Maria E Fernandez1, Lara S Savas1, John S Atkinson1, Katherine Ball Ricks2, Lynn N Ibekwe1, Inimfon Jackson3, Philip E Castle4,5, David Jobe6, Sally W Vernon1. 1. Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA. 2. Cecil G. Sheps Center for Health Service Research, University of North Carolina, Chapel Hill, NC, USA. 3. Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA. 4. Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA. 5. Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD, USA. 6. 2-1-1 Texas/United Way HELPLINE, United Way of Greater Houston, Houston, TX, USA.
Abstract
PURPOSE: To evaluate the effectiveness of a telephone navigation intervention for increasing use of cancer control services among underserved 2-1-1 callers. DESIGN: Randomized controlled trial. SETTING: 2-1-1 call centers in Houston and Weslaco, Texas (located in the Rio Grande Valley near the Mexican border). PARTICIPANTS: 2-1-1 callers in need of Pap test, mammography, colorectal cancer screening, smoking cessation counseling, and/or HPV vaccination for a daughter (n = 1,554). A majority were low-income and described themselves as Black or Hispanic. INTERVENTION: Participants were randomly assigned to receive either a cancer control referral for the needed service(s) with telephone navigation from a trained cancer control navigator (n = 995) or a referral only (n = 559). MEASURES: Uptake of each individual service and any needed service. ANALYSIS: Assessed uptake in both groups using bivariate chi-square analyses and multivariable logistic regression analyses, adjusted for sociodemographic covariates. Both per-protocol and intent-to-treat approaches were used. RESULTS: Both interventions increased cancer control behaviors. Referral with navigation intervention resulted in significantly greater completion of any needed service (OR = 1.38; p = .042), Pap test (OR = 1.56; p = .023), and smoking cessation counseling (OR = 2.66; p = .044), than referral-only condition. Other outcomes showed the same trend although the difference was not statistically significant: mammography (OR = 1.53; p = .106); colorectal cancer screening (OR = 1.80; p = .095); and HPV vaccination of a daughter (OR = 1.61; p = .331). CONCLUSION: Adding cancer control referrals and navigation to an informational service like the 2-1-1 program can increase overall participation in cancer control services.
PURPOSE: To evaluate the effectiveness of a telephone navigation intervention for increasing use of cancer control services among underserved 2-1-1 callers. DESIGN: Randomized controlled trial. SETTING: 2-1-1 call centers in Houston and Weslaco, Texas (located in the Rio Grande Valley near the Mexican border). PARTICIPANTS: 2-1-1 callers in need of Pap test, mammography, colorectal cancer screening, smoking cessation counseling, and/or HPV vaccination for a daughter (n = 1,554). A majority were low-income and described themselves as Black or Hispanic. INTERVENTION: Participants were randomly assigned to receive either a cancer control referral for the needed service(s) with telephone navigation from a trained cancer control navigator (n = 995) or a referral only (n = 559). MEASURES: Uptake of each individual service and any needed service. ANALYSIS: Assessed uptake in both groups using bivariate chi-square analyses and multivariable logistic regression analyses, adjusted for sociodemographic covariates. Both per-protocol and intent-to-treat approaches were used. RESULTS: Both interventions increased cancer control behaviors. Referral with navigation intervention resulted in significantly greater completion of any needed service (OR = 1.38; p = .042), Pap test (OR = 1.56; p = .023), and smoking cessation counseling (OR = 2.66; p = .044), than referral-only condition. Other outcomes showed the same trend although the difference was not statistically significant: mammography (OR = 1.53; p = .106); colorectal cancer screening (OR = 1.80; p = .095); and HPV vaccination of a daughter (OR = 1.61; p = .331). CONCLUSION: Adding cancer control referrals and navigation to an informational service like the 2-1-1 program can increase overall participation in cancer control services.
Entities:
Keywords:
HPV vaccination; cancer disparities; cancer prevention and screening; health promotion; low income; patient navigation; population health; racial minority groups; social support; tobacco control
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