Screening for colorectal cancer (CRC) reduces mortality, yet more than one third of age-eligible Americans are unscreened.

To examine the effect of a digital health intervention, Mobile Patient Technology for Health–CRC (mPATH-CRC), on rates of CRC screening.

Randomized clinical trial. (ClinicalTrials.gov: NCT02088333)

6 community-based primary care practices.

450 patients (223 in the mPATH-CRC group and 227 in usual care) scheduled for a primary care visit and due for routine CRC screening.

An iPad application that displays a CRC screening decision aid, lets patients order their own screening tests, and sends automated follow-up electronic messages to support patients.

The primary outcome was chart-verified completion of CRC screening within 24 weeks. Secondary outcomes were ability to state a screening preference, intention to receive screening, screening discussions, and orders for screening tests. All outcome assessors were blinded to randomization.

Baseline characteristics were similar between groups; 37% of participants had limited health literacy, and 53% had annual incomes less than $20 000. Screening was completed by 30% of mPATH-CRC participants and 15% of those receiving usual care (logistic regression OR, 2.5 [95% CI, 1.6 to 4.0]). Compared with usual care, more mPATH-CRC participants could state a screening preference, planned to be screened within 6 months, discussed screening with their provider, and had a screening test ordered. Half of mPATH-CRC participants (53%; 118 of 223) “self-ordered” a test via the program.

Participants were English speakers in a single health care system.

A digital health intervention that allows patients to self-order tests can increase CRC screening. Future research should identify methods for implementing similar interventions in clinical care.

National Cancer Institute.

筛查结直肠癌（CRC）可以降低死亡率，但超过三分之一的符合年龄要求的美国人尚未接受筛查。

为了检查数字健康干预措施（CRC移动患者技术-CRC（mPATH-CRC））对CRC筛查率的影响。

随机临床试验。（ClinicalTrials.gov：NCT02088333）

6种基于社区的初级保健实践。

450例患者（mPATH-CRC组为223例，常规护理为227例）计划进行初次就诊，并应接受常规CRC筛查。

iPad应用程序显示CRC筛查决策辅助工具，让患者订购自己的筛查测试，并发送自动的后续电子消息以支持患者。

主要结果是在24周内通过图表验证完成CRC筛查。次要结果是陈述筛查偏好的能力，接受筛查的意图，筛查讨论和筛查测试的命令。所有结果评估者均不接受随机分组。

各组之间的基线特征相似；37％的参与者的健康素养有限，53％的年收入低于2万美元。30％的mPATH-CRC参与者和15％接受常规护理的参与者完成了筛查（逻辑回归OR，2.5 [95％CI， 1.6至4.0]）。与常规护理相比，更多的mPATH-CRC参与者可以陈述筛查偏好，计划在6个月内进行筛查，与提供者讨论筛查并下令进行筛查测试。一半的mPATH-CRC参与者（53％； 223位中的118位）通过该程序“自行订购”了一项测试。

参加者为单一医疗体系中的讲英语的人。

允许患者进行自检的数字健康干预措施可以提高CRC筛查的效率。未来的研究应确定在临床护理中实施类似干预措施的方法。

国家癌症研究所。