BACKGROUND: Colorectal cancer (CRC) is a leading cause of cancer death in the United States. Early detection through recommended screening has been shown to have favorable treatment outcomes, yet screening rates among the medically underserved and uninsured are low, particularly for rural and minority populations. This study evaluated the effectiveness of a patient navigation program that addresses individual and systemic barriers to CRC screening for patients at rural, federally qualified community health centers. METHODS: This quasi-experimental evaluation compared low-income patients at average risk for CRC (n = 809) from 4 intervention clinics and 9 comparison clinics. We abstracted medical chart data on patient demographics, CRC history and risk factors, and CRC screening referrals and examinations. Outcomes of interest were colonoscopy referral and examination during the study period and being compliant with recommended screening guidelines at the end of the study period. We conducted multilevel logistic analyses to evaluate the program's effectiveness. RESULTS: Patients at intervention clinics were significantly more likely than patients at comparison clinics to undergo colonoscopy screening (35% versus 7%, odds ratio = 7.9, P < .01) and be guideline-compliant on at least one CRC screening test (43% versus 11%, odds ratio = 5.9, P < .001). CONCLUSIONS: Patient navigation, delivered through the Community Cancer Screening Program, can be an effective approach to ensure that lifesaving, preventive health screenings are provided to low-income adults in a rural setting.
BACKGROUND:Colorectal cancer (CRC) is a leading cause of cancer death in the United States. Early detection through recommended screening has been shown to have favorable treatment outcomes, yet screening rates among the medically underserved and uninsured are low, particularly for rural and minority populations. This study evaluated the effectiveness of a patient navigation program that addresses individual and systemic barriers to CRC screening for patients at rural, federally qualified community health centers. METHODS: This quasi-experimental evaluation compared low-income patients at average risk for CRC (n = 809) from 4 intervention clinics and 9 comparison clinics. We abstracted medical chart data on patient demographics, CRC history and risk factors, and CRC screening referrals and examinations. Outcomes of interest were colonoscopy referral and examination during the study period and being compliant with recommended screening guidelines at the end of the study period. We conducted multilevel logistic analyses to evaluate the program's effectiveness. RESULTS:Patients at intervention clinics were significantly more likely than patients at comparison clinics to undergo colonoscopy screening (35% versus 7%, odds ratio = 7.9, P < .01) and be guideline-compliant on at least one CRC screening test (43% versus 11%, odds ratio = 5.9, P < .001). CONCLUSIONS:Patient navigation, delivered through the Community Cancer Screening Program, can be an effective approach to ensure that lifesaving, preventive health screenings are provided to low-income adults in a rural setting.
Authors: Stephanie B Wheeler; Tzy-Mey Kuo; Ravi K Goyal; Anne-Marie Meyer; Kristen Hassmiller Lich; Emily M Gillen; Seth Tyree; Carmen L Lewis; Trisha M Crutchfield; Christa E Martens; Florence Tangka; Lisa C Richardson; Michael P Pignone Journal: Health Place Date: 2014-07-24 Impact factor: 4.078
Authors: Cam Escoffery; Maria E Fernandez; Sally W Vernon; Shuting Liang; Annette E Maxwell; Jennifer D Allen; Andrea Dwyer; Peggy A Hannon; Marlana Kohn; Amy DeGroff Journal: J Public Health Manag Pract Date: 2015 Sep-Oct
Authors: Adam B Weiner; Richard S Matulewicz; Jeffrey J Tosoian; Joseph M Feinglass; Edward M Schaeffer Journal: Urol Oncol Date: 2017-11-15 Impact factor: 3.498
Authors: Gloria D Coronado; Eric S Johnson; Michael C Leo; Jennifer L Schneider; David Smith; Raj Mummadi; Amanda F Petrik; Jamie H Thompson; Ricardo Jimenez Journal: Contemp Clin Trials Date: 2019-12-24 Impact factor: 2.226