title: Clinic type and patient characteristics affecting time to resolution after an abnormal cancer-screening exam.
abstract: BACKGROUND
  Research shows that multilevel factors influence healthcare delivery and patient outcomes. The study goal was to examine how clinic type [academic medical center (AMC) or federally qualified health center (FQHC)] and patient characteristics influence time to resolution (TTR) among individuals with an abnormal cancer-screening test enrolled in a patient navigation (PN) intervention.
  
  
  METHODS
  Data were obtained from the Ohio Patient Navigation Research Project, a group-randomized trial of 862 patients from 18 clinics in Columbus, Ohio. TTR of patient after an abnormal breast, cervical, or colorectal screening test and the clinics' patient and provider characteristics were obtained. Descriptive statistics and Cox shared frailty proportional hazards regression models of TTR were used.
  
  
  RESULTS
  The mean patient age was 44.8 years and 71% of patients were white. In models adjusted for study arm, FQHC patients had a 39% lower rate of resolution than AMC patients (P = 0.004). Patient factors of having a college education, private insurance, higher income, and being older were significantly associated with lower TTR. After adjustment for factors that substantially affected the effect of clinic type (patient insurance status, education level, and age), clinic type was not significantly associated with TTR.
  
  
  CONCLUSIONS
  These results suggest that TTR among individuals participating in PN programs are influenced by multiple socioeconomic patient-level factors rather than clinic type. Consequently, PN interventions should be tailored to address socioeconomic status factors that influence TTR.
  
  
  CONCLUSIONS
  These results provide clues regarding where to target PN interventions and the importance of recognizing predictors of TTR according to clinic type.
authors.affiliation: Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Krok-Schoen
authors.affiliation: Allegheny County Health Department, Pittsburgh, Pennsylvania.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Kurta
authors.affiliation: Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio. Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio.
authors.forename: Rory C
authors.initials: RC
authors.lastname: Weier
authors.affiliation: Center for Biostatistics, The Ohio State University, Columbus, Ohio.
authors.forename: Greg S
authors.initials: GS
authors.lastname: Young
authors.affiliation: College of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio.
authors.forename: Autumn B
authors.initials: AB
authors.lastname: Carey
authors.affiliation: Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio.
authors.forename: Cathy M
authors.initials: CM
authors.lastname: Tatum
authors.affiliation: Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio. Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio. Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio. electra.paskett@osumc.edu.
authors.forename: Electra D
authors.initials: ED
authors.lastname: Paskett
mesh_terms: D016022:Case-Control Studies; D015331:Cohort Studies; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062526:Patient Navigation