Rural barriers to colonoscopy screening identified through patient navigation

Area of Science:

• Public Health
• Health Services Research
• Cancer Prevention

Background:

• Rural populations face disparities in colorectal cancer (CRC) screening and outcomes.
• Limited data exists on barriers to colonoscopy completion after referral in rural settings.
• Patient navigation (PN) is an effective strategy for addressing cancer screening barriers.

Purpose of the Study:

• To examine barriers to colonoscopy screening encountered by rural patients in real-time.
• To analyze barriers identified by a patient navigator in the Colonoscopy Outreach for Rural Communities (CORC) study.

Main Methods:

• Descriptive analysis of barrier frequencies reported by the CORC patient navigator.
• Qualitative descriptive analysis of patient navigator field notes.
• Framework Method applied to data from 157 rural CORC PN patients.

Main Results:

• Patient navigators identified barriers in 64.3% of patients.
• Scheduling (31.2%) and knowledge (28.0%) were the most frequent barrier types.
• Higher prevalence of barriers (scheduling, time, cost, psychosocial, language) among those not completing colonoscopy.

Conclusions:

• Utilizing patient navigation documentation offers an innovative approach to understanding real-time, experienced barriers.
• Findings provide detailed insights into dynamic barriers faced by rural patients during screening colonoscopy.
• This approach captures barriers within the context of health system interactions and personal circumstances.