Decision Support and Navigation to Increase Colorectal Cancer Screening Among Hispanic Patients

Area of Science:

• Public Health
• Health Disparities
• Preventive Medicine

Background:

• Colorectal cancer (CRC) screening rates are suboptimal among Hispanic populations.
• Effective strategies are needed to address disparities in CRC screening.
• Primary care settings are crucial for implementing screening interventions.

Purpose of the Study:

• To evaluate the effectiveness of a Decision Support and Navigation Intervention (DSNI) compared to a Standard Intervention (SI) for improving CRC screening adherence in Hispanic primary care patients.
• To assess the impact of DSNI on screening test preference, decision stage, knowledge, and perceptions.

Main Methods:

• A randomized controlled trial involving 400 Hispanic primary care patients.
• Intervention group received DSNI including patient navigation and support for CRC screening kit completion (fecal immunochemical test and colonoscopy).
• Control group received standard care and CRC screening kit instructions. Outcomes assessed at 12 months via surveys and chart reviews.

Main Results:

• DSNI significantly increased overall CRC screening adherence (OR, 4.8).
• Higher rates of fecal immunochemical stool blood test (SBT) screening (OR, 4.2) and colonoscopy screening (OR, 8.8) were observed in the DSNI group.
• The DSNI group showed greater forward progression in screening decision stage (OR, 4.9), but no differences in knowledge or perceptions.

Conclusions:

• The DSNI demonstrated a significantly greater positive impact on CRC screening outcomes compared to the SI.
• Patient navigation and decision support are effective in enhancing CRC screening adherence.
• Health systems can implement DSNI to reduce CRC screening disparities in Hispanic populations.