Decision support and navigation to increase colorectal cancer screening among Hispanic patients

Ronald E. Myers, Brian Stello, Constantine Daskalakis, Randa Sifri, Evelyn T. Gonzalez, Melissa DiCarlo, Melanie B. Johnson, Sarah E. Hegarty, Kyle Shaak, Alicia Rivera, Lucas Gordils-Molina, Anett Petrich, Beth Careyva, Rosa De-Ortiz, Liselly Diaz

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Background: Effective strategies are needed to raise colorectal cancer screening rates among Hispanics. Methods: We surveyed and randomized 400 Hispanic primary care patients either to a Decision Support and Navigation Intervention (DSNI) Group (n ¼ 197) or a Standard Intervention (SI) Group (n ¼ 203). Both groups received a colorectal cancer screening kit [bilingual informational booklet, fecal immunochemical stool blood test (SBT), and colonoscopy screening instructions]. The DSNI Group received a telephone contact from a patient navigator. The navigator clarified screening test preference and likelihood of test performance, helped to develop a screening plan, and provided guidance through test performance. An endpoint telephone survey and medical chart review were completed. Multivariable analyses were conducted to assess 12-month screening adherence, change in decision stage, and knowledge and perceptions. Results: Screening adherence was significantly higher in the DSNI Group than the SI Group [OR, 4.8; 95% confidence interval (CI), 3.1-7.6]. The DSNI Group, compared with the SI Group, also displayed higher SBT screening [OR, 4.2; 95% CI, 2.6-6.7), higher colonoscopy screening (OR, 8.8; 95% CI, 4.1-18.7), and greater forward change in screening decision stage (OR, 4.9; 95% CI, 2.6-9.5). At endpoint, study groups did not differ in screening knowledge or perceptions. Conclusions: The DSNI had a greater positive impact on colorectal cancer screening outcomes than the SI. Impact: Health system implementation of DSNI strategies may help to reduce Hispanic colorectal cancer screening disparities in primary care.

Original languageEnglish
Pages (from-to)384-391
Number of pages8
JournalCancer Epidemiology Biomarkers and Prevention
Issue number2
StatePublished - Feb 2019


  • Colorectal Neoplasms/diagnosis
  • Decision Making
  • Early Detection of Cancer
  • Female
  • Hispanic or Latino
  • Humans
  • Male
  • Middle Aged
  • United States


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