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Stakeholder Perspectives on Colonoscopy Navigation and Colorectal Cancer Screening Inequities.

Authors
  • Farr, Deeonna E1
  • Haynes, Venice E2
  • Armstead, Cheryl A3
  • Brandt, Heather M2
  • 1 Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, 2307 Carol G. Belk Building, Mail Stop 529, Greenville, NC, 27858, USA. [email protected]
  • 2 Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA.
  • 3 Department of Psychology, University of South Carolina Health Equity Laboratory, Barnwell College, Rm. 429, University of South Carolina, Columbia, SC, 29208, USA.
Type
Published Article
Journal
Journal of Cancer Education
Publisher
Springer-Verlag
Publication Date
Aug 01, 2021
Volume
36
Issue
4
Pages
670–676
Identifiers
DOI: 10.1007/s13187-019-01684-2
PMID: 31970699
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Black adults complete colonoscopies at lower rates than other groups despite increased colorectal cancer risk. Patient navigation represents a strategy to address the varied factors that influence colonoscopy completion, but few reports describe how navigation reduces racial disparities in colorectal cancer screening rates. The purpose of this study was to understand how a statewide colonoscopy navigation program addressed the challenges faced by low-income Black adults attempting to complete screening colonoscopy. A qualitative case study analysis was conducted at a participating clinical site of a statewide colonoscopy navigation program. Clinical observations, document reviews, and semi-structured interviews were conducted with patients, patient navigators, and clinical staff. Patient participants were recruited to ensure maximum variation related to gender and colonoscopy completion. Thematic coding allowed researchers to examine experiences, perceptions, and emotions related to patient navigation. In total, 31 interviews were completed between October 2014 and February 2015. Patients and patient navigators reported logistical, psychosocial, and knowledge-related barriers to colonoscopy completion. Clinical staff reports focused mostly on logistical barriers. Benefits of patient navigation also varied by participant type with clinical staff revealing positive effects on the clinic's relationships with referring specialty practices. Patient navigators address barriers that are important to patients, but often unseen by clinical staff/providers. New information about the benefits different stakeholders derive from this strategy was revealed. Together these findings provide insight into the processes associated with this strategy and novel information about the appeal of patient navigation to various stakeholders. © 2020. American Association for Cancer Education.

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