Online Program

321656
An Effective Patient Navigation Intervention: Results from a Study of the New Hampshire Colorectal Cancer Screening Program (NHCRCSP)


Monday, November 2, 2015 : 9:10 a.m. - 9:30 a.m.

Ketra Rice, PhD, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
Lynn Butterly, MD, New Hampshire Colorectal Cancer Screening Program, Lebanon, NH
LIndsay Gressard, MPH, MEd, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
Amy DeGroff, PhD, MPH, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
Joanne Gersten, RN, New Hampshire Colorectal Cancer Control Program, Lebanon, NH
Janene Robie, MBA, New Hampshire Colorectal Cancer Control Program, Lebanon, NH
Rebecca Glover-Kudon, PhD, MSPH, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
Steven Leadbetter, MS, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
Introduction: Patient navigation (PN) can reduce cancer disparities by addressing barriers to cancer screening. In colorectal cancer, evidence is accumulating supporting the effectiveness of PN in improving colonoscopy adherence. This study examined the effectiveness of a structured PN intervention model involving six call types delivered telephonically by two nurse navigators in New Hampshire.

Methods: We conducted a retrospective, quasi-experimental comparison group study at one endoscopy center in New Hampshire comparing navigated patients (NHCRCSP patients) to those receiving usual care. All study patients were low income (<250% FPL), aged 50-64, and scheduled for colonoscopy at the study site between July 1, 2012 and September 30, 2013. Program data collected on all navigated patients were used with comparison data collected through medical chart abstraction. Outcomes assessed included screening adherence and screening no-shows and cancellations.

Results: We included a total of 208 patients in the analysis, 133 navigated patients and 75 receiving usual care. Mean patient age was 55, while 29.8% represented racial/ethnic minorities and 33.2% were non-English speakers. Preliminary data suggest colonoscopy adherence rates were significantly greater among navigated patients than those receiving usual care (96.0% vs 72.0%, P<.001). Navigated patients had significantly fewer no-shows (0.0% vs 9.3%, P<.001) and cancellations < 24 hours before scheduled appointment (0.8% vs 17.3%, P<.115).

Conclusions: This PN program is highly effective in increasing colonoscopy adherence and reducing appointment no-shows and cancellations. Findings further advance the evidence base for PN as an important public health practice.      

Learning Areas:

Assessment of individual and community needs for health education
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
Discuss the effectiveness of patient navigation in increasing colonoscopy adherence and reducing no-shows and cancellations. Demonstrate the efffectiveness of patient navigation by reporting findings from a quasi-experimental comparison group study.

Keyword(s): Cancer Prevention and Screening, Adherence

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract author on the content I am responsible for because I led the quantitative analyis for the project. My educational background and experience in public policy and public health qualifies me as a presenter for this activity.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.