ArticleCurrent oncology (Toronto, Ont.)2019
Testing e-mail content to encourage physicians to access an audit and feedback tool: a factorial randomized experiment.
Open access · goldAbstract read
In one paragraph
Article in Current oncology (Toronto, Ont.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
4.2field-weighted citation impact, top 6% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.
- Audit and feedback: effects on professional practice.The Cochrane database of systematic reviews · 2025Pooled it
- Primary care practice-based interventions and their effect on participation in population-based cancer screening programs: a systematic narrative review.Primary health care research & development · 2024Pooled it
- Advancing rapid cycle research in cancer care delivery: a National Cancer Institute workshop report.Journal of the National Cancer Institute · 2023Article
- Conceptual tensions and practical trade-offs in tailoring implementation interventions.Frontiers in health services · 2022Article
- Audit feedback interventions to address high-risk prescriptions in long-term care homes: a costing study and return on investment analysis.Implementation science communications · 2021Article
- Changing Health-Related Behaviours 5: On Interventions to Change Physician Behaviours.Methods in molecular biology (Clifton, N.J.) · 2021Article
- Impetus to change: a multi-site qualitative exploration of the national audit of dementia.Implementation science : IS · 2020Article
- Effectiveness of confidential reports to physicians on their prescribing of antipsychotic medications in nursing homes.Implementation science communications · 2020Article
- Impact of the Knowledge Translation Research Network's grants program in cancer knowledge translation.Current oncology (Toronto, Ont.) · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 2 institutions in 1 country.
G VaissonQuebec: Office of Education and Professional Development, Faculty of Medicine, Laval University (Vaisson, Witteman, Chipenda-Dansokho), Research Centre of the CHU de Québec, Laval University (Vaisson, Witteman), Department of Family and Emergency Medicine, Laval University (Witteman), and Laval University Primary Care Research Centre, Laval University, Quebec City (Witteman).
H O WittemanQuebec: Office of Education and Professional Development, Faculty of Medicine, Laval University (Vaisson, Witteman, Chipenda-Dansokho), Research Centre of the CHU de Québec, Laval University (Vaisson, Witteman), Department of Family and Emergency Medicine, Laval University (Witteman), and Laval University Primary Care Research Centre, Laval University, Quebec City (Witteman).
S Chipenda-DansokhoQuebec: Office of Education and Professional Development, Faculty of Medicine, Laval University (Vaisson, Witteman, Chipenda-Dansokho), Research Centre of the CHU de Québec, Laval University (Vaisson, Witteman), Department of Family and Emergency Medicine, Laval University (Witteman), and Laval University Primary Care Research Centre, Laval University, Quebec City (Witteman).
M SaragosaOntario: Family Practice Health Centre, Women's College Hospital, Toronto (Saragosa, Desveaux, Ivers); Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto (Saragosa, Bouck, Desveaux, Ivers); Dalla Lana School of Public Health, University of Toronto, Toronto (Bouck); Prevention and Cancer Control, Cancer Care Ontario, Toronto (Bravo, Llovet, Umar, Tinmouth); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto (Llovet); Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa (Presseau, Taljaard, Grimshaw); School of Epidemiology and Public Health, University of Ottawa, Ottawa (Presseau, Taljaard); School of Psychology, University of Ottawa, Ottawa (Presseau); Department of Medicine, University of Ottawa, Ottawa (Grimshaw); Institute for Clinical Evaluative Sciences, Toronto (Tinmouth); Department of Medicine, University of Toronto, Toronto (Tinmouth); and Department of Family and Community Medicine, University of Toronto, Toronto (Ivers).
Z BouckOntario: Family Practice Health Centre, Women's College Hospital, Toronto (Saragosa, Desveaux, Ivers); Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto (Saragosa, Bouck, Desveaux, Ivers); Dalla Lana School of Public Health, University of Toronto, Toronto (Bouck); Prevention and Cancer Control, Cancer Care Ontario, Toronto (Bravo, Llovet, Umar, Tinmouth); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto (Llovet); Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa (Presseau, Taljaard, Grimshaw); School of Epidemiology and Public Health, University of Ottawa, Ottawa (Presseau, Taljaard); School of Psychology, University of Ottawa, Ottawa (Presseau); Department of Medicine, University of Ottawa, Ottawa (Grimshaw); Institute for Clinical Evaluative Sciences, Toronto (Tinmouth); Department of Medicine, University of Toronto, Toronto (Tinmouth); and Department of Family and Community Medicine, University of Toronto, Toronto (Ivers).
