Implementing a successful patient navigation program for follow-up colonoscopy: Lessons from the PRECISE study.

Area of Science:

• Oncology
• Public Health
• Health Services Research

Background:

• Annual fecal immunochemical tests (FIT) are effective for colorectal cancer (CRC) screening.
• Nearly 50% of patients with abnormal FIT results do not complete recommended follow-up colonoscopies.
• Patient navigation (PN) can improve colonoscopy completion rates, but optimal implementation in community settings is not well understood.

Purpose of the Study:

• To present lessons learned from a patient navigation intervention aimed at improving follow-up colonoscopy completion after abnormal FIT results.
• To identify successes, challenges, and recommendations for implementing PN programs in community health centers.

Main Methods:

• The PRECISE study utilized a patient-randomized trial comparing PN to usual care for follow-up colonoscopy.
• Implementation support included navigator training, technical assistance, and quality assurance.
• Lessons learned were gathered through training reflections and navigator debrief interviews, analyzed across five categories.

Main Results:

• Patient navigators found training adequate but faced challenges with workload, documentation, and gastroenterology partnerships.
• Key lessons included streamlining navigation outreach, maintaining implementation support, ensuring adequate staffing, fostering GI partnerships, and using unified data tracking.

Conclusions:

• Findings provide guidance for implementing and sustaining PN programs for follow-up colonoscopy after abnormal FIT results in community settings.