Decision Support and Navigation to Increase Colorectal Cancer Screening among Hispanic Primary Care Patients.

Authors

Ronald E. Myers PhD
Brian Stello MD, Lehigh Valley Health NetworkFollow
Constantine Daskalakis
Randa Sifri MD
Melissa DiCarlo MPH, MS
Melanie B. Johnson MPA, Lehigh Valley Health NetworkFollow
Evelyn T. Gonzalez MA
Sarah Hegarty MPhil
Alicia Rivera, Lehigh Valley Health NetworkFollow
Lucas Gordils- Molina, Lehigh Valley Health NetworkFollow
Kyle Shaak BS, Lehigh Valley Health NetworkFollow
Anna Quinn MPH, RYT
Beth Careyva M.D., Lehigh Valley Health NetworkFollow
Rosa Anderson-deOrtiz

Publication/Presentation Date

3-2017

Abstract

The study compared the impact of a novel decision support and navigation intervention (DSNI) to a mailed standard intervention (SI) on colorectal cancer (CRC) screening among Hispanic patients from 5 primary care practices in the Lehigh Valley Health Network (LVHN). Methods. We randomized surveyed and consented patients who were 50 to 75 years of age and were eligible for CRC screening either to an SI Group (n = 200) or a DSNI Group (n = 200). Following randomization, SI Group participants were mailed a set of standard materials (i.e., a letter from the participant's primary care practice encouraging selection and performance of either colonoscopy screening or a stool blood test (SBT) screening, a SBT kit, and instructions for arranging a colonoscopy appointment. Print materials were provided in English and Spanish. DSNI Group participants were also mailed the standard materials. In addition, DSNI participants received a telephone call from a bilingual patient navigator who reviewed the screening materials and verified the participant's preferred CRC screening test. During the call, the patient navigator used an online Decision Counseling Program© (DCP) to determine the participant's likelihood of test performance and to develop a personalized test preference- and likelihood-based screening plan. The plan was mailed to the participant and his/her primary care practice; and a participant screening status report was sent to the practice at 6 months. Finally, a 6-month survey was targeted to participants in both study groups. Results. Based on 6-month survey and medical records data, we found that CRC screening adherence was significantly higher (OR = 3.48, CI: 2.29, 5.29, P < 0.001) in the DSNI Group (73%) versus the SI Group (44%). Conclusions. A decision support and navigation intervention significantly increased CRC screening adherence among Hispanic primary care patients.

Volume

26

Issue

3

First Page

433

Comments

AACR Publications.

Published In/Presented At

Myers, R. E., Stello, B. Daskalakis, C. Sifri, R. DiCarlo, M. Johnson, M. Gonzalez, E. Hegarty, S. Rivera, A. Gordis-Molina, L. Shaak, K. Quinn, A. Careyva, B. Anderson-Ortiz, R. (2017). Decision Support and Navigation to Increase Colorectal Cancer Screening among Hispanic Primary Care Patients. Cancer Epidemiology, Biomarkers & Prevention. 26(3),433. DOI: 10.1158/1055-9965.

Disciplines

Family Medicine | Medical Specialties | Medicine and Health Sciences

Department(s)

Department of Family Medicine, Department of Family Medicine Faculty

Document Type

Article