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Development and use of culturally-grounded text-messages to increase colorectal cancer screening rates in Alaska Native Community: A mixed methods study
Methods: Text messages were developed through collaborative engagement and iterative consultation with patients, providers, and tribal leaders. First, we elicited views about health screening, CRC, and technology through focus groups and used our findings to tailor messages. Next, we randomized ~800 AN/AIs who were overdue for CRC screening and who agreed to accept health promotion reminders to receive either CRC text messages for up to 3 consecutive months (intervention) or usual care with no CRC text messages (control). Electronic health records were queried 6 months after randomization to compare CRC screening rates between groups.
Results: Our methods successfully created meaningful, culturally appropriate text messages. Only 12% of participants opted out of the intervention group. Many participants provided positive comments by text messaging or by telephone during CRC scheduling.
Conclusion: Collaborative, community-based methods are important for developing relevant, culturally appropriate health promotion interventions in Native communities. Our innovative text-messaging intervention appears to increase CRC screening among AN/AIs who did not respond to conventional methods of promoting screening adherence.
Learning Areas:
Administer health education strategies, interventions and programsCommunication and informatics
Diversity and culture
Learning Objectives:
Identify and describe health-screening communication preferences of Alaska Native and American Indian people receiving care at a tribal healthcare organization.
Evaluate the effectiveness of electronic health-screening reminders in Alaska Native and American Indian population.
Keyword(s): Cancer Prevention and Screening, Communication Technology
Qualified on the content I am responsible for because: I have been the principal or co-principal investigator on multiple federally funded grants focusing on health communication technology, health disparities, culturally appropriate interventions, and medical decision-making. My research supports Southcentral Foundation's mission to improve the wellness of the Native Community, and I have conducted studies on depression, suicide, pharmacogenomics, and acceptance of technology in health screening initiatives.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.