Enhancing Mammography Programs for Outreach, Wellness, Education, and Resources (EMPOWER) in Underserved Populations Study

NCT ID: NCT07029490

Last Updated: 2025-11-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

2700 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-11-19

Study Completion Date

2028-09-30

Brief Summary

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This study is investigating the feasibility of a digital tool called a chatbot for providing educational information about mammography through a tablet, computer, or phone. This study will recruit participants who recently had a mammogram with the University of Utah. Based on their mammography results, women will be placed into two cohorts using their BI-RADS category. Once mammogram results are available, patients will be randomized 1:1 to either usual care or usual care with chatbot. This study will randomly invite participants from four groups for focus group discussions (FGDs) based on their mammogram results and adherence to screening recommendations

Detailed Description

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Breast cancer screening inequities are drivers of disparities for rural and Latina women.

Chatbots are increasingly popular in various healthcare contexts and can be easily accessed through smartphones, tablets, laptops, and desktops. Chatbots have many advantages for patient messaging, including providing scripted education and motivational information interactively, chunking information into digestible segments, and allowing for choice in the amount of information received at any one time. Thus, with chatbots this study can tailor the interaction based on individual patient factors. Chatbots are accessible to the vast majority of U.S. adults. While chatbots have been used successfully in some clinical contexts, there is a lack of studies that investigated the use of chatbots as part of a mobile screening program to increase adherence to follow-up recommendations about either screening or diagnostic care.

Study staff will approach women at the time of or soon after a patient's routine breast cancer screening and invite the patient to participate in the study. Participants will complete baseline surveys at time of enrollment. This survey includes demographics and preferred contact method (e.g., text, email) that will be used to initiate the chatbot communication which can be completed via phone or website. Usual clinical procedures will be used to interpret participants' routine screening mammograms, including the use of the breast imaging-reporting and data system (BI-RADS), typically within 1 week of imaging.

Based on their mammography results, women will be placed into two cohorts using their BI-RADS category.

All participants will complete follow-up questionnaires, available in English and Spanish. For the follow-up surveys, the research team will contact participants via their preferred method (text or email) and send a link to the follow-up survey. If unsuccessful, the research team will then contact participants by phone to complete the survey via text or call.

Once mammogram results are available, patients will be randomized 1:1 to either usual care or usual care with chatbot, with randomization in permuted blocks of size and stratified by age (\<55 vs. ≥55 years, a proxy for menopause and indicator of risk); rural/frontier vs. urban; language preference (English vs. Spanish); and cohort (normal vs. abnormal result).

This study will randomly invite participants from four groups for focus group discussions (FGDs) based on their mammogram results and adherence to screening recommendations. This study aim to conduct 8 FGDs (2 per group, one in Spanish and one in English) with 8-10 participants each.

Conditions

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Breast Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Usual Care

Usual Care: This will include participants randomized to usual care.

Group Type NO_INTERVENTION

No interventions assigned to this group

Chatbot

Chatbot: This will include participants randomized to usual care with the Chatbot.

Group Type EXPERIMENTAL

Chatbot

Intervention Type OTHER

The Chatbot used in this study will be used after mammography to facilitate follow-up, answer patient questions, and provide information.

Interventions

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Chatbot

The Chatbot used in this study will be used after mammography to facilitate follow-up, answer patient questions, and provide information.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Adult (equal to or above 18 years old)
* English or Spanish speaking
* Visit a mammography program for routine screening.

Exclusion Criteria

* Patients who are currently in treatment for breast cancer
* Patients who are not of 18 years of age.
* Patients who don't speak English or Spanish
* Men
* Cognitive limitations that impede informed consent
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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University of Utah

OTHER

Sponsor Role lead

American Cancer Society, Inc.

OTHER

Sponsor Role collaborator

Responsible Party

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Responsibility Role SPONSOR

Locations

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Huntsman Cancer Institute/ University of Utah

Salt Lake City, Utah, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Anthony Ariotti

Role: CONTACT

801-213-6542

Facility Contacts

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Elissa Ozanne, PhD

Role: primary

801-213-4130

References

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Cancer Stat Facts: Female Breast Cancer. https://seer.cancer.gov/statfacts/html/breast.html. Accessed Oct 11, 2021.

Reference Type BACKGROUND

American Cancer Society. Cancer Facts & Figures for Hispancis/Latinos 2018-2020. Atlanta: American Cancer Society, Inc.;2018.

Reference Type BACKGROUND

Death Rates for Selected Cancers by Race and Ethnicity, US, 2010-2014. 2016; https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2017/death-rates-for-selected-cancers-by-race-and-ethnicity-us-2010-2014.pdf. Accessed Oct 11, 2021.

