Behavioral Science and Hepatitis C Screening Outreach
| Status: | Enrolling by invitation |
|---|---|
| Conditions: | Hepatitis, Hepatitis |
| Therapuetic Areas: | Immunology / Infectious Diseases |
| Healthy: | No |
| Age Range: | 53 - 73 |
| Updated: | 3/23/2019 |
| Start Date: | March 15, 2019 |
| End Date: | April 30, 2020 |
This project aims to evaluate different approaches to increase Hepatitis C screening among
primary care patients at Penn Medicine through a centralized screening outreach program. In a
pragmatic trial, we will evaluate different approaches to increase completion of screening
among eligible patients, including changing the default from opt-in to opt-out and
incorporating behavioral science principles into the outreach communication.
primary care patients at Penn Medicine through a centralized screening outreach program. In a
pragmatic trial, we will evaluate different approaches to increase completion of screening
among eligible patients, including changing the default from opt-in to opt-out and
incorporating behavioral science principles into the outreach communication.
The hepatitis C virus (HCV) is the leading cause of liver transplant and hepatocellular
carcinoma in the US. New direct-acting antivirals are available that can eradicate the
disease in over 95% of those that are treated, with minimal side effects. As a result of new
therapies and a five-fold higher risk among baby boomers, the US Preventive Services Task
Force and CDC now recommend HCV screening for all patients born between 1945 and 1965. Of the
estimated 3.2 million people chronically infected with HCV, about 75% were born during this
time frame. Despite this, national rates of screening among this group remain low at less
than 30%. If more people could get screened, we could potentially identify more undiagnosed
disease and help navigate to treatment.
At Penn Medicine primary care practices, HCV screening rates have risen from 37% in 2014 to
61% in 2017, likely from a combination of provider educational efforts and EHR alerts. There
is also significant practice variation ranging from 4% to 99% screening rates. While EHR
alerts have been shown to increase HCV screening rates, there is potential to complement this
with direct outreach to patients homes, as has been incorporated into cancer screening
initiatives. Additionally, there is a mandate from the state of Pennsylvania requiring health
care providers to offer HCV testing to all primary care patients. There is an opportunity to
provide direct outreach to all eligible primary care patients at Penn Medicine, while also
evaluating different approaches to increasing HCV screening rates.
Insights from behavioral science have been shown to increase participation in health
promoting behaviors in a variety of ways. Switching from opt-in to opt-out framing has been
shown to triple patient participation in remote monitoring and CRC screening. Additionally,
messaging that incorporates social norms, reciprocity, and precommitment have also been shown
to increase participation. However, it is not clear how these approaches would translate to
HCV screening.
carcinoma in the US. New direct-acting antivirals are available that can eradicate the
disease in over 95% of those that are treated, with minimal side effects. As a result of new
therapies and a five-fold higher risk among baby boomers, the US Preventive Services Task
Force and CDC now recommend HCV screening for all patients born between 1945 and 1965. Of the
estimated 3.2 million people chronically infected with HCV, about 75% were born during this
time frame. Despite this, national rates of screening among this group remain low at less
than 30%. If more people could get screened, we could potentially identify more undiagnosed
disease and help navigate to treatment.
At Penn Medicine primary care practices, HCV screening rates have risen from 37% in 2014 to
61% in 2017, likely from a combination of provider educational efforts and EHR alerts. There
is also significant practice variation ranging from 4% to 99% screening rates. While EHR
alerts have been shown to increase HCV screening rates, there is potential to complement this
with direct outreach to patients homes, as has been incorporated into cancer screening
initiatives. Additionally, there is a mandate from the state of Pennsylvania requiring health
care providers to offer HCV testing to all primary care patients. There is an opportunity to
provide direct outreach to all eligible primary care patients at Penn Medicine, while also
evaluating different approaches to increasing HCV screening rates.
Insights from behavioral science have been shown to increase participation in health
promoting behaviors in a variety of ways. Switching from opt-in to opt-out framing has been
shown to triple patient participation in remote monitoring and CRC screening. Additionally,
messaging that incorporates social norms, reciprocity, and precommitment have also been shown
to increase participation. However, it is not clear how these approaches would translate to
HCV screening.
Inclusion Criteria:
- at least 2 visits to primary care provider within 2 years
- born between 1945 and 1965
Exclusion Criteria:
- have had 1 HCV antibody test, viral load test or are considered up-to-date on HCV
screening by health maintenance
We found this trial at
1
site
3400 Spruce St
Philadelphia, Pennsylvania 19104
Philadelphia, Pennsylvania 19104
(215) 662-4000
Hospital of the University of Pennsylvania The Hospital of the University of Pennsylvania (HUP) is...
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