Improving Fecal Occult Blood Test Completion Rates Among Veterans

Corporal Michael J. Crescenz VA Medical Center

Status and phase: Completed; Phase 2; Phase 1

Conditions: Colorectal Cancer

Treatments: Behavioral: Stage 1; Behavioral: Stage 2

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT01516489

01334

Details and patient eligibility

About

This is a 4-arm cluster randomized controlled trial to evaluate whether patient financial incentives directly integrated into primary care can improve fecal occult blood test (FOBT) completion rates. We will recruit primary care patients at the Philadelphia Veterans Affairs Medical Center (PVAMC) in 2 stages. In stage 1, we hypothesize that, compared to usual care, $5, $10, $20 incentives will each lead to a statistically significant increase in the rate of FOBT completion. We also hypothesize that there will be a direct dose-response relationship between the incentive amount and rates of FOBT completion. In stage 2, we hypothesize that a lottery-based incentive and a raffle-based incentive will both lead to a statistically significant increase in the rate of FOBT completion compared to a fixed payment incentive with an equivalent dollar per patient value.

Enrollment: 1,549 patients

Sex: Male

Volunteers: No Healthy Volunteers

Inclusion criteria

• PVAMC outpatients who are prescribed an FOBT kit in Module B or C during the study period.

Exclusion criteria

• None. All PVAMC outpatients who are prescribed an FOBT kit in Module B or C during the study period will be eligible.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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1,549 participants in 8 patient groups

Stage 1 Control Group

No Intervention group

Description:

In the FOBT kit, individuals will receive a card that asks them to complete and return their FOBT kit within 30 days.

$5 Incentive

Experimental group

Description:

In the FOBT kit, individuals will receive a card that states that if they complete and return their FOBT kit within 30 days, they will be mailed a voucher that can be exchanged for $5 at PVAMC.

Treatment:

Behavioral: Stage 1

$10 Incentive

Experimental group

Description:

In the FOBT kit, individuals will receive a card that states that if they complete and return their FOBT kit within 30 days, they will be mailed a voucher that can be exchanged for $10 at PVAMC.

Treatment:

Behavioral: Stage 1

$20 Incentive

Experimental group

Description:

In the FOBT kit, individuals will receive a card that states that if they complete and return their FOBT kit within 30 days, they will be mailed a voucher that can be exchanged for $20 at PVAMC.

Treatment:

Behavioral: Stage 1

$5 Voucher-Based Incentive

Experimental group

Description:

In the FOBT kit, individuals will receive a card that states that if they complete and return their FOBT kit within 30 days, they will be mailed a voucher that can be exchanged for $5 at PVAMC.

Treatment:

Behavioral: Stage 2

$50 Lottery-Based Incentive

Experimental group

Description:

In the FOBT kit, individuals will receive a card that states that if they complete and return their FOBT kit within 30 days, they will have a 1 in 10 chance of being mailed a voucher that can be exchanged for $50 at PVAMC.

Treatment:

Behavioral: Stage 2

$500 Raffle-Based Incentive

Experimental group

Description:

In the FOBT kit, individuals will receive a card that states that if they complete and return their FOBT kit within 30 days, they will be entered into a raffle in which 1 randomly chosen patient (out of about 100 patients) will be mailed a check in the amount of $500.

Treatment:

Behavioral: Stage 2

Stage 2 Control Group

No Intervention group

Description:

In the FOBT kit, individuals will receive a card that asks them to complete and return their FOBT kit within 30 days.