C A BravoOntario: Family Practice Health Centre, Women's College Hospital, Toronto (Saragosa, Desveaux, Ivers); Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto (Saragosa, Bouck, Desveaux, Ivers); Dalla Lana School of Public Health, University of Toronto, Toronto (Bouck); Prevention and Cancer Control, Cancer Care Ontario, Toronto (Bravo, Llovet, Umar, Tinmouth); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto (Llovet); Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa (Presseau, Taljaard, Grimshaw); School of Epidemiology and Public Health, University of Ottawa, Ottawa (Presseau, Taljaard); School of Psychology, University of Ottawa, Ottawa (Presseau); Department of Medicine, University of Ottawa, Ottawa (Grimshaw); Institute for Clinical Evaluative Sciences, Toronto (Tinmouth); Department of Medicine, University of Toronto, Toronto (Tinmouth); and Department of Family and Community Medicine, University of Toronto, Toronto (Ivers).
L DesveauxOntario: Family Practice Health Centre, Women's College Hospital, Toronto (Saragosa, Desveaux, Ivers); Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto (Saragosa, Bouck, Desveaux, Ivers); Dalla Lana School of Public Health, University of Toronto, Toronto (Bouck); Prevention and Cancer Control, Cancer Care Ontario, Toronto (Bravo, Llovet, Umar, Tinmouth); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto (Llovet); Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa (Presseau, Taljaard, Grimshaw); School of Epidemiology and Public Health, University of Ottawa, Ottawa (Presseau, Taljaard); School of Psychology, University of Ottawa, Ottawa (Presseau); Department of Medicine, University of Ottawa, Ottawa (Grimshaw); Institute for Clinical Evaluative Sciences, Toronto (Tinmouth); Department of Medicine, University of Toronto, Toronto (Tinmouth); and Department of Family and Community Medicine, University of Toronto, Toronto (Ivers).
D LlovetOntario: Family Practice Health Centre, Women's College Hospital, Toronto (Saragosa, Desveaux, Ivers); Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto (Saragosa, Bouck, Desveaux, Ivers); Dalla Lana School of Public Health, University of Toronto, Toronto (Bouck); Prevention and Cancer Control, Cancer Care Ontario, Toronto (Bravo, Llovet, Umar, Tinmouth); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto (Llovet); Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa (Presseau, Taljaard, Grimshaw); School of Epidemiology and Public Health, University of Ottawa, Ottawa (Presseau, Taljaard); School of Psychology, University of Ottawa, Ottawa (Presseau); Department of Medicine, University of Ottawa, Ottawa (Grimshaw); Institute for Clinical Evaluative Sciences, Toronto (Tinmouth); Department of Medicine, University of Toronto, Toronto (Tinmouth); and Department of Family and Community Medicine, University of Toronto, Toronto (Ivers).
J PresseauOntario: Family Practice Health Centre, Women's College Hospital, Toronto (Saragosa, Desveaux, Ivers); Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto (Saragosa, Bouck, Desveaux, Ivers); Dalla Lana School of Public Health, University of Toronto, Toronto (Bouck); Prevention and Cancer Control, Cancer Care Ontario, Toronto (Bravo, Llovet, Umar, Tinmouth); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto (Llovet); Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa (Presseau, Taljaard, Grimshaw); School of Epidemiology and Public Health, University of Ottawa, Ottawa (Presseau, Taljaard); School of Psychology, University of Ottawa, Ottawa (Presseau); Department of Medicine, University of Ottawa, Ottawa (Grimshaw); Institute for Clinical Evaluative Sciences, Toronto (Tinmouth); Department of Medicine, University of Toronto, Toronto (Tinmouth); and Department of Family and Community Medicine, University of Toronto, Toronto (Ivers).
M TaljaardOntario: Family Practice Health Centre, Women's College Hospital, Toronto (Saragosa, Desveaux, Ivers); Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto (Saragosa, Bouck, Desveaux, Ivers); Dalla Lana School of Public Health, University of Toronto, Toronto (Bouck); Prevention and Cancer Control, Cancer Care Ontario, Toronto (Bravo, Llovet, Umar, Tinmouth); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto (Llovet); Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa (Presseau, Taljaard, Grimshaw); School of Epidemiology and Public Health, University of Ottawa, Ottawa (Presseau, Taljaard); School of Psychology, University of Ottawa, Ottawa (Presseau); Department of Medicine, University of Ottawa, Ottawa (Grimshaw); Institute for Clinical Evaluative Sciences, Toronto (Tinmouth); Department of Medicine, University of Toronto, Toronto (Tinmouth); and Department of Family and Community Medicine, University of Toronto, Toronto (Ivers).
S UmarOntario: Family Practice Health Centre, Women's College Hospital, Toronto (Saragosa, Desveaux, Ivers); Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto (Saragosa, Bouck, Desveaux, Ivers); Dalla Lana School of Public Health, University of Toronto, Toronto (Bouck); Prevention and Cancer Control, Cancer Care Ontario, Toronto (Bravo, Llovet, Umar, Tinmouth); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto (Llovet); Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa (Presseau, Taljaard, Grimshaw); School of Epidemiology and Public Health, University of Ottawa, Ottawa (Presseau, Taljaard); School of Psychology, University of Ottawa, Ottawa (Presseau); Department of Medicine, University of Ottawa, Ottawa (Grimshaw); Institute for Clinical Evaluative Sciences, Toronto (Tinmouth); Department of Medicine, University of Toronto, Toronto (Tinmouth); and Department of Family and Community Medicine, University of Toronto, Toronto (Ivers).
