Effectiveness and implementation of mPATH™-CRC: a mobile health system for colorectal cancer screening

Anna C. Snavely, Kristie Foley, Ajay Dharod, Mark Dignan, Holly Brower, Elena Wright, David P. Miller

Research output: Contribution to journalArticlepeer-review


Background: Screening for colorectal cancer (CRC) is widely recommended but underused, even though CRC is the third most diagnosed cancer and the second leading cause of cancer death in the USA. The mPATH™ program is an iPad-based application designed to identify patients due for CRC screening, educate them on the commonly used screening tests, and help them select their best option, with the goal of increasing CRC screening rates. Methods: The mPATH™ program consists of questions asked of all adult patients at check-in (mPATH™-CheckIn), as well as a module specific for patients due for CRC screening (mPATH™-CRC). In this study, the mPATH™ program is evaluated through a Type III hybrid implementation-effectiveness design. Specifically, the study consists of three parts: (1) a cluster-randomized controlled trial of primary care clinics comparing a “high touch” evidence-based implementation strategy with a “low touch” implementation strategy; (2) a nested pragmatic study evaluating the effectiveness of mPATH-CRC™ on completion of CRC screening; and (3) a mixed-methods study evaluating factors that facilitate or impede the maintenance of interventions like mPATH-CRC™. The primary objective is to compare the proportion of patients aged 50–74 who are eligible for CRC screening who complete mPATH™-CRC in the 6th month following implementation between the “high touch” and “low touch” implementation strategies. Effectiveness of mPATH™-CRC is evaluated by comparing the proportion who complete CRC screening within 16 weeks of their visit to the clinic between a pre-implementation cohort (8 months before implementation) and a post-implementation cohort (8 months after implementation). Discussion: This study will provide data on both the implementation of the mPATH™ program and its effectiveness in improving screening rates for CRC. In addition, this work has the potential to have an even broader impact by identifying strategies to support the sustained use of other similar technology-based primary care interventions. Trial registration: ClinicalTrials.gov NCT03843957. Registered on 18 February 2019.

Original languageEnglish
Article number274
Issue number1
StatePublished - Dec 2023

Bibliographical note

Funding Information:
Funding for this project comes from the NCI (R01CA218416). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NCI or NIH. The NCI approved the research proposal, but had no role in the design and execution of the study, and will not have any role in the analysis, interpretation of the data, or writing of manuscripts.

Publisher Copyright:
© 2023, The Author(s).


  • Colorectal cancer
  • Implementation
  • Mobile health
  • Screening

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Pharmacology (medical)


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