Reference Type BACKGROUND

Henry KA, Sherman R, Farber S, Cockburn M, Goldberg DW, Stroup AM. The joint effects of census tract poverty and geographic access on late-stage breast cancer diagnosis in 10 US States. Health Place. 2013 May;21:110-21. doi: 10.1016/j.healthplace.2013.01.007. Epub 2013 Mar 1.

Reference Type BACKGROUND
PMID: 23454732 (View on PubMed)

DeSantis CE, Ma J, Goding Sauer A, Newman LA, Jemal A. Breast cancer statistics, 2017, racial disparity in mortality by state. CA Cancer J Clin. 2017 Nov;67(6):439-448. doi: 10.3322/caac.21412. Epub 2017 Oct 3.

Reference Type BACKGROUND
PMID: 28972651 (View on PubMed)

Doescher MP, Jackson JE. Trends in cervical and breast cancer screening practices among women in rural and urban areas of the United States. J Public Health Manag Pract. 2009 May-Jun;15(3):200-9. doi: 10.1097/PHH.0b013e3181a117da.

Reference Type BACKGROUND
PMID: 19363399 (View on PubMed)

Roche LM, Niu X, Stroup AM, Henry KA. Disparities in Female Breast Cancer Stage at Diagnosis in New Jersey: A Spatial-Temporal Analysis. J Public Health Manag Pract. 2017 Sep/Oct;23(5):477-486. doi: 10.1097/PHH.0000000000000524.

Reference Type BACKGROUND
PMID: 28430705 (View on PubMed)

Williams F, Jeanetta S, O'Brien DJ, Fresen JL. Rural-urban difference in female breast cancer diagnosis in Missouri. Rural Remote Health. 2015 Jul-Sep;15(3):3063. Epub 2015 Jul 29.

Reference Type BACKGROUND
PMID: 26223824 (View on PubMed)

Bennett KJ, Pumkam C, Bellinger JD, Probst JC. Cancer screening delivery in persistent poverty rural counties. J Prim Care Community Health. 2011 Oct 1;2(4):240-9. doi: 10.1177/2150131911406123. Epub 2011 May 17.

Reference Type BACKGROUND
PMID: 23804842 (View on PubMed)

Bennett KJ, Probst JC, Bellinger JD. Receipt of cancer screening services: surprising results for some rural minorities. J Rural Health. 2012 Jan;28(1):63-72. doi: 10.1111/j.1748-0361.2011.00365.x. Epub 2011 Mar 11.

Reference Type BACKGROUND
PMID: 22236316 (View on PubMed)

Coughlin SS, Leadbetter S, Richards T, Sabatino SA. Contextual analysis of breast and cervical cancer screening and factors associated with health care access among United States women, 2002. Soc Sci Med. 2008 Jan;66(2):260-75. doi: 10.1016/j.socscimed.2007.09.009. Epub 2007 Nov 19.

Reference Type BACKGROUND
PMID: 18022299 (View on PubMed)

Horner-Johnson W, Dobbertin K, Iezzoni LI. Disparities in receipt of breast and cervical cancer screening for rural women age 18 to 64 with disabilities. Womens Health Issues. 2015 May-Jun;25(3):246-53. doi: 10.1016/j.whi.2015.02.004. Epub 2015 Apr 9.

Reference Type BACKGROUND
PMID: 25864023 (View on PubMed)

Leung J, McKenzie S, Martin J, McLaughlin D. Effect of rurality on screening for breast cancer: a systematic review and meta-analysis comparing mammography. Rural Remote Health. 2014;14(2):2730. Epub 2014 Jun 23.

Reference Type BACKGROUND
PMID: 24953122 (View on PubMed)

Incidence Rates for Utah by County Breast (Late Stage), 2014-2018, All Races (includes Hispanic), Female, All Ages. https://statecancerprofiles.cancer.gov/map/map.withimage.php?49&county&001&055211&00&2&11&0&1&5&0#results. Accessed Oct 11, 2021.

Reference Type BACKGROUND

Guillaume E, Launay L, Dejardin O, Bouvier V, Guittet L, Dean P, Notari A, De Mil R, Launoy G. Could mobile mammography reduce social and geographic inequalities in breast cancer screening participation? Prev Med. 2017 Jul;100:84-88. doi: 10.1016/j.ypmed.2017.04.006. Epub 2017 Apr 10.

Reference Type BACKGROUND
PMID: 28408217 (View on PubMed)

Other Identifiers

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SPA-RFA-Team23-1001996-01-PASD

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

HCI185522

Identifier Type: -

Identifier Source: org_study_id

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