Outreach for the Increase of Breast Cancer Screening

PRIMARY OBJECTIVES:

I. To evaluate if centralized bulk ordering of mammograms increases response rate.

II. To evaluate if text messaging could increase uptake in addition to conventional outreach methods MyPennMedicine- MPM/letters).

III. To evaluate if an endorsement from the PCP increases response rate.

OUTLINE:

BULK ORDER TRIAL: Patients are randomized to 1 of 4 arms.

ARM 1 (No Order [NO]): Patients receive a letter or MyPennMedicine (MPM) signed by their primary care physician (PCP) informing them that they are due for a mammogram.

ARM 2 (No Order + Text [NO + T]): Patients receive a letter or MPM as in Arm 1, and receive a series of texts about the breast cancer screening until a mammogram is scheduled or completed.

ARM 3 (Bulk Order [BO]): Patients receive a mammogram booking and a letter of MPM as in Arm 1.

ARM 4 (Bulk Order + Text [BO + T]): Patients receive a mammogram booking, a letter or MPM as in Arm 1, and a series of texts about breast cancer screening until a mammogram is scheduled or completed.

CLINICAL ENDORSEMENT TRIAL (PRINCETON ONLY): Patients are randomized to 1 of 4 arms.

ARM 1 (Clinician Endorsement [CE]): Patients receive a letter or MPM signed by their PCP informing them that they are due for a mammogram.

ARM 2 (Clinician Endorsement + Text [CE + T]): Patients receive a letter or MPM as in Arm 1, and receive a series of texts about breast cancer screening until a mammogram is scheduled or completed.

ARM 3 (Standard Messaging [SM]): Patients receive a letter or MPM from the practice informing them that they are due for a mammogram.

ARM 4 (Standard Messaging + Text [SM+T]): Patients receive a letter or MPM from the practice, and receive a series of texts about breast cancer screening until a mammogram is scheduled or completed.