Tailored navigation in colorectal cancer screening.
Med Care
; 46(9 Suppl 1): S123-31, 2008 Sep.
Article
en En
| MEDLINE
| ID: mdl-18725824
ABSTRACT
BACKGROUND:
Colorectal cancer (CRC) screening is underutilized. Effective methods to increase screening use are needed. This study sought to determine the impact of tailored navigation on CRC screening in primary care.METHODS:
The study included 154 primary care practice patients who were 50 or more years of age, were eligible for CRC screening, and had an office visit within 2 years before study initiation. Baseline telephone survey data were collected on participant sociodemographic characteristics, psychosocial factors, and screening test [fecal occult blood test (FOBT) or colonoscopy] decision stage. By comparing decision stage data, we identified that test with the highest decision stage (ie, preferred screening test). Participants who preferred FOBT were sent an FOBT kit and a reminder. Those preferring colonoscopy were sent colonoscopy instructions. After this mailing, a study patient navigator made a telephone call to guide participants towards screening. Six-month end point survey and medical records data were obtained. Univariable and multivariable analyses were performed to identify predictors of screening and of change in preferred screening test decision stage.RESULTS:
At end point, 63 (41%) study participants had screened. From baseline to end point, overall screening preference increased for 75 (63%) participants. Age and perceived salience and coherence (ie, screening is important and sensible) were positive, significant predictors of screening use (P = 0.02 and P = 0.05, respectively); while only age predicted change in overall screening preference (P = 0.03).CONCLUSIONS:
Study participant screening use and preference increased. Age and attitudes predicted outcomes. Randomized trials are needed to determine intervention impact at the population level.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Participación del Paciente
/
Atención Primaria de Salud
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Pautas de la Práctica en Medicina
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Neoplasias Colorrectales
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Conocimientos, Actitudes y Práctica en Salud
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
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Prognostic_studies
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Qualitative_research
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Screening_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Med Care
Año:
2008
Tipo del documento:
Article
País de afiliación:
Estados Unidos