{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T02:47:15Z","timestamp":1791254835517,"version":"4.1.0"},"reference-count":41,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Colorectal cancer screening rates in the US remain suboptimal, particularly among low-income and minoritized populations, despite the availability of effective, low-cost options such as the fecal immunochemical test (FIT). Scalable outreach strategies are needed to improve uptake and reduce staff burden in safety-net settings.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate whether a behavioral economics\u2013informed, automated text messaging strategy was associated with increased FIT completion compared with nurse-led telephone call outreach.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This quality improvement randomized clinical trial was conducted from April 7 to June 24, 2025, at 8 Federally Qualified Health Centers (FQHCs) in Brooklyn, New York, within the Family Health Centers at NYU Langone. Participants included adults (aged \u226518 years) with a new FIT order who listed English, Spanish, or Chinese (Mandarin or Cantonese) as their preferred language and had not opted out of text messaging.<\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n Patients were randomized 1:1 to receive either 3 automated, 1-way text message reminders on days 2, 5, and 8 (intervention) or a single nurse-led telephone call reminder on day 8 (usual care).<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n \n The primary outcome was FIT completion within 21 days of the test order, assessed from the electronic health record. Secondary outcomes included completion at 7 and 14 days. FIT completion at 7, 14, and 21 days was compared between groups using \u03c7\n 2<\/jats:sup>\n tests.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 1275 eligible randomized participants, 649 were assigned to the text group (418 female participants [64.4%]; mean [SD] age, 56.4 [9.3] years) and 626 to the telephone group (398 female participants [63.6%]; mean [SD] age, 56.7 [9.6] years). FIT completion within 21 days was higher in the text group (382 of 649 participants [58.9%]) compared with the telephone group (312 of 626 participants [49.8%]) with an absolute difference of 9.0 percentage points (95% CI, 3.6-14.5 percentage points;\n P<\/jats:italic>\n \u2009=\u2009.001). Post hoc analyses found no evidence of differential effectiveness by age, sex, race and ethnicity, or patient portal use.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this quality improvement randomized clinical trial, a behaviorally informed text messaging strategy was associated with significantly improved FIT completion compared with usual nurse-led telephone outreach. Automated messaging may offer a scalable, low-cost strategy to promote preventive care and reduce staff burden in underserved populations.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT06632054<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.7122","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T15:30:30Z","timestamp":1776958230000},"page":"e267122","source":"Crossref","is-referenced-by-count":4,"title":["Behaviorally Informed Text Messaging to Promote Colon Cancer Screening"],"prefix":"10.1001","volume":"9","author":[{"given":"Olivia","family":"Korostoff-Larsson","sequence":"first","affiliation":[{"name":"Division of Healthcare Delivery Science, Department of Population Health, NYU Grossman School of Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William 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