Grant Details
Grant Number: |
5R01CA254515-04 Interpret this number |
Primary Investigator: |
Cole, Allison |
Organization: |
University Of Washington |
Project Title: |
Rural Community Support for Colonoscopy |
Fiscal Year: |
2024 |
Abstract
PROJECT SUMMARY/ABSTRACT
Colorectal cancer (CRC) is the third leading cause of cancer death in the United States.
Appropriate screening can reduce CRC mortality. Colonoscopy, a procedure to detect CRC
early, is recommended for patients with a positive fecal immunochemical test (FIT) result to
detect CRC and can even prevent CRC through the removal of pre-cancerous polyps. Rural
and low-income populations face significant barriers to colonoscopy completion after positive
FIT, including difficult access to the procedure (lack of local providers/long travel times),
socioeconomic barriers to completing the procedure (difficulty getting time off work, arranging
childcare and transportation, high out of pocket procedure costs), lack of knowledge about the
procedure and its role in CRC screening and early detection, and fear of the procedure and of
CRC. Patient navigation is an evidence-based approach to increasing colonoscopy completion.
Patient navigation provides one-on-one support to patients preparing for and completing
colonoscopy and addresses barriers through education, motivational interviewing, care
coordination and connection to community resources. The effectiveness of patient navigation
for increasing colonoscopy completion among low-income rural populations with positive FIT
has not been demonstrated. The overall objective of this study is to test the effectiveness of a
patient navigation program for increasing colonoscopy completion among rural, low-income
populations who have had a positive FIT result. The project will be implemented in partnership
with the Rural Health Council and the Washington Association for Community Health, and will
engage four rural Federally Qualified Health Centers (FQHCs). The intervention will be
evaluated in a type 1 hybrid implementation-effectiveness study that includes a 600-patient
randomized controlled trial and comprehensive quantitative and qualitative data collection to
better understand implementation and sustainability of the program. 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.
Publications
Colonoscopy Outreach for Rural Communities (CORC): A study protocol of a pragmatic randomized controlled trial of a patient navigation program to improve colonoscopy completion for colorectal cancer screening.
Authors: Keppel G.A.
, Ike B.
, Leroux B.G.
, Ko L.K.
, Osterhage K.P.
, Jacobs J.D.
, Cole A.M.
.
Source: Contemporary Clinical Trials, 2024 Jun; 141, p. 107539.
EPub date: 2024-04-12 00:00:00.0.
PMID: 38615750
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