Background
Patient navigation (PN) has been an effective intervention to increase cancer screening rates. This study focuses on predicting outcomes of screening colonoscopy (SC) for colorectal cancer among African Americans using different PN formats.
Methods
In a randomized clinical trial, patients over 50 years of age without significant comorbidities were randomized into three navigation groups: Peer-PN (n = 181), Pro-PN (n = 123) and Standard (n = 46). Pro-PNs were health professionals who performed culturally targeted navigation whereas Peer-PNs were community members trained in PN who also discussed their personal experiences with SC. Two assessments gathered sociodemographic, medical, and intrapersonal information.
Results
SC completion rate was 75.7% across all groups with no significant differences in completion between the three study arms. Annual income over $10,000 was an independent predictor of SC adherence. Unexpectedly, low social influence also predicted SC completion.
Conclusions
In an urban African American population, PN was effective in increasing SC rates to 15% above the national average, regardless of PN type or content.
Impact
Because PN successfully increases colonoscopy adherence, cultural targeting may not be necessary in some populations.
Latinos have a higher rate of mortality and lower rate of colorectal cancer (CRC) screening than most racial groups in the United States. This study examines the predictors of screening colonoscopy (SC) for CRC among Latinos in a patient navigation (PN) intervention. Participants were randomized to either a culturally-targeted PN group (n = 225) or a standard PN group (n = 167). Each completed an interview assessing sociodemographic and intrapersonal information. There was no difference in SC completion between PN groups (80.9 and 79.0 %). Logistic regression revealed that low language acculturation (OR = 2.22) and annual income above $10,000 (OR = 1.97) were independent predictors of completion. Both standard and culturally-targeted PN successfully increased SC completion by nearly 30 % above the recent estimation for physician-referred patients. Our findings suggest a need to further reduce barriers to SC in low income and highly acculturated Latino groups.
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