This study aims to test the effectiveness of a remotely-delivered patient navigation program for increasing colonoscopy completion for colorectal cancer screening, among rural populations. The study will partner with geographically disparate primary care organizations to recruit patients aged 45-75 to the study. The patient navigation program will be delivered through a community organization. This project is critical in advancing our knowledge of the effectiveness of patient navigation for increasing colonoscopy in this patient population as well as for understanding factors that can support long term implementation and sustainability of effective interventions.
Colorectal cancer (CRC) is a leading cause of cancer death in the United States and its burden is greater in rural and low-income communities. Failure to complete recommended colonoscopy contributes to later-stage CRC diagnosis and worse CRC outcomes, which means timely and successful colonoscopy is a key opportunity to reduce CRC mortality. Using a Type 1 Hybrid Implementation-Effectiveness design, we will randomize 480-600 subjects from 6-8 primary care clinical organizations in a randomized controlled trial (RCT) to accomplish the following: * Test the effectiveness of a patient navigation program, remotely-delivered by a community-based organization, for increasing colonoscopy completion rates for colorectal cancer screening among rural patients. * Assess implementation and sustainability of the patient navigation program from the perspectives of both community and clinical stakeholders.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE
Enrollment
527
Patients will receive navigation from a trained lay navigator at a community-based nonprofit organization that supports access to high quality healthcare. The patient navigator will work with patients to schedule their colonoscopy and identify, explore, and overcome barriers. They will educate patients about the colonoscopy procedure and preparation, provide resources, and coach and motivate patients.
Educational brochure about colonoscopy
University of Washington
Seattle, Washington, United States
Number of participants who complete colonoscopy within 1 year of the colonoscopy referral
Time frame: 1 year
Number of participants who complete colonoscopy within 6 months of the colonoscopy referral
Time frame: 6 months
Time to completion of colonoscopy or end of follow-up after the colonoscopy referral
Time frame: 1 year
Number of participants who complete colonoscopy within 9 months of the colonoscopy referral
Time frame: 9 months
Number of participants who have completed colonoscopies with adequate preparation
Time frame: 1 year
Number of participants who have colonoscopies with cecal intubation
Time frame: 1 year
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