Deliver public health messages at the right time

I was 31 when my mother died of breast cancer. One day, while sitting with her in the hospital, her oncologist asked me a question no one had ever asked me before: “Have you ever had a mammogram?”

Although my mother was diagnosed with breast cancer at age 34, I never thought about getting a mammogram or discussed it with my doctor. The problem wasn’t that I didn’t have access to health care. The problem was that no one had ever suggested that a mammogram was right for me, given my family history.

This speaks to a larger communication gap within the US healthcare system. Health care providers and public health officials need to find ways to deliver simple, concrete messages about preventive care to people who need it.

Solving this problem could not be more urgent. The U.S. Preventive Services Task Force recently released new guidelines lowering the age at which all women should have regular mammograms from 50 to 40. According to these guidelines, some women – like me, based on their family history – should be tested for breast cancer. cancer even earlier.

I had my first mammogram shortly after this discussion with my mother’s oncologist and learned that I should have had mammograms since I was 25 years old. Cancer kills nearly 1,700 Americans every day, but if detected early, many cancers, including breast cancer, can be treated so that people have a greater chance of survival and better health. of life when they undergo treatment.

But as many as two in five American adults don’t know they need to be tested for a hidden cancer. For what? Because most people don’t think about cancer screening regularly and only hear about it during an annual appointment with their doctor. Many guidelines are based on a person’s specific clinical profile and family history, and they change from time to time, making it more difficult to know when to get them. For example, in addition to recently updated guidelines lowering the age at which women should start getting regular mammograms, the age for colorectal cancer screening has also been lowered. Too often, awareness campaigns do not encourage people to talk to their doctor, make an appointment and get tested.

Part of the reason is that 20th century marketing tactics are being used to communicate 21st century guidelines, and they aren’t working. In almost every area of ​​daily life, people receive personalized messages when they need to take action. Book a beach hotel, for example, and you’ll receive notifications about flights, rental cars or restaurants in the area. You can click on it and make the booking immediately, when you are actively planning your trip.

Public health messages are delivered in many ways, including television commercials or even TikTok campaigns, but people usually don’t think about their health at these times.

One of the times people actively think about their health is during medical appointments. Waiting rooms are often filled with information about the latest public health guidelines, from which vaccines they may be eligible for to preventative measures to take. But the stack of brochures, the posters hanging on the walls, or the TV screens playing on an endless video loop are easy to ignore, because none of it is personalized to the reader or viewer.

This places the burden of communicating preventive care guidelines on primary care providers, who already have too much to cover in short appointments, leaving them little time to ensure their patients understand these guidelines.

The CDC is trying to get public health messages to patients through their trusted doctors, but it’s time to help providers shoulder this burden. Public health guidance should be provided as people engage with their health, in a way that makes it easy to understand and simple to act on.

What is needed is better use of technology to deliver messages that are relevant, private and tailored to individual needs. when they can act. In The Annals of Internal Medicine earlier this year, researchers advocated this approach, citing work I led at Phreesia to deliver messages about vaccination to more than 20 million people as they registered for their medical visits on their phone or tablet. the doctor’s office. A third of them indicated their intention to get vaccinated in a follow-up survey.

In my work with health care providers, I have also found that this approach also works in breast cancer prevention. One health system, for example, sent text or email messages to more than 87,000 people about mammograms, and 32% of them subsequently requested a mammogram appointment.

The new guidelines for mammography and colorectal cancer screening will undoubtedly save lives, but only if people know about them and can follow them. Relevant messages are particularly important in this case because the guidelines depend on the individual profile. When awareness campaigns are limited to brochures in a doctor’s office, TV commercials, or even TikTok campaigns, people may not understand their individual risks and recommendations. Now is the time to make it easier for people to understand what screenings they need and take preventative measures.

Hilary Hatch, Ph.D. is the Chief Clinical Officer of Phreesia, a company that offers providers, life sciences companies, payers and other organizations tools to help patients take a more active role in their care, and a member of the National Quality Foundation Leadership Consortium.