J M GrimshawOntario: Family Practice Health Centre, Women's College Hospital, Toronto (Saragosa, Desveaux, Ivers); Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto (Saragosa, Bouck, Desveaux, Ivers); Dalla Lana School of Public Health, University of Toronto, Toronto (Bouck); Prevention and Cancer Control, Cancer Care Ontario, Toronto (Bravo, Llovet, Umar, Tinmouth); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto (Llovet); Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa (Presseau, Taljaard, Grimshaw); School of Epidemiology and Public Health, University of Ottawa, Ottawa (Presseau, Taljaard); School of Psychology, University of Ottawa, Ottawa (Presseau); Department of Medicine, University of Ottawa, Ottawa (Grimshaw); Institute for Clinical Evaluative Sciences, Toronto (Tinmouth); Department of Medicine, University of Toronto, Toronto (Tinmouth); and Department of Family and Community Medicine, University of Toronto, Toronto (Ivers).
J TinmouthOntario: Family Practice Health Centre, Women's College Hospital, Toronto (Saragosa, Desveaux, Ivers); Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto (Saragosa, Bouck, Desveaux, Ivers); Dalla Lana School of Public Health, University of Toronto, Toronto (Bouck); Prevention and Cancer Control, Cancer Care Ontario, Toronto (Bravo, Llovet, Umar, Tinmouth); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto (Llovet); Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa (Presseau, Taljaard, Grimshaw); School of Epidemiology and Public Health, University of Ottawa, Ottawa (Presseau, Taljaard); School of Psychology, University of Ottawa, Ottawa (Presseau); Department of Medicine, University of Ottawa, Ottawa (Grimshaw); Institute for Clinical Evaluative Sciences, Toronto (Tinmouth); Department of Medicine, University of Toronto, Toronto (Tinmouth); and Department of Family and Community Medicine, University of Toronto, Toronto (Ivers).
N M IversOntario: Family Practice Health Centre, Women's College Hospital, Toronto (Saragosa, Desveaux, Ivers); Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto (Saragosa, Bouck, Desveaux, Ivers); Dalla Lana School of Public Health, University of Toronto, Toronto (Bouck); Prevention and Cancer Control, Cancer Care Ontario, Toronto (Bravo, Llovet, Umar, Tinmouth); Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto (Llovet); Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa (Presseau, Taljaard, Grimshaw); School of Epidemiology and Public Health, University of Ottawa, Ottawa (Presseau, Taljaard); School of Psychology, University of Ottawa, Ottawa (Presseau); Department of Medicine, University of Ottawa, Ottawa (Grimshaw); Institute for Clinical Evaluative Sciences, Toronto (Tinmouth); Department of Medicine, University of Toronto, Toronto (Tinmouth); and Department of Family and Community Medicine, University of Toronto, Toronto (Ivers).
Women's College Hospital · CAUniversité Laval · CA
Funding
CIHR FDN 143269CIHR FDN 148426
Abstract
Background: In Ontario, an online audit and feedback tool that provides primary care physicians with detailed information about patients who are overdue for cancer screening is underused. In the present study, we aimed to examine the effect of messages operationalizing 3 behaviour change techniques on access to the audit and feedback tool and on cancer screening rates. Methods: During May-September 2017, a pragmatic 2×2×2 factorial experiment tested 3 behaviour change techniques: anticipated regret, material incentive, and problem-solving. Outcomes were assessed using routinely collected administrative data. A qualitative process evaluation explored how and why the e-mail messages did or did not support Screening Activity Report access. Results: Of 5449 primary care physicians randomly allocated to 1 of 8 e-mail messages, fewer than half opened the messages and fewer than 1 in 10 clicked through the messages. Messages with problem-solving content were associated with a 12.9% relative reduction in access to the tool (risk ratio: 0.871; 95% confidence interval: 0.791 to 0.958; Conclusions: For audit and feedback to work, recipients must engage with the data; for e-mail messages to prompt activity, recipients must open and review the message content. This large factorial experiment demonstrated that small changes in the content of such e-mail messages might influence clinical behaviour. Future research should focus on strategies to make cancer screening more user-centred.
Indexed as
Early Detection of CancerElectronic MailMass ScreeningPhysiciansPrimary Health CareBehaviorFemaleFormative FeedbackHumansMaleMotivationProblem SolvingQuality Assurance, Health CareRandom Allocationaudit and feedbackbehaviour change techniquesCancer screeninge-mailfactorial experimentspersuasive communicationprimary health careprocess evaluations
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.