Can Text Message Reminders Lead to More Women Taking Up Cervical Screening?

Priscilla Lynch 

July 13, 2020

Text message (SMS) reminders can help increase cervical screening participation by approximately 5%, according to the findings of a pre-press study of almost 15,000 women in the UK published in the journal  Preventive Medicine.

Women invited for cervical screening in Northwest London from February 2015 to October 2015 were eligible for the study, which aimed to try to address falling cervical cancer screening rates in the UK (75.7% uptake in 2011 vs 72.0% in 2017).

In study group 1, 3133 women aged 24-29 years were randomly assigned (1:1) to 'no SMS' (control participants) or a primary care physician (PCP)-endorsed SMS (SMS-PCP).

In study group 2, 11,405 women aged 30-64 were randomly assigned to (1:1:1:1:1:1:1) either: no SMS, an SMS without manipulation (SMS-NM), SMS-PCP, an SMS with a total or proportionate social norm or an SMS with a gain-framed or loss-framed message.

The primary outcome was participation in screening at 18 weeks.

In study group 1, participation was significantly higher in the SMS-PCP arm (31.4%) compared with control participants (26.4%; aOR, 1.29; 95% CI, 1.09-1·51; P=.002).

In study group 2, participation was highest in the SMS-PCP (38.4%) and SMS-NM (38.1%) arms compared with control participants (34.4%; aOR, 1.19; 95% CI, 1.03-1.38; P=.02 and aOR, 1.18; 95% CI, 1.02-1.37; P=.03, respectively).

The results demonstrate that behavioural SMSs improve cervical screening participation, with message content playing an important role in the effect, the study authors said.

Based on these findings, the NHS rolled out SMS reminders across London in late 2018 for a 6-month trial period. According to figures published by Public Health England, attendance increased by 4.8%, which is the equivalent of 13,400 more women being screened at 18 weeks.

The researchers are now studying whether the specific wording of SMS reminders can influence rates of breast cancer screening.

Huf S, Kerrison RS, King D, Chadborn T, Richmond A, Cunningham D, Friedman E, Shukla H, Tseng FM, Judah G, Darzi A, Vlaev I. Behavioral economics informed message content in text message reminders to improve cervical screening participation: Two pragmatic randomized controlled trials. Prev Med. 2020 Jun 28 [Epub ahead of print]. doi: 10.1016/j.ypmed.2020.106170. PMID: 32610059.  Abstract.

This article originally appeared on Univadis, part of the Medscape Professional Network.


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