BACKGROUND Women who are uninsured and Black or Hispanic tend to be diagnosed with breast cancer at a younger age, with more advanced disease. Rates of mammogram screenings are lower than the national average at Federally Qualified Health Centers (FQHCs). In this study, we evaluated the impact of an SMS text message intervention, a patient reminder regarding their eligibility for a screening mammogram, on mammogram completion rates at a regional FQHC network. OBJECTIVE This study examined the effectiveness of the SMS text message intervention and the disparities in breast cancer screening rates within an FQHC population in Texas. METHODS The study sample (n = 1,481) consisted of female adults at least 45 years old receiving care at a series of large FQHCs in Texas between 2022 and 2023. In addition to patient characteristics, healthcare utilization information, and geographic factors, we report the adjusted odds ratio from a multiple logistic regression model to assess characteristics associated with completing the mammogram screening after the text message reminder. RESULTS Participants tended to be younger (50-59 years of age: 42.26%), Hispanic (47.15%), and uninsured (44.29%). The intervention did not significantly affect breast screening via mammogram after controlling for all covariates (aOR = 0.79, 95% CI 0.56 — 1.10). The strongest factors positively associated with text message reminders for mammography screening were being uninsured (aOR = 2.46, 95% CI 1.20 — 5.43), Medicare coverage (aOR = 2.16, 95% CI 1.01 — 4.92), or location in a large city (aOR = 6.32, 95% CI 1.25 — 36.34). CONCLUSIONS Text message reminders alone may be insufficient to increase mammogram screenings for Hispanic women at FQHCs. Combinations of text messages with other types of reminders may be more suitable. Consistent with prior literature, uninsured women living in urban areas were more likely to complete the mammograms. Developing additional strategies to complement and support text message reminders is crucial for equitably increasing breast cancer screening amongst women served by FQHCs.
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