Online Program

333289
Decision support and navigation to determine the likelihood of colorectal cancer screening among Hispanics


Tuesday, November 3, 2015

Melissa DiCarlo, MPH, MS, Department of Medical Oncology, Division of Population Science, Thomas Jefferson University, Philadelphia, PA
Amy Leader, DrPH, MPH, Department of Medical Oncology, Division of Population Science, Thomas Jefferson University, Philadelphia, PA
Anett Petrich, RN, MSN, Department of Medical Oncology, Division of Population Science, Thomas Jefferson University, Philadelphia, PA
Alicia Rivera, Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA
Lucas Gordils-Molina, Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA
Kyle Shaak, RHIA, Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA
Melanie Johnson, MPA, Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA
Rosa Anderson-deOrtiz, Office of Health Communications and Health Disparities, Fox Chase Cancer Center, Philadelphia, PA
Beth Careyva, MD, Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA
Evelyn T. Gonzalez, MA, Office of Health Communications and Health Disparities, Fox Chase Cancer Center, Philadelphia, PA
Randa Sifri, MD, Department of Family & Community Medicine, Thomas Jefferson University, Philadelphia, PA
Brian Stello, MD, Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA
Ronald E. Myers, PhD, Department of Medical Oncology, Division of Population Science, Thomas Jefferson University, Philadelphia, PA
Hispanics have significantly lower colorectal cancer (CRC) screening rates and are more likely to be diagnosed with late-stage CRC than other racial or ethnic groups. Novel interventions are needed to promote screening adherence among Hispanic patients.

Hispanic primary care patients were randomized (n=103) to receive, a mailed standard intervention (SI) or a mailing plus telephone decision support and navigation intervention (DSNI). At enrollment, CRC screening test (stool blood test (SBT) or colonoscopy) preference was assessed for all participants. During the DSNI call, a bilingual patient assistant reviewed an educational pamphlet, used an online decision support tool to identify factors affecting the likelihood of screening and determined the patient’s likelihood of adherence. Likelihood of adherence was measured from 0.0 (overwhelmingly unlikely) to 1.0 (overwhelmingly likely).

Thus far, 22 DSNI participants have completed the intervention. Participants were mainly female (64%), under the age of 60 (64%), and Spanish speakers (86%). At baseline, most participants had an equal preference for SBT and colonoscopy (73%). After educational pamphlet review, 45% preferred SBT, while 55% preferred colonoscopy.  Participants had an average screening likelihood score of 0.77.  Among those who preferred SBT screening, the desire for knowledge about personal health, followed by favorable test characteristics influenced the likelihood of performance. For those who preferred colonoscopy, desire for knowledge, followed by worries and concerns about cancer affected likelihood of performance.

Patient education and decision support helped participants clarify their preferred screening test. Reported likelihood of screening performance was influenced by desire for health knowledge and other factors.

Learning Areas:

Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
Discuss relative importance of change in CRC screening test preference following educational review with a trained patient assistant. Identify types factors impacting CRC screening likelihood among Hispanics. Explore approaches that may be used to address barriers to screening that can be ameliorated.

Keyword(s): Cancer Prevention and Screening, Latinos

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the project manager on federally funded grants focusing on CRC Screening. On this particular project I am acting Project Manager at the Thomas Jefferson site, and have been involved in development, training, implementation, and preliminary analysis thus far.
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.