title: Culturally targeted patient navigation for increasing african americans' adherence to screening colonoscopy: a randomized clinical trial.
abstract: BACKGROUND
  Patient navigation has been an effective intervention to increase cancer screening rates. This study focuses on predicting outcomes of screening colonoscopy for colorectal cancer among African Americans using different patient navigation formats.
  
  
  METHODS
  In a randomized clinical trial, patients more than 50 years of age without significant comorbidities were randomized into three navigation groups: peer-patient navigation (n = 181), pro-patient navigation (n = 123), and standard (n = 46). Pro-patient navigations were health care professionals who conducted culturally targeted navigation, whereas peer-patient navigations were community members trained in patient navigation who also discussed their personal experiences with screening colonoscopy. Two assessments gathered sociodemographic, medical, and intrapersonal information.
  
  
  RESULTS
  Screening colonoscopy completion rate was 75.7% across all groups with no significant differences in completion between the three study arms. Annual income more than $10,000 was an independent predictor of screening colonoscopy adherence. Unexpectedly, low social influence also predicted screening colonoscopy completion.
  
  
  CONCLUSIONS
  In an urban African American population, patient navigation was effective in increasing screening colonoscopy rates to 15% above the national average, regardless of patient navigation type or content.
  
  
  CONCLUSIONS
  Because patient navigation successfully increases colonoscopy adherence, cultural targeting may not be necessary in some populations.
authors.affiliation: Department of Oncological Sciences, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1130, New York, NY 10029, USA. lina.jandorf@mssm.edu
authors.forename: Lina
authors.initials: L
authors.lastname: Jandorf
authors.forename: Caitlyn
authors.initials: C
authors.lastname: Braschi
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ernstoff
authors.forename: Carrie R
authors.initials: CR
authors.lastname: Wong
authors.forename: Linda
authors.initials: L
authors.lastname: Thelemaque
authors.forename: Gary
authors.initials: G
authors.lastname: Winkel
authors.forename: Hayley S
authors.initials: HS
authors.lastname: Thompson
authors.forename: William H
authors.initials: WH
authors.lastname: Redd
authors.forename: Steven H
authors.initials: SH
authors.lastname: Itzkowitz
mesh_terms: D001741:Black or African American; D000368:Aged; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000208:ethnology* / Q000517:prevention & control; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010349:Patient Compliance / Q000208:ethnology*; D062526:Patient Navigation / Q000379:methods*