Details:

Alternative Title:
Prev Chronic Dis
Personal Author:
Leone, Lucia A. ; Reuland, Daniel S. ; Lewis, Carmen L. ; Ingle, Mary ; Erman, Brian ; ... More +
Leone, Lucia A. ; Reuland, Daniel S. ; Lewis, Carmen L. ; Ingle, Mary ; Erman, Brian ; Summers, Tyana J. ; DuBard, C. Annette ; Pignone, Michael P. Less -
Description:
Introduction

Screening for colorectal cancer can reduce incidence and death, but screening is underused, especially among vulnerable groups such as Medicaid patients. Effective interventions are needed to increase screening frequency. Our study consisted of a controlled trial of an intervention designed to improve colorectal cancer screening among Medicaid patients in North Carolina.

Methods

The intervention included a mailed screening reminder letter and decision aid followed by telephone support from an offsite, Medicaid-based, patient navigator. The study included 12 clinical practices, 6 as intervention practices and 6 as matched controls. Eligible patients were aged 50 years or older, covered by Medicaid, and identified from Medicaid claims data as not current with colorectal cancer screening recommendations. We reviewed Medicaid claims data at 6 months and conducted multivariate logistic regression to compare participant screening in intervention practices with participants in control practices. We controlled for sociodemographic characteristics.

Results

Most of the sample was black (53.1%) and female (57.2%); the average age was 56.5 years. On the basis of Medicaid claims, 9.2% of intervention participants (n = 22/240) had had a colorectal cancer screening at the 6-month review, compared with 7.5% of control patients (n = 13/174). The adjusted odds ratio when controlling for age, comorbidities, race, sex, and continuous Medicaid eligibility was 1.44 (95% confidence interval, 0.68–3.06). The patient navigator reached 44 participants (27.6%).

Conclusion

The intervention had limited reach and little effect after 6 months on the number of participants screened. Higher-intensity interventions, such as use of practice-based navigators, may be needed to reach and improve screening rates in vulnerable populations.


Subjects:
[+]
Aged Colorectal Neoplasms Female Health Knowledge, Attitudes, Practice Humans Logistic Models Male Mass Screening Medicaid Middle Aged Patient Navigation Program Evaluation Questionnaires Telephone
Source:
Prev Chronic Dis. 10.
Document Type:
Journal Article
Place as Subject:
North Carolina
Location:
North America
Collection(s):
Preventing Chronic Disease
Main Document Checksum:
[+]
urn:sha256:5325835296aaf631cad8f25699a5def9095624a308e42ed61b08d474f09c76b2
Download URL:
https://stacks.cdc.gov/view/cdc/19686/cdc_19686_DS1.pdf
File Type:

Supporting Files

• 	license.txt	txt
  	PCD-10-E82.nxml	txt
  	PCD-10-E82s01.gif	gif
  	PCD-10-E82s01.jpg	jpeg

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