Stories

By Leslie Bienen, KPCHR Writer and Editor

 Gloria Coronado, PhD

Did you know that 97% of people in the United States now own a cell phone? Yet, despite the very high penetration of smart phones into life and society, many health systems do not fully leverage these powerful tools to engage patients in their care. Investigators at the Kaiser Permanente Center for Health Research are showing the benefits of using cell phones for patient outreach and education. Dr. Gloria Coronado and her team are partnering with the nation’s largest independent community health centers to reach more patients with tools to keep them healthy. The research, described in an article recently published in PLOS Digital Health, tests a program that sends text messages with links to short, animated videos that show people how to complete an easy at-home test to find colorectal cancer (also called a FIT test).

The PLOS article explains that while “text messaging can reach far more people than in-person educational sessions or live phone calls, for a fraction of the cost, text messaging alone has limitations. …Video messaging can help overcome language and health-literacy barriers, is more engaging, and can demonstrate how to do a task that might be difficult to explain solely using words.” The program is ongoing, but results are promising. The video messaging program yielded a 40% FIT return rate, nearly double the average return rate reported in systematic reviews of mailed FIT outreach. Both patients and health professionals were positive about the program and its benefits.

Video messaging is also low cost—way less expensive than live phone calling. In our study, the cost per message sent was $0.04. As the cost of video production goes down, and familiarity with smart-phone technology goes up as today’s younger digital natives age into cancer screening, the utility and ease of such methods will continue to improve. Health systems and providers need to catch up with the advantages that video messaging, and other forms of telehealth via smartphones, can provide as a cheap and effective way to engage with patients and to increase patients’ engagement with their own healthcare.

This program is part of a larger NIH-funded effort to study the effects of a telehealth care delivery program to improve the quality, reach, and effectiveness of colorectal cancer screening in predominantly Latinx clinic populations aged 45-54. The program will use video text messages to educate patients about colorectal cancer screening, link them to community-based services (e.g., food assistance, transportation, language services), and provide personalized navigation to support uptake of screening and follow-up care. This trial is being conducted in partnership with AltaMed, a large urban federally qualified health center that operates clinics in Los Angeles and Orange Counties in California. The program sends short (<1 min) animated videos for both English- and Spanish-speakers about the importance of CRC screening and instructs patients on how to complete a FIT test. The videos address common errors in FIT completion such as too much/too little sample collected, omitting the collection date, and other errors that can occur. The videos also address health messages about routine screening for average-risk adults and can be sent without privacy concerns. The animated videos were initially developed by Ms. Annie Thibault from the University of South Carolina. In partnership with Ms. Thibault and staff at Alta Med, Dr. Coronado and her team translated the videos into Spanish and added more videos to the collection. For this they were honored to receive the 2022 SCOPY award for Best Comprehensive Digital Production.

Adults in the Pacific Northwest can also benefit. Kaiser Permanente Northwest is conducting a head-to-head comparison of standard vs. video-text messages in its healthcare system. They are delivering video text messages to more than 10,000 patients ages 45-75 to see if video messaging improves colorectal cancer screening rates. The results from this comparison are due out in a couple of months.