Increasing colon cancer screening in primary care among African Americans

Ronald E. Myers, Randa Sifri, Constantine Daskalakis, Melissa DiCarlo, Praveen Ramakrishnan Geethakumari, James Cocroft, Christopher Minnick, Nancy Brisbon, Sally W. Vernon

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background The study aimed to determine the effect of preference-based tailored navigation on colorectal cancer (CRC) screening adherence and related outcomes among African Americans (AAs). Methods We conducted a randomized controlled trial that included 764 AA patients who were age 50 to 75 years, were eligible for CRC screening, and had received care through primary care practices in Philadelphia. Consented patients completed a baseline telephone survey and were randomized to either a Standard Intervention (SI) group (n = 380) or a Tailored Navigation Intervention (TNI) group (n = 384). The SI group received a mailed stool blood test kit plus colonoscopy instructions, and a reminder. The TNI group received tailored navigation (a mailed stool blood test kit or colonoscopy instructions based on preference, plus telephone navigation) and a reminder. A six-month survey and a 12-month medical records review were completed to assess screening adherence, change in overall screening preference, and perceptions about screening. Multivariable analyses were performed to assess intervention impact on outcomes. Results At six months, adherence in the TNI group was statistically significantly higher than in the SI group (OR = 2.1, 95% CI = 1.5 to 2.9). Positive change in overall screening preference was also statistically significantly greater in the TNI group compared with the SI group (OR = 1.5, 95% CI = 1.0 to 2.3). There were no statistically significant differences in perceptions about screening between the study groups. Conclusions Tailored navigation in primary care is a promising approach for increasing CRC screening among AAs. Research is needed to determine how to maximize intervention effects and to test intervention impact on race-related disparities in mortality and survival.

Original languageEnglish (US)
Article numberdju344
JournalJournal of the National Cancer Institute
Volume106
Issue number12
DOIs
StatePublished - Jan 1 2014

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Early Detection of Cancer
African Americans
Colonic Neoplasms
Primary Health Care
Colorectal Neoplasms
Hematologic Tests
Colonoscopy
Telephone
Medical Records
Randomized Controlled Trials
Survival
Mortality
Research
Surveys and Questionnaires

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Myers, R. E., Sifri, R., Daskalakis, C., DiCarlo, M., Geethakumari, P. R., Cocroft, J., ... Vernon, S. W. (2014). Increasing colon cancer screening in primary care among African Americans. Journal of the National Cancer Institute, 106(12), [dju344]. https://doi.org/10.1093/jnci/dju344

Increasing colon cancer screening in primary care among African Americans. / Myers, Ronald E.; Sifri, Randa; Daskalakis, Constantine; DiCarlo, Melissa; Geethakumari, Praveen Ramakrishnan; Cocroft, James; Minnick, Christopher; Brisbon, Nancy; Vernon, Sally W.

In: Journal of the National Cancer Institute, Vol. 106, No. 12, dju344, 01.01.2014.

