Effects of a Community-to-Clinic Navigation Intervention on Colorectal Cancer Screening Among Underserved People

Colorectal cancer screening remains suboptimal among poor and underserved people. We tested the effectiveness of a community-to-clinic navigator intervention to guide multicultural, underinsured individuals into primary care clinics to complete colorectal cancer screening. This two-phase behavioral...

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Vydáno v:Annals of behavioral medicine Ročník 54; číslo 5; s. 308
Hlavní autoři: Menon, Usha, Szalacha, Laura A, Kue, Jennifer, Herman, Patricia M, Bucho-Gonzalez, Julie, Lance, Peter, Larkey, Linda
Médium: Journal Article
Jazyk:angličtina
Vydáno: England 01.05.2020
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ISSN:1532-4796, 1532-4796
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Abstract Colorectal cancer screening remains suboptimal among poor and underserved people. We tested the effectiveness of a community-to-clinic navigator intervention to guide multicultural, underinsured individuals into primary care clinics to complete colorectal cancer screening. This two-phase behavioral intervention study was conducted in Phoenix, Arizona (2012-2018). Community sites were randomized to group education or group education plus tailored navigation to increase attendance at primary care clinics (Phase I). Individuals who completed a clinic appointment received the tailored navigation in person or via phone (Phase II). In Phase I (N = 345), 37.9% of the intervention group scheduled a clinic appointment versus 19.4% of the comparison group. In Phase II, 26.5% of the original intervention group were screened versus only 10.4% of the original comparison group. Those in the intervention group were 3.84 times more likely to be screened than were those in the comparison group (odds ratio = 3.84; 95% confidence interval = 1.81-6.92). Translation of an efficacious tailored navigation intervention for colorectal cancer screening to a community-to-clinic context is associated with significantly increased rates of colorectal cancer screening. Navigation assistance to address barriers to screening may serve as the most important component of any educational program to increase individual adherence to colorectal cancer screening.
AbstractList Colorectal cancer screening remains suboptimal among poor and underserved people. We tested the effectiveness of a community-to-clinic navigator intervention to guide multicultural, underinsured individuals into primary care clinics to complete colorectal cancer screening. This two-phase behavioral intervention study was conducted in Phoenix, Arizona (2012-2018). Community sites were randomized to group education or group education plus tailored navigation to increase attendance at primary care clinics (Phase I). Individuals who completed a clinic appointment received the tailored navigation in person or via phone (Phase II). In Phase I (N = 345), 37.9% of the intervention group scheduled a clinic appointment versus 19.4% of the comparison group. In Phase II, 26.5% of the original intervention group were screened versus only 10.4% of the original comparison group. Those in the intervention group were 3.84 times more likely to be screened than were those in the comparison group (odds ratio = 3.84; 95% confidence interval = 1.81-6.92). Translation of an efficacious tailored navigation intervention for colorectal cancer screening to a community-to-clinic context is associated with significantly increased rates of colorectal cancer screening. Navigation assistance to address barriers to screening may serve as the most important component of any educational program to increase individual adherence to colorectal cancer screening.
Colorectal cancer screening remains suboptimal among poor and underserved people.BACKGROUNDColorectal cancer screening remains suboptimal among poor and underserved people.We tested the effectiveness of a community-to-clinic navigator intervention to guide multicultural, underinsured individuals into primary care clinics to complete colorectal cancer screening.PURPOSEWe tested the effectiveness of a community-to-clinic navigator intervention to guide multicultural, underinsured individuals into primary care clinics to complete colorectal cancer screening.This two-phase behavioral intervention study was conducted in Phoenix, Arizona (2012-2018). Community sites were randomized to group education or group education plus tailored navigation to increase attendance at primary care clinics (Phase I). Individuals who completed a clinic appointment received the tailored navigation in person or via phone (Phase II).METHODSThis two-phase behavioral intervention study was conducted in Phoenix, Arizona (2012-2018). Community sites were randomized to group education or group education plus tailored navigation to increase attendance at primary care clinics (Phase I). Individuals who completed a clinic appointment received the tailored navigation in person or via phone (Phase II).In Phase I (N = 345), 37.9% of the intervention group scheduled a clinic appointment versus 19.4% of the comparison group. In Phase II, 26.5% of the original intervention group were screened versus only 10.4% of the original comparison group. Those in the intervention group were 3.84 times more likely to be screened than were those in the comparison group (odds ratio = 3.84; 95% confidence interval = 1.81-6.92).RESULTSIn Phase I (N = 345), 37.9% of the intervention group scheduled a clinic appointment versus 19.4% of the comparison group. In Phase II, 26.5% of the original intervention group were screened versus only 10.4% of the original comparison group. Those in the intervention group were 3.84 times more likely to be screened than were those in the comparison group (odds ratio = 3.84; 95% confidence interval = 1.81-6.92).Translation of an efficacious tailored navigation intervention for colorectal cancer screening to a community-to-clinic context is associated with significantly increased rates of colorectal cancer screening. Navigation assistance to address barriers to screening may serve as the most important component of any educational program to increase individual adherence to colorectal cancer screening.CONCLUSIONSTranslation of an efficacious tailored navigation intervention for colorectal cancer screening to a community-to-clinic context is associated with significantly increased rates of colorectal cancer screening. Navigation assistance to address barriers to screening may serve as the most important component of any educational program to increase individual adherence to colorectal cancer screening.
Author Szalacha, Laura A
Bucho-Gonzalez, Julie
Larkey, Linda
Herman, Patricia M
Kue, Jennifer
Lance, Peter
Menon, Usha
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  givenname: Usha
  surname: Menon
  fullname: Menon, Usha
  organization: University of South Florida, Tampa, FL, USA
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  fullname: Szalacha, Laura A
  organization: University of South Florida, Tampa, FL, USA
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  givenname: Jennifer
  surname: Kue
  fullname: Kue, Jennifer
  organization: The Ohio State University, Columbus, OH, USA
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  givenname: Patricia M
  surname: Herman
  fullname: Herman, Patricia M
  organization: Rand Corporation, Santa Monica, CA, USA
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  surname: Bucho-Gonzalez
  fullname: Bucho-Gonzalez, Julie
  organization: Arizona State University, Phoenix, AZ, USA
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  givenname: Peter
  surname: Lance
  fullname: Lance, Peter
  organization: University of Arizona Cancer Center, Tucson, AZ, USA
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  givenname: Linda
  surname: Larkey
  fullname: Larkey, Linda
  organization: Arizona State University, Phoenix, AZ, USA
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Issue 5
Keywords Patient navigation
Colorectal cancer
Implementation science
Cancer screening
Language English
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Snippet Colorectal cancer screening remains suboptimal among poor and underserved people. We tested the effectiveness of a community-to-clinic navigator intervention...
Colorectal cancer screening remains suboptimal among poor and underserved people.BACKGROUNDColorectal cancer screening remains suboptimal among poor and...
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SubjectTerms Aged
Arizona
Colorectal Neoplasms - diagnosis
Early Detection of Cancer - statistics & numerical data
Female
Health Promotion - organization & administration
Health Promotion - statistics & numerical data
Health Services Accessibility - organization & administration
Health Services Accessibility - statistics & numerical data
Humans
Implementation Science
Male
Medically Uninsured - statistics & numerical data
Middle Aged
Patient Navigation - organization & administration
Patient Navigation - statistics & numerical data
Process Assessment, Health Care - statistics & numerical data
Program Development
Program Evaluation
Title Effects of a Community-to-Clinic Navigation Intervention on Colorectal Cancer Screening Among Underserved People
URI https://www.ncbi.nlm.nih.gov/pubmed/31676898
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