Julie Bucho-Gonzalez1, Patricia M Herman2, Linda Larkey3, Usha Menon4, Laura Szalacha5. 1. Edson College of Nursing and Health Innovation, Arizona State University, 500 N 3rd Street, Phoenix, AZ, 85004, USA. Electronic address: Julie.Bucho-Gonzalez@asu.edu. 2. RAND Health Care, RAND Corporation, 776 Main Street, Santa Monica, CA, 90401-3208, USA. Electronic address: pherman@rand.org. 3. Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 500 N 3rd Street, Phoenix, AZ, 85004, USA. Electronic address: Linda.Larkey@asu.edu. 4. College of Nursing, University of South Florida, 12901 Bruce B. Downs Blvd, Tampa, FL, 33612, USA. Electronic address: umenon@usf.edu. 5. Morsani College of Medicine and College of Nursing, University of South Florida, 12901 Bruce B. Downs Blvd, Tampa, FL, 33612, USA. Electronic address: lszalacha@usf.edu.
Abstract
BACKGROUND: Colorectal cancer (CRC) is the third leading cause of cancer-related death in the United States. Despite improvements in screening, testing for CRC is underutilized in some populations, suggesting a need to identify efficient test promotion strategies. METHODS: Our intervention guided individuals from low-income, underserved communities into primary care clinics to receive CRC screening referrals. Community sites were randomized to education or education plus navigation. The Phase I community-to-clinic navigation outcome was clinic attendance; the Phase II clinic-to-screening navigation outcome was screening completion. We used micro-costing to determine costs necessary to replicate our project in a similar, non-research setting. RESULTS: Over the 4-year project, startup costs tended to decrease as implementation costs increased. The largest component of startup costs (32 % of total) was community site recruitment. Implementation costs per class attendee were higher in the navigation group ($1084) than control ($798). But costs per participant who made a clinic appointment ($3573 versus $6292) and per participant who completed screening ($4083 versus $7640) were lower in the navigation group. CONCLUSIONS: Our description of startup and implementation costs for this intervention provides decision makers with information needed to plan and budget for a similar project to guide individuals from community into clinics.
BACKGROUND: Colorectal cancer (CRC) is the third leading cause of cancer-related death in the United States. Despite improvements in screening, testing for CRC is underutilized in some populations, suggesting a need to identify efficient test promotion strategies. METHODS: Our intervention guided individuals from low-income, underserved communities into primary care clinics to receive CRC screening referrals. Community sites were randomized to education or education plus navigation. The Phase I community-to-clinic navigation outcome was clinic attendance; the Phase II clinic-to-screening navigation outcome was screening completion. We used micro-costing to determine costs necessary to replicate our project in a similar, non-research setting. RESULTS: Over the 4-year project, startup costs tended to decrease as implementation costs increased. The largest component of startup costs (32 % of total) was community site recruitment. Implementation costs per class attendee were higher in the navigation group ($1084) than control ($798). But costs per participant who made a clinic appointment ($3573 versus $6292) and per participant who completed screening ($4083 versus $7640) were lower in the navigation group. CONCLUSIONS: Our description of startup and implementation costs for this intervention provides decision makers with information needed to plan and budget for a similar project to guide individuals from community into clinics.
Authors: Usha Menon; Rhonda Belue; Stéphanie Wahab; Kathryn Rugen; Anita Y Kinney; Peter Maramaldi; Debra Wujcik; Laura A Szalacha Journal: Ann Behav Med Date: 2011-12
Authors: Iris Lansdorp-Vogelaar; Marjolein van Ballegooijen; Ann G Zauber; J Dik F Habbema; Ernst J Kuipers Journal: J Natl Cancer Inst Date: 2009-09-24 Impact factor: 13.506
Authors: Florence K L Tangka; Sujha Subramanian; Maggie C Beebe; Sonja Hoover; Janet Royalty; Laura C Seeff Journal: Cancer Date: 2013-08-01 Impact factor: 6.860