Abstract A020: Engagement with text message-based social needs screening among cancer survivors in urban oncology settings

Abstract Purpose. Publications on SMS text messaging strategies to administer health-related social needs (HRSN) screening to patients are limited, despite widespread mobile phone ownership and use of SMS in the US. Methods. We launched a SMS screener among adults with a history of cancer at four hospital locations within a single mid-Atlantic hospital system. The initial message explained that the hospital system’s community health team would help the patient access community resources upon the patient’s completion of the screener. Patients were identified from cancer registries if they were aged >18 years and within 12 months from diagnosis of an invasive cancer (stage I-IV). The screener was based on the National Academy of Medicine tool covering domains of financial strain, food insecurity, transportation, utilities, employment, and housing instability. We used descriptive statistics and Chi-square tests to assess whether and which patients responded to SMS text messaging on HRSN. Results. From August 2024-May 2025, 95.1% (852/896) of screeners sent via SMS were successfully delivered (i.e., working mobile phone number in medical record), and 48.1% (410/852) of patients who received the screener completed it. Of the individuals who completed the screener, the average age was 64 years. We observed inverse trends in response rate by age: 69% of patients aged 18-34 years responded, 53% of those aged 35-54 years responded, 47% of those aged 55-84 years responded, and 29% of those aged 85+ years responded (p=0.029). Women were more likely than men to respond (51% vs 42%) (p=0.016). A higher proportion of White patients (57%) responded to the screener compared to Black (45%), Asian (48%), or other race categories (including “Other,” “Declined to Answer,” and “Unknown”) (35%) (p<0.0001). Of those who completed the screener, 13.2% (54/410) reported at least one HRSN. The most commonly reported HRSN was financial strain, followed closely by food insecurity. Community health workers followed up with those who reported needs to provide resources or referrals. Conclusions. While nearly half of patients who received the screener completed it, differences in response rates by age, sex, and race provide important considerations for targeting SMS-based messaging and where more personalized outreach than SMS-based messaging may be needed. Additional research could inform strategies for scaling HRSN screening to reduce burden on the clinical staff conducting screening, increase screening reach, and increase ability to address any identified needs. Funding This project is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award (U01DP006639). The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CDC/HHS, or the U.S. government. Citation Format: Marjanna Smith, Jessica Rivera Rivera, Mandi L. Pratt-Chapman, Alex Atkinson, Susan Sabatino, Elizabeth A. Rohan, Hannah Arem. Engagement with text message-based social needs screening among cancer survivors in urban oncology settings [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A020.