868; χ12=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. 
%M 30664486
%R 10.2196/mhealth.9351
%U https://mhealth.jmir.org/2019/1/e9351/
%U https://doi.org/10.2196/mhealth.9351
%U http://www.ncbi.nlm.nih.gov/pubmed/30664486