Text and Talk: A multi-level intervention to increase opportunities to prevent cancer

Understanding how specific actions of healthcare settings affect communication between providers and parents will inform the development of tailored or complementary strategies aimed at increasing cancer prevention. Text & Talk is a 30-clinic pragmatic trial in Florida assessing the effectiveness of two implementation strategies: (1) brief provider education and communication training and (2) parent-targeted educational text message reminders. Text & Talk has 58 participating providers (37 trained in communication skills during the study period and 21 to be trained in communication skills after data collection) and 7,837 11- to 12-year-olds randomized for their parents to receive educational text messages about available cancer prevention options. The goal of this proposal is to understand how providers’ integrated the communication training skills from the provider education training into their practice and for which families and geospatial areas the educational text messages were most useful. For the provider-targeted education and communication training, the hypothesis is that providers will have varying experiences with implementing and sustaining the trained communication skills in their practice that will guide improvement and refinement of future education and communication trainings. For the parent-targeted educational text messages, text message effectiveness is hypothesized to be moderated by individual and geospatial factors. Specific aims are to: (1) Evaluate providers’ experiences with and sustainability of integrating communication training skills into their practice; and (2) Measure moderation of the effectiveness of a parent-targeted educational text message intervention by individual and geospatial differences. Hypotheses will be evaluated by triangulating data collected in Text & Talk with additional data collected during the extension period via mixed methods including in-depth, semi-structured provider interviews, provider behavioral surveys about continued use of trained communication skills, and spatially linking addresses. The innovations are a more in-depth focus on provider learning than previous studies and expanding existing understanding of parent-targeted educational text messages. The significance lies in the potential to improve the communication from healthcare providers and practices to parents about cancer prevention opportunities and other important health outcomes.