EndCancer: development and pilot testing of multimedia recruitment for a text message campaign to increase cancer screening

Nicole M. Harty, Kirstin Le Grice, Christi Cahill, Sheana Bull, Andrea Dwyer


Background: Colorectal cancer (CRC) is the second leading cause of cancer mortality in the US but is preventable with timely colonoscopy screening. Although CRC incidence and mortality have been decreasing and screening rates increasing, southeastern Coloradans in particular remain in great need of CRC screening. Media outreach campaigns have previously proven successful in this region, and local clinical partners expressed interest in text messaging and social media community outreach.
Methods: The Colorado Cancer Screening Program partnered with the Colorado Cancer Coalition and two community health centers to develop theory-based text messages to encourage cancer screening behavior. Participants were recruited into this text message program through 4 weeks of radio advertisements, locally-posted flyers, and 12 weeks of social media messaging asking community members to text a key word or enter their phone number online to receive additional information about cancer screening.
Results: Facebook advertisement proved to be the most successful in engaging community members in the outreach campaign with over 22,600 exposed to ads. Radio and print advertisements were less successful than previous campaigns suggested. Theory-based text messages were effective in maintaining interest in the topic of cancer screening. Ninety-six percent of text message participants remained enrolled through receipt of all CRC messages.
Conclusions: The EndCancer campaign provides evidence of strategies that can be used to reach hard-to-reach and hard-to-screen populations in need of CRC screening. Engagement was high with Facebook ads, and those who viewed ads clicked through to the sign-up page, an indication of intent to enroll. Given the promising results of engagement with Facebook ads among the target demographic, social media marketing may prove a successful avenue to enroll hard-to-reach populations into cancer screening educational initiatives.