In Healthcare, Direct Mail Isn’t Dead

Direct mail can still be a beneficial medium, according to a recent study directed towards patients at the Heartland International Health Center (HIHC), which provides primary care to low-income, uninsured people. Direct_Mail

In the study, the HIHC, which serves more than 13,000 patients annually at eight clinical sites in Chicago, found that patients who randomly received an outreach intervention via direct mail had a much higher rate of compliance then patients who did not get the outreach.

As had been done in the past, patients were electronically reminded to have a colorectal cancer screening at all routine primary care visits. Select random patients got a special mailing ahead of time with the following components:

  • A letter from their physician recommending fecal occult blood testing (FOBT) screening
  • A colorectal cancer fact sheet in English and Spanish from the Centers for Disease Control and Prevention
  • A 3-sample FOBT test and manufacturer-supplied instructions covering patient preparation, sample collection, and FOBT kit handling

Patients were instructed to return the completed FOBT kit in person or by mail, using a postage-paid envelope, to the healthcare laboratory.

Patients who did not return the completed FOBT kit received up to three reminder calls two weeks apart from a health educator who was proficient in both English and Spanish. Patients who still did not comply received a second letter from their physician six weeks after initial mail communications, urging compliance.

Communications took place between February and April 2010. All forms of colorectal cancer screening performed on the two groups up to the end of June 2010 were considered evidence of compliance.

Only 5 percent of the usual-care group completed colorectal screening compared with 30 percent compliance among patients receiving the outreach intervention. Nearly all of the completed colorectal cancer screenings were FOBTs.

The study demonstrated that direct-to-patient outreach intervention was very effective. It also concluded that direct mailing of FOBT kits to patients for colorectal cancer screenings may be a good option for improving adherence to screening guidelines in historically underserved communities.

For help in creating an effective direct mail program that can get patients into your hospital for preventive screenings contact Wax Custom Communications at 305-350-5700 or visit

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