Qualitative Outcomes of Colorectal Cancer Screening Outreach Using Patient Navigation to Follow-Up Colonoscopy in...

Area of Science:

• Public Health
• Health Services Research
• Rural Health

Background:

• Colorectal cancer (CRC) screening rates remain suboptimal in the U.S.
• Patient navigation can overcome barriers to CRC screening completion.
• Existing research on patient navigation primarily focuses on urban settings, potentially overlooking rural populations.

Purpose of the Study:

• To evaluate a patient navigation program for improving CRC screening in rural Medicaid populations.
• To explore barriers, facilitators, feasibility, and acceptability of patient navigation within rural primary care settings.

Main Methods:

• A pragmatic study incorporating qualitative and implementation data.
• Data sources included interviews, contract logs, and tracking systems.
• Focus on clinic staff-delivered patient navigation.

Main Results:

• Only 57% of intervention clinics had eligible patients.
• Among patients with abnormal FIT tests, 50% received navigation, and 23% completed colonoscopy.
• Barriers included staffing disruptions, limited colonoscopy availability, and patient mistrust; facilitators included protocol adaptations and collaboration.

Conclusions:

• Patient navigation in rural settings faces significant implementation challenges.
• System-level interventions and stronger partnerships between clinics, providers, and payers are recommended.
• Leveraging quality improvement best practices is crucial for future rural navigation models.