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Increasing Colonoscopy Screening for Latino Americans Through a Patient Navigation Model: A Randomized Clinical Trial

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Abstract

Latinos have a higher rate of mortality and lower rate of colorectal cancer (CRC) screening than most racial groups in the United States. This study examines the predictors of screening colonoscopy (SC) for CRC among Latinos in a patient navigation (PN) intervention. Participants were randomized to either a culturally-targeted PN group (n = 225) or a standard PN group (n = 167). Each completed an interview assessing sociodemographic and intrapersonal information. There was no difference in SC completion between PN groups (80.9 and 79.0 %). Logistic regression revealed that low language acculturation (OR = 2.22) and annual income above $10,000 (OR = 1.97) were independent predictors of completion. Both standard and culturally-targeted PN successfully increased SC completion by nearly 30 % above the recent estimation for physician-referred patients. Our findings suggest a need to further reduce barriers to SC in low income and highly acculturated Latino groups.

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References

  1. American Cancer Society: Colorectal Cancer Facts & Figures 2011–2013. 2011.

  2. McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ Behav. 1988;15:351–77.

    Article  CAS  Google Scholar 

  3. Green AR, Peters-Lewis A, Percac-Lima S, Betancourt JR, Richter JM, Janairo MP, Gamba GB, Atlas SJ. Barriers to screening colonoscopy for low-income Latino and white patients in an urban community health center. J Gen Intern Med. 2008;23:834–40.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Jandorf L, Ellison J, Villagra C, Winkel G, Varela A, Quintero-Canetti Z, Castillo A, Thelemaque L, King S, Duhamel K. Understanding the barriers and facilitators of colorectal cancer screening among low income immigrant hispanics. J Immigr Minor Health. 2010;12:462–9.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Varela A, Jandorf L, Duhamel K. Understanding factors related to Colorectal Cancer (CRC) screening among urban Hispanics: use of focus group methodology. J Cancer Educ. 2010;25:70–5.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Shelton RC, Jandorf L, Ellison J, Villagra C, DuHamel KN. The influence of sociocultural factors on colonoscopy and FOBT screening adherence among low-income Hispanics. J Health Care Poor Underserved. 2011;22:925–44.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Abraido-Lanza AF, Chao MT, Florez KR. Do healthy behaviors decline with greater acculturation? Implications for the Latino mortality paradox. Soc Sci Med. 2005;61:1243–55.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Documet PI, Sharma RK. Latinos’ health care access: financial and cultural barriers. J Immigr Health. 2004;6:5–13.

    Article  PubMed  Google Scholar 

  9. Walsh JM, Salazar R, Nguyen TT, Kaplan C, Nguyen LK, Hwang J, McPhee SJ, Pasick RJ. Healthy colon, healthy life: a novel colorectal cancer screening intervention. Am J Prev Med. 2010;39:1–14.

    Article  PubMed  Google Scholar 

  10. Shah M, Zhu K, Wu H, Potter J. Hispanic acculturation and utilization of cervical cancer screening in the US. Prev Med. 2006;42:146.

    Article  PubMed  Google Scholar 

  11. Afable-Munsuz A, Liang S, Ponce NA, Walsh JM. Acculturation and colorectal cancer screening among older Latino adults: differential associations by national origin. J Gen Intern Med. 2009;24:963–70.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Arcia E, Skinner M, Bailey D, Correa V. Models of acculturation and health behaviors among Latino immigrants to the US. Soc Sci Med. 2001;53:41–53.

    Article  CAS  PubMed  Google Scholar 

  13. Jerant AF, Fenton JJ, Franks P. Determinants of racial/ethnic colorectal cancer screening disparities. Arch Intern Med. 2008;168:1317.

    Article  PubMed  Google Scholar 

  14. Natale-Pereira A, Marks J, Vega M, Mouzon D, Hudson SV, Salas-Lopez D. Barriers and facilitators for colorectal cancer screening practices in the Latino community: perspectives from community leaders. Cancer Control. 2008;15:157.

    PubMed  Google Scholar 

  15. Christie J, Hooper C, Redd WH, Winkel G, DuHamel K, Itzkowitz S, Jandorf L. Predictors of endoscopy in minority women. J Natl Med Assoc. 2005;97:1361–8.

    PubMed Central  PubMed  Google Scholar 

  16. Diaz JA, Roberts MB, Goldman RE, Weitzen S, Eaton CB. Effect of language on colorectal cancer screening among Latinos and non-Latinos. Cancer Epidemiol Biomark Prev. 2008;17:2169–73.

    Article  Google Scholar 

  17. Linsky A, McIntosh N, Cabral H, Kazis LE. Patient-provider language concordance and colorectal cancer screening. J Gen Intern Med. 2011;26:142–7.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Zambrana RE, Breen N, Fox SA, Gutierrez-Mohamed ML. Use of cancer screening practices by Hispanic women: analyses by subgroup. Prev Med. 1999;29:466–77.

