Use of a patient navigator to increase colorectal cancer screening in an urban neighborhood health clinic

Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY 10029, USA.
Journal of Urban Health (Impact Factor: 1.94). 07/2005; 82(2):216-24. DOI: 10.1093/jurban/jti046
Source: PubMed

ABSTRACT Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. Racial disparities in CRC incidence and mortality have been well documented. In addition, lower rates of CRC screening among ethnic minorities have been reported. Therefore, we tested the effectiveness of a patient navigator (PN) in increasing compliance with CRC screening in a minority community health setting. Men and women aged 50 or older attending a primary care practice were enrolled if they had not had a fecal occult blood test within the past year, a sigmoidoscopy or barium enema within the past 3-5 years, or a colonoscopy within the past 10 years. Participants were randomly assigned either to receive navigator services (PN+) or not to receive navigator services (PN-). There were no demographic differences between the two groups. Within 6 months of physician recommendation, 15.8% in the PN+group had complied with an endoscopic examination, compared with only 5% in the PN - group (P=.019). The PN+group also demonstrated higher rates of fecal occult blood test completion (42.1% vs. 25%, P=.086). Thus, a PN system successfully increases CRC screening rates among a predominantly minority population of low socioeconomic status.

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Available from: Lina Jandorf, Feb 18, 2014
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    • "Training outcomes— n/a. Intervention outcomes—n/a J Canc Educ (2015) 30:173–186 179 Author's personal copy Table 2 Clinic-based navigator programs (n=12) Author (year), title, journal Purpose of the study Setting Target group Identification/ Recruitment Study Design Theory/ Construct CHN training CHN intervention Results/Outcome Jandorf et al. (2005) "
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    • "In 9 of the studies, the intervention was compared with usual care [42] [45] [46] [50] [52] [55] [56] [58]. In 6 of them (67%), the intervention increased participation rates compared with usual care [42] [46] [50] [52] [55] [56]. Overall, in 12 of the RCT (80%), the intervention increased participation rates [26, 42, 46, 50–57, 115]. "
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    • "It has been shown to be beneficial in increasing patients' cancer knowledge (Schlueter et al. 2010), decreasing emotional distress (Davis et al. 2009; Ferrante et al. 2008; Schlueter et al. 2010), and increasing emotional support (Carroll et al. 2010; Schlueter et al. 2010). The program also is noted to have increased patients' completion of cancer screenings (Chen et al. 2008; Jandorf et al. 2005), timeliness to diagnosis after abnormal cancer screenings (Ferrante et al. 2008), and increased adherence to follow-up treatments (Ell et al. 2007) by providing transportation services, education, assistance with appointments , and coordination of services. The effects of PNP are greater when navigators are community members (Steinberg et al. 2006). "
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