1. Digital health intervention resulted in significantly higher colon cancer screening rates among participants.
2. No statistically significant relationship was observed between the digital health intervention and health literacy, income, or race and ethnicity.
Evidence Rating Level: 1 (Excellent)
Study Rundown: Colorectal cancer (CRC) is one of the leading causes of cancer in both men and women over aged 50. Screening has been shown to reduce incidence and mortality from CRC. Despite recommendations for screening, there are many different barriers that result in lower screening rates; over one third of eligible Americans remain unscreened. The authors of this study at Wake Forest School of Medicine aimed to evaluate whether utilizing an iPad app as a digital health intervention could result in higher screening rates for CRC. Overall, it was observed that the iPad app was successful in increasing CRC screening among participants. This study has several limitations. Of note, the study examined only a single health care system. Further studies assessing the impact of the iPad app in multiple different contexts must be done for the results to become more generalizable. Furthermore, there may have been some selection bias implicated in this study, as recruited patients were required to arrive to the clinic early to enroll in the program.
Relevant Reading: How to Increase Colorectal Cancer Screening Rates in Practice
In-Depth [randomized controlled trial]: The authors of this study recruited a total of 450 patients, of which 223 were randomized to the digital intervention arm and 227 received usual care. The digital intervention consisted of an iPad app that displayed a decision aid tool for CRC screening. The app also provided patients with the opportunity to order their screening tests and sent multiple reminders for CRC screening follow-up to help improve screening rates. The authors assessed the efficacy of the digital health intervention by assessing chart-verified completion of CRC within 24 weeks. In general, it was observed that screening was completed by 30% of the digital health intervention group and 15% of the usual care group (logistic regression OR, 2.5 [95% CI, 1.6 to 4.0]). Furthermore, CRC test ordering was also higher in the digital health intervention group compared to usual care (69% [153 of 223] vs. 32% [72 or 227]). Characteristics between both study populations were similar.
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