Increasing preventive health services via tailored health communications

Abstract

Objectives: To develop a methodology that stratifies members by likelihood of completing a colorectal cancer screening (CRCS). Such information can guide the communication development and the allocation of resources for tailored communication outreaches.

Study design: Prospective study of an insured commercial population that includes randomized assignments to a control group or a treatment group for communication interventions.

Methods: A total of 46,697 members overdue (nonadherent based on available administrative data) for a CRCS were assigned to 1 of 5 graded segments as part of an interactive voice response (IVR) call. Another 400 members per outreach segment were randomly assigned to a control group and received no communication. Primary outcome: receipt of CRCS (assessed Healthcare Effectiveness Data and Information Set [HEDIS] summary data, 3 months after IVR) for each graded segment within the control and the intervention groups. Secondary outcomes: association between the CRCS rates and the identified segments; communication cost per completed screening.

Results: Primary outcome: 1971 members completed the screening. Screening rates for the 5 graded segments were 2.4%, 3.6%, 5.0%, 7.2%, and 8.0%. Secondary outcome: c2 proportions test a significant association between the segment groups and the CRCS completion rates. The association between segment and screening rates follow the expected predicted range in both the intervention and holdout groups. Communication cost per screening: $14.84.

Conclusions: Segmenting members by variables that are associated with CRCS completion identified graded segments that completed the CRCSs at different rates. Tailored interventions can be developed to promote a health service for each segment. The segmentation approach proves to be beneficial.