Messaging Intervention to Increase Medicare Annual Wellness Visits -- the NUDGE AWV Clinical Trial

Trial Title: Messaging Intervention to Increase Medicare Annual Wellness Visits -- the NUDGE AWV Clinical Trial

NCT ID: NCT06640426

Condition: Annual Wellness Visit
Breast Cancer Screening
Colon Cancer Screening

Conditions: Official terms:
Colonic Neoplasms

Study type: Interventional

Study phase: N/A

Overall status: Not yet recruiting

Study design:

Allocation: Randomized

Intervention model: Parallel Assignment

Intervention model description: This study will use a randomized controlled trial to evaluate a health system initiative to improve Medicare Annual Wellness Visit (AWV) completion. Investigators will randomly assign Ascension Health patients who are eligible for an AWV to one of three conditions. Patients in Treatment Condition #1 will receive a set of up to five email and text messages over the course of eight days, while also receiving usual care which could include messaging from their practice or the electronic health record. Patients in Treatment Condition #2 will receive a set of two email and text messages on a single day. Patients in the Control Condition will receive no messages as part of this campaign, but will be receiving usual care, which could include messages related to AWV's from their primary care practice or from the electronic health record.

Primary purpose: Health Services Research

Masking: Double (Investigator, Outcomes Assessor)

Intervention:

Intervention type: Behavioral
Intervention name: Two Messaging Nudges
Description: This intervention involves receiving one personalized email and one personalized text message, which include the provider's name, the patient's name, and a phone number to schedule an Annual Wellness Visit
Arm group label: Two Messages

Intervention type: Behavioral
Intervention name: Five messaging nudges
Description: This intervention involves patients receiving up to five personalized email and text messages, which include the provider's name, the patient's name, and a phone number to schedule an Annual Wellness Visit
Arm group label: Up To Five Messages

Summary: Medicare Annual Wellness Visits (AWVs) are critical for addressing preventive care needs among older adults, yet the most recent estimates from the Center for Medicare Services suggest less than 50% of eligible patients take advantage of this free healthcare benefit. Behavioral science-informed messaging interventions offer a promising strategy to increase AWV participation by guiding patient behavior. In this study, investigators will evaluate a health system initiative that utilizes personalized email and text messages to encourage Medicare beneficiaries to schedule and attend their AWVs. This approach aims to boost patient engagement in preventive health services, ultimately improving care outcomes for older adult populations

Detailed description: The Centers for Medicare & Medicaid Services (CMS) recommends Annual Wellness Visits (AWVs) to encourage preventive care and improve long-term health outcomes for Medicare beneficiaries. These visits are designed to provide a proactive approach to healthcare by focusing on identifying risk factors, updating medical histories, and developing personalized prevention plans that promote early detection of diseases. By prioritizing prevention over treatment, AWVs help reduce the overall cost burden on the healthcare system while enhancing patient engagement and empowering individuals to take a more active role in managing their health. Yet despite these benefits, most Medicare members who are eligible for an AWV - at no cost to them - do not complete one. Behavioral science research suggests that personalized messages, designed to facilitate action, can have significant impacts on health behavior. Studies have found these messaging interventions can increase vaccination rates, cancer screening rates, and other care gap closure.

Criteria for eligibility:
Criteria:
Inclusion Criteria: - Age 65 or older - Have either a mobile phone number or an email address on file with the health system - Included in and non-compliant on the Ascension AWV Clinical Priority Goal measure - Have consented to receive electronic communications from the health system Exclusion Criteria: - Patients whose primary care providers are exempted from the campaign by the health system - Completed MAWV appointment in previous 30 days - Has an upcoming AWV appointment scheduled - Have received a nudge campaign from the Clinical Transformation team in the past 90 days - Patients who have previously opted out of receiving electronic communications from the health system in our message delivery platform (Salesforce)

Gender: All

Minimum age: 65 Years

Maximum age: N/A

Healthy volunteers: Accepts Healthy Volunteers

Start date: October 2024

Completion date: May 2025

Lead sponsor:
Agency: Emily Rosenzweig
Agency class: Industry

Source: Ascension Health

Record processing date: ClinicalTrials.gov processed this data on November 12, 2024

Source: ClinicalTrials.gov page: https://clinicaltrials.gov/ct2/show/NCT06640426