Patient Navigation as a tool to improving colonoscopy screening rates for immigrants

Documented barriers to colorectal cancer screening are not only nativity but also language, poverty, culture, lack of insurance and low educational attainment, all of which are especially associated with immigrant health. Language, such as being a primarily Spanish speaker, has been specifically associated with a decrease in colorectal cancer screening rates. In New York City, the Colonoscopy Patient Navigator program introduced community health workers in an innovative program to guide patients through the colonoscopy process in three public hospitals. No show rates for colonoscopy after provider referral had been very high and navigators were potentially an important initiative to address this problem. The NYC Department of Health and Mental Hygiene conducted an exploratory study of the program and found that navigators played a key role in guiding Spanish speaking patients through the colonoscopy process. This qualitative study interviewed patients, providers, hospital staff and navigators. Findings showed that virtually all patients felt positive about their patient navigator experience and would return for a colonoscopy in ten years. Our results suggest that navigators may have been an especially critical component in colonoscopy completion by Latino and low education patients. Providers and staff also highlighted the importance of bilingual navigators in serving patients receiving a colonoscopy. Patient navigation may especially help immigrants access the increasingly complex hospital system through addressing language and cultural issues.