    Article  CAS  PubMed  Google Scholar 

  19. Skaer TL, Robison LM, Sclar DA, Harding GH. Cancer-screening determinants among Hispanic women using migrant health clinics. J Health Care Poor Underserved. 1996;7:338–54.

    Article  CAS  PubMed  Google Scholar 

  20. Denberg TD, Melhado TV, Coombes JM, Beaty BL, Berman K, Byers TE, Marcus AC, Steiner JF, Ahnen DJ. Predictors of nonadherence to screening colonoscopy. J Gen Intern Med. 2005;20:989–95.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Jandorf L, Gutierrez Y, Lopez J, Christie J, Itzkowitz SH. Use of a patient navigator to increase colorectal cancer screening in an urban neighborhood health clinic. J Urban Health. 2005;82:216–24.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Chen LA, Santos S, Jandorf L, Christie J, Castillo A, Winkel G, Itzkowitz S. A program to enhance completion of screening colonoscopy among urban minorities. Clin Gastroenterol Hepatol. 2008;6:443–50.

    Article  PubMed  Google Scholar 

  23. Christie J, Itzkowitz S, Lihau-Nkanza I, Castillo A, Redd W, Jandorf L. A randomized controlled trial using patient navigation to increase colonoscopy screening among low-income minorities. J Natl Med Assoc. 2008;100:278–84.

    PubMed  Google Scholar 

  24. Gorin SS. Correlates of colorectal cancer screening compliance among urban Hispanics. J Behav Med. 2005;28:125–37.

    Article  PubMed  Google Scholar 

  25. Moher D, Schulz K, Altman D. The CONSORT statement: revised recommendations for improving the quality of reports of parallel group randomized trials. BMC Med Res Methodol. 2001;1:2.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Jandorf L, Braschi C, Erstoff E, Wong CR, Thelemaque LD, Winkel G, Thompson HS, Redd WH, Itzkowitz SH: Culturally targeted patient navigation for increasing African American’s adherence to screening colonoscopy: a randomized clinical trial. Cancer Epidemiol Biomarkers Prev (In Press).

  27. Marin G, Sabogal F, Marin BV, Otero-Sabogal R, Perez-Stable EJ. Development of a short acculturation scale for Hispanics. Hispanic J Behav Sci. 1987;9:183–205.

    Article  Google Scholar 

  28. Lara M, Gamboa C, Kahramanian MI, Morales LS, Bautista DE. Acculturation and Latino health in the United States: a review of the literature and its sociopolitical context. Annu Rev Public Health. 2005;26:367–97.

    Article  PubMed  Google Scholar 

  29. Prislin R, Suarez L, Simspon DM, Dyer JA. When acculturation hurts: the case of immunization. Soc Sci Med. 1998;47:1947–56.

    Article  CAS  PubMed  Google Scholar 

  30. Gorin SS, Heck JE. Cancer screening among Latino subgroups in the United States. Prev Med. 2005;40:515–26.

    Article  PubMed  Google Scholar 

  31. Johnson-Kozlow M. Colorectal cancer screening of Californian adults of Mexican origin as a function of acculturation. J Immigr Minor Health. 2010;12:454–61.

    Article  PubMed  Google Scholar 

  32. Echeverria SE, Carrasquillo O. The roles of citizenship status, acculturation, and health insurance in breast and cervical cancer screening among immigrant women. Med Care. 2006;44:788.

    Article  PubMed  Google Scholar 

  33. Klabunde CN, Brown M, Ballard-Barbash R, White M, Thompson T, Plescia M, Coleman King S. Cancer screening—United States, 2010. Morb Mortal Wkly Rep. 2012;61:41–5.

    Google Scholar 

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Acknowledgments

We thank our study participants, without whom this research could not have been conducted, as well as our staff of recruiters and navigators.

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Authors and Affiliations

  1. Department of Oncological Sciences, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1130, New York, NY, 10029, USA

    Caitlyn D. Braschi, Jamilia R. Sly, Smriti Singh, Cristina Villagra & Lina Jandorf

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  1. Caitlyn D. Braschi
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  2. Jamilia R. Sly
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  3. Smriti Singh
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  4. Cristina Villagra
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  5. Lina Jandorf
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Correspondence to Lina Jandorf.

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Braschi, C.D., Sly, J.R., Singh, S. et al. Increasing Colonoscopy Screening for Latino Americans Through a Patient Navigation Model: A Randomized Clinical Trial. J Immigrant Minority Health 16, 934–940 (2014). https://doi.org/10.1007/s10903-013-9848-y

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  • DOI: https://doi.org/10.1007/s10903-013-9848-y

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