title: A randomized controlled trial using patient navigation to increase colonoscopy screening among low-income minorities.
abstract: Organizational barriers play a key role in colorectal cancer (CRC) screening disparities in low-income minorities. This is a prospective, randomized trial to determine whether a patient navigator (PN) can help overcome the organizational barriers low-income minorities face in trying to obtain screening colonoscopy. Patients of average risk for CRC were referred by their primary care physician for screening colonoscopy. After the PN received the referral, patients were randomly assigned to either receive navigation (PN+) to screening colonoscopy or not receive navigation (PN-). We hypothesized that a PN would increase patient compliance with screening colonoscopy. A total of 21 patients were enrolled in the pilot study (PN+ = 13, PN- = 8); 54% of navigated patients completed screening colonoscopy versus 13% of nonnavigated patients (p = 0.058). Eighty-six percent of navigated patients had an excellent or very good colon prep; however, there was no difference in prep quality between groups ( p = 0.10). One-hundred percent of navigated patients were very satisfied with navigation services. A PN improves compliance with screening colonoscopy in low-income minorities. Larger studies are needed to evaluate what features of navigation are most effective in facilitating completion of screening colonoscopy.
authors.affiliation: Department of Medicine, Mount Sinai School of Medicine, New York, NY, USA. jennifer.christie@emoryhealthcare.org
authors.forename: Jennifer
authors.initials: J
authors.lastname: Christie
authors.forename: Steven
authors.initials: S
authors.lastname: Itzkowitz
authors.forename: Irene
authors.initials: I
authors.lastname: Lihau-Nkanza
authors.forename: Anabella
authors.initials: A
authors.lastname: Castillo
authors.forename: William
authors.initials: W
authors.lastname: Redd
authors.forename: Lina
authors.initials: L
authors.lastname: Jandorf
mesh_terms: D001741:Black or African American; D001071:Appointments and Schedules; D001294:Attitude to Health; D003113:Colonoscopy / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000517:prevention & control; D005260:Female; D015438:Health Behavior; D006297:Health Services Accessibility; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D054525:Minority Health; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011203:Poverty; D011446:Prospective Studies; D017010:Reminder Systems; D012959:Socioeconomic Factors; D014481:United States