title: Tailored message interventions versus typical messages for increasing participation in colorectal cancer screening among a non-adherent population: A randomized controlled trial.
abstract: The purpose of this study was to examine the effectiveness and cost-efficiency of a tailored message intervention compared with a non-tailored message intervention for increasing colorectal cancer (CRC) screening rates among a non-adherent population, in a community-based client reminder program.
  
  
  
  After a baseline survey for psychological segmentation, 2140 eligible individuals were randomly assigned either to a group with a tailored matched-message condition (N = 356), a group with a non-tailored unmatched-message condition (N = 355), or to two control groups, one using a typical message with a professional design (N = 717) and one without a professional design (N = 712). The main outcome measure was attendance rates in a community-organized CRC screening program within five months of receiving a print reminder.
  
  
  
  There was a significant difference in fecal occult blood test (FOBT) attendance rates at follow-up assessments between the tailored matched-message condition (14.0 %) and the control (9.9 %; OR = 1.48, p = 0.026), while there was no significant difference between the unmatched-message condition (11.0 %) and the control (OR = 1.12, p = 0.558), and between the matched-message condition and the unmatched-message condition (OR = 1.32, p = 0.219). The cost of a one-person increase in FOBT screening was 3,740 JPY for the tailored matched-message condition, while it was 2,747 JPY for the control.
  
  
  
  A tailored-message intervention for segmented individuals designed to increase CRC screening rates in a community-based client reminder program was significantly effective compared to a usual reminder, but not more effective than an unmatched message in a randomized controlled trial, and was not sufficiently effective to highlight its value from a cost perspective. Therefore, the tailored intervention including target segmentation needs to be improved for future implementation in a CRC screening program for a non-adherent population.
  
  
  
  UMIN Clinical Trials Registry UMIN000004384 . Date of Registration: March 2011.
authors.affiliation: Graduate School of Human Sciences, and Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita-shi, Osaka, 565-0871, Japan. khirai@grappo.jp.
authors.forename: Kei
authors.initials: K
authors.lastname: Hirai
authors.affiliation: Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Ishikawa
authors.affiliation: Cancer Scan, Tokyo, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Fukuyoshi
authors.affiliation: Cancer Scan, Tokyo, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Yonekura
authors.affiliation: Graduate School of Human Development and Environment, Kobe University, Kobe, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Harada
authors.affiliation: Cancer Detection Center, Miyagi Cancer Society, Miyagi, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Shibuya
authors.affiliation: Public Health Policy Research Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Public Health Policy Research Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Mizota
authors.affiliation: Screening Assessment and Management Division, National Cancer Center, Tokyo, Japan.
authors.forename: Chisato
authors.initials: C
authors.lastname: Hamashima
authors.affiliation: Screening Assessment and Management Division, National Cancer Center, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Saito
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006293:Health Promotion / Q000191:economics / Q000379:methods; D006801:Humans; D007564:Japan; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods; D008875:Middle Aged; D009780:Occult Blood; D010349:Patient Compliance; D017010:Reminder Systems / Q000191:economics*
keywords: CRC screening; Cancer worry; Cost-effectiveness; Non-adherent population; Tailored intervention