Tailored Messaging for CRC Screening

The proposed study is a prospective, randomized trial. All eligible subjects (patients
identified to be contacted to schedule screening colonoscopy) will be randomized to one of
three study arms: usual scheduling process (control), a generic message arm, or a tailored
message arm. Patients in the "tailored message" arm will receive a telephone call and be
asked a series of questions that will be used to assign patients to one of four messaging
cohorts. After these questions have been answered, the patient will then receive a tailored
message corresponding to his or her respective messaging cohort, encouraging them to schedule
a colonoscopy with a directed script. In the "generic message" arm, patients will receive a
telephone call and be asked to answer the same series of questions as the "tailored message"
group, then receive a single, standard script encouraging them to schedule a colonoscopy.

Inclusion Criteria:

1. University of Pennsylvania Health System (UPHS) patients with an active order for
screening or surveillance colonoscopy without an existing colonoscopy appointment

2. 50-75 years of age

3. Due for CRC screening or surveillance (defined as no evidence of: colonoscopy in the
past 5 years, fecal immunochemical testing in the past 12 months, flexible
sigmoidoscopy or CT colonography in the past 5 years, stool DNA test or Cologuard in
the last 3 years)

Exclusion Criteria:

1. Age <50 or >75

2. Pregnant woman

3. Evidence of prior colonoscopy in the past 5 years, fecal immunochemical testing in the
past 12 months, flexible sigmoidoscopy or CT colonography in the past 5 years, fecal
DNA test or Cologuard in the last 3 years

4. History of colorectal cancer

5. History of inflammatory bowel disease (Crohn's disease or Ulcerative colitis)

6. History of colon surgery or resection

7. History of symptoms concerning for colorectal cancer, such as lower GI bleeding,
within the past 6 months

8. Family history of a hereditary colorectal cancer syndrome, such as familial
adenomatous polyposis (FAP) or hereditary non-polyposis colon cancer (HNPCC)

9. Current serious medical condition with estimated life expectancy of less than 6
months, such as incurable cancer, end-stage congestive heart failure, decompensated
cirrhosis, end stage renal disease, etc.

10. Dementia

11. Does not speak English

12. No telephone number listed in electronic medical record

13. Has any other condition that, in the opinion of the investigator, excludes the patient
from participating in this study