Background and Objectives: Survival rates are higher among colorectal cancer (CRC) patients if the cancer is detected earlier. Despite compelling evidence, screening rates are lower than the recommended thresholds. Increasing public awareness through interventions may improve screening completions. The current prospective study examined the effectiveness of a a multi-media intervention campaign on multi-target stool DNA (mt-sDNA) completion rates and follow-up colonoscopy rates.

Methods: The campaign featured articles in a multi-topic benefits newsletter that was both printed/mailed to homes and emailed to Metro Nashville Public Schools employees and their dependents (aged 45-64 years old) in the last week of February 2020. Data were manually and electronically extracted and compiled from EHRs and other available data sources. Email effectiveness was assessed through the open rates and conversion rates. The mt-sDNA completion rate was calculated as a proportion of individuals who returned the mt-sDNA kit after it had been shipped to their home and had a test result recorded. Finally, a proportion of patients who performed follow-up colonoscopy was calculated among individuals with a positive mt-sDNA test result.

Results: The newsletter was mailed to 5,631 active employees. The email open rates ranged from 40.7%-53.3%. Among those who opened at least one of the emails or received a mailed newsletter, 119 members completed the assessment to confirm they were average risk and due for screening (conversion rate=3.9%). Among this population, the mt-sDNA completion rate was 64.5% (69 orders completed out of 107 ordered mt-sDNA kits). All 6 patients with a positive mt-sDNA result underwent a follow-up colonoscopy with the mean (±SD; median) days to follow-up colonoscopy of 49 (±27; 42) days.

Conclusions: Distributing educational materials via emails and mailed newsletters in conjunction with other targeted interventions to outreach and educate members regarding CRC screening may be an effective strategy to enhance mt-sDNA completion rates.