Research output: Contribution to journalArticle

Myers, RE, Sifri, R, Daskalakis, C, DiCarlo, M, Geethakumari, PR, Cocroft, J, Minnick, C, Brisbon, N & Vernon, SW 2014, 'Increasing colon cancer screening in primary care among African Americans', Journal of the National Cancer Institute, vol. 106, no. 12, dju344. https://doi.org/10.1093/jnci/dju344
Myers, Ronald E. ; Sifri, Randa ; Daskalakis, Constantine ; DiCarlo, Melissa ; Geethakumari, Praveen Ramakrishnan ; Cocroft, James ; Minnick, Christopher ; Brisbon, Nancy ; Vernon, Sally W. / Increasing colon cancer screening in primary care among African Americans. In: Journal of the National Cancer Institute. 2014 ; Vol. 106, No. 12.
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abstract = "Background The study aimed to determine the effect of preference-based tailored navigation on colorectal cancer (CRC) screening adherence and related outcomes among African Americans (AAs). Methods We conducted a randomized controlled trial that included 764 AA patients who were age 50 to 75 years, were eligible for CRC screening, and had received care through primary care practices in Philadelphia. Consented patients completed a baseline telephone survey and were randomized to either a Standard Intervention (SI) group (n = 380) or a Tailored Navigation Intervention (TNI) group (n = 384). The SI group received a mailed stool blood test kit plus colonoscopy instructions, and a reminder. The TNI group received tailored navigation (a mailed stool blood test kit or colonoscopy instructions based on preference, plus telephone navigation) and a reminder. A six-month survey and a 12-month medical records review were completed to assess screening adherence, change in overall screening preference, and perceptions about screening. Multivariable analyses were performed to assess intervention impact on outcomes. Results At six months, adherence in the TNI group was statistically significantly higher than in the SI group (OR = 2.1, 95{\%} CI = 1.5 to 2.9). Positive change in overall screening preference was also statistically significantly greater in the TNI group compared with the SI group (OR = 1.5, 95{\%} CI = 1.0 to 2.3). There were no statistically significant differences in perceptions about screening between the study groups. Conclusions Tailored navigation in primary care is a promising approach for increasing CRC screening among AAs. Research is needed to determine how to maximize intervention effects and to test intervention impact on race-related disparities in mortality and survival.",
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N2 - Background The study aimed to determine the effect of preference-based tailored navigation on colorectal cancer (CRC) screening adherence and related outcomes among African Americans (AAs). Methods We conducted a randomized controlled trial that included 764 AA patients who were age 50 to 75 years, were eligible for CRC screening, and had received care through primary care practices in Philadelphia. Consented patients completed a baseline telephone survey and were randomized to either a Standard Intervention (SI) group (n = 380) or a Tailored Navigation Intervention (TNI) group (n = 384). The SI group received a mailed stool blood test kit plus colonoscopy instructions, and a reminder. The TNI group received tailored navigation (a mailed stool blood test kit or colonoscopy instructions based on preference, plus telephone navigation) and a reminder. A six-month survey and a 12-month medical records review were completed to assess screening adherence, change in overall screening preference, and perceptions about screening. Multivariable analyses were performed to assess intervention impact on outcomes. Results At six months, adherence in the TNI group was statistically significantly higher than in the SI group (OR = 2.1, 95% CI = 1.5 to 2.9). Positive change in overall screening preference was also statistically significantly greater in the TNI group compared with the SI group (OR = 1.5, 95% CI = 1.0 to 2.3). There were no statistically significant differences in perceptions about screening between the study groups. Conclusions Tailored navigation in primary care is a promising approach for increasing CRC screening among AAs. Research is needed to determine how to maximize intervention effects and to test intervention impact on race-related disparities in mortality and survival.

AB - Background The study aimed to determine the effect of preference-based tailored navigation on colorectal cancer (CRC) screening adherence and related outcomes among African Americans (AAs). Methods We conducted a randomized controlled trial that included 764 AA patients who were age 50 to 75 years, were eligible for CRC screening, and had received care through primary care practices in Philadelphia. Consented patients completed a baseline telephone survey and were randomized to either a Standard Intervention (SI) group (n = 380) or a Tailored Navigation Intervention (TNI) group (n = 384). The SI group received a mailed stool blood test kit plus colonoscopy instructions, and a reminder. The TNI group received tailored navigation (a mailed stool blood test kit or colonoscopy instructions based on preference, plus telephone navigation) and a reminder. A six-month survey and a 12-month medical records review were completed to assess screening adherence, change in overall screening preference, and perceptions about screening. Multivariable analyses were performed to assess intervention impact on outcomes. Results At six months, adherence in the TNI group was statistically significantly higher than in the SI group (OR = 2.1, 95% CI = 1.5 to 2.9). Positive change in overall screening preference was also statistically significantly greater in the TNI group compared with the SI group (OR = 1.5, 95% CI = 1.0 to 2.3). There were no statistically significant differences in perceptions about screening between the study groups. Conclusions Tailored navigation in primary care is a promising approach for increasing CRC screening among AAs. Research is needed to determine how to maximize intervention effects and to test intervention impact on race-related disparities in mortality and survival.

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