Effect of patient navigation on colorectal cancer screening in a community-based randomized controlled trial of urban African American adults

Purpose: In recent years, colorectal cancer (CRC) screening rates have increased steadily in the USA, though racial and ethnic disparities persist. In a community-based randomized controlled trial, we investigated the effect of patient navigation on increasing CRC screening adherence among older Afr...

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Veröffentlicht in:Cancer causes & control Jg. 26; H. 2; S. 239 - 246
Hauptverfasser: Horne, Hisani N., Phelan-Emrick, Darcy F., Pollack, Craig E., Markakis, Diane, Wenzel, Jennifer, Ahmed, Saifuddin, Garza, Mary A., Shapiro, Gary R., Bone, Lee R., Johnson, Lawrence B., Ford, Jean G.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Cham Springer 01.02.2015
Springer International Publishing
Springer Nature B.V
Schlagworte:
African Americans
Aged
Aged, 80 and over
Biomedical and Life Sciences
Biomedicine
Black or African American
Cancer Research
Clinical trials
Colonoscopy
Colonoscopy - statistics & numerical data
Colorectal cancer
Colorectal Neoplasms - diagnosis
Colorectal Neoplasms - ethnology
Disease prevention
Early Detection of Cancer - methods
Educational materials
Enrollments
Epidemiology
Female
Guideline Adherence
Health care policy
Health disparities
Health education
Health literacy
Healthcare Disparities
Hematology
Humans
Intervention
Male
Medical screening
Medicare
Mortality
Occult Blood
Oncology
Original Paper
Patient Education as Topic
Patient Navigation - methods
Patient Navigation - statistics & numerical data
Public Health
Sigmoidoscopy - statistics & numerical data
Surveys and Questionnaires
Urban Population
United States > US
Baltimore Maryland
Randomized controlled trial
Colorectal cancer
Patient navigator
Health disparities
ISSN:0957-5243, 1573-7225, 1573-7225
Online-Zugang:Volltext
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Zusammenfassung:Purpose: In recent years, colorectal cancer (CRC) screening rates have increased steadily in the USA, though racial and ethnic disparities persist. In a community-based randomized controlled trial, we investigated the effect of patient navigation on increasing CRC screening adherence among older African Americans. Methods: Participants in the Cancer Prevention and Treatment Demonstration were randomized to either the control group, receiving only printed educational materials (PEM), or the intervention arm where they were assigned a patient navigator in addition to PEM. Navigators assisted participants with identifying and overcoming screening barriers. Logistic regression analyses were used to assess the effect of patient navigation on CRC screening adherence. Up-to-date with screening was defined as self-reported receipt of colonoscopy/sigmoidoscopy in the previous 10 years or fecal occult blood testing (FOBT) in the year prior to the exit interview. Results: Compared with controls, the intervention group was more likely to report being up-to-date with CRC screening at the exit interview (OR 1.55, 95 % CI 1.07–2.23), after adjusting for select demographics. When examining the screening modalities separately, the patient navigator increased screening for colonoscopy/sigmoidoscopy (OR 1.53, 95 % CI 1.07–2.19), but not FOBT screening. Analyses of moderation revealed stronger effects of navigation among participants 65–69 years and those with an adequate health literacy level. Conclusions: In a population of older African Americans adults, patient navigation was effective in increasing the likelihood of CRC screening. However, more intensive navigation may be necessary for adults over 70 years and individuals with low literacy levels.
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ISSN:0957-5243
1573-7225
1573-7225
DOI:10.1007/s10552-014-0505-0