Patient Navigation After Positive Fecal Immunochemical Test Results Increases Diagnostic Colonoscopy and Highlights Multilevel Barriers to Follow-Up

Perceptions on Barriers and Facilitators to Colonoscopy Completion After Abnormal Fecal Immunochemical Test Results in a Safety Net System

“… 24 Through EHR analysis, we previously reported that lack of clinician referral, complex medical and social issues, and missed colonoscopy appointments after scheduling were associated with a lack of colonoscopy completion after abnormal FIT results in a safety net health system. 10 While 2 studies from 2021 13 , 14 signaled that patient navigation may be associated with improved colonoscopy completion, qualitative studies of clinician-identified barriers that may inform interventions to further improve follow-up colonoscopy completion are limited. 25 , 26 , 27 Through semistructured clinician interviews, our study extends the existing literature by identifying potential areas of intervention within safety net health systems at the patient level (eg, patient transportation), clinician level (eg, patient education), and health system level (eg, primary and specialty care coordination).…”

“…Colonoscopy completion is a complex process that requires effective communication and coordination among patients, primary and specialty care clinicians, and the health care system. 12 In 2 studies from 2021, 31% 13 and 46% 14 of patients completed a colonoscopy within 6 months of their abnormal FIT results after receiving patient navigation. While these results are promising, they suggest the need for additional interventions to achieve the US Multi-Society Task Force (USMSTF) follow-up colonoscopy goal of 80%.…”

Colorectal Cancer Screening and Yield in a Mailed Outreach Program in a Safety-Net Healthcare System

“…These strategies may include prioritizing scheduling of diagnostic vs. screening colonoscopy; implementing standard tracking and reporting procedures; administrative algorithms that identify the appropriate follow-up needs of individual patients based on test results; and automated phone calls linked to test results, progressing to personal phone calls, as needed [38,39]. More intensive navigation may also be needed to reduce disparities in follow-up among underserved patients [40].…”

Centralized colorectal cancer screening outreach and patient navigation for vulnerable populations in North Carolina: study protocol for the SCORE randomized controlled trial

“…Although activities vary across settings, patient navigation is a barriers-focused intervention that typically includes identifying and addressing patient, provider, and system-level barriers to appropriate healthcare, as well as providing health education and psychosocial support [25,26]. Mounting evidence supports the efficacy of patient navigation for improving screening colonoscopy completion [10,[27][28][29], and although it is a promising approach for bolstering follow-up colonoscopy completion after a positive fecal blood test [30,31], additional research is needed in this area, particularly around implementation and costeffectiveness [10].…”