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Knowledge of Polyp History and Recommended Follow-Up Among a Predominately African American Patient Population and the Impact of Patient Navigation

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Abstract

Background and Aims

Colorectal screening (CRS) rates in minority and uninsured populations have increased through patient navigation (PN) interventions. However, patient knowledge of colonoscopy results and follow-up recommendations has not been described in an African American (AA) population or following PN. Our objectives were to determine patient knowledge of colonoscopy results and follow-up recommendations within an AA patient population and to compare post-colonoscopy knowledge among patients who received either PN or usual care.

Methods

This is a prospective observational study of patients who completed a screening colonoscopy in 2014. A semi-structured telephone survey was completed by 96 participants (69 % AA, 78 % female, and mean age 63 years). The survey assessed patient recall of polyp results and follow-up recommendations. Responses were compared with the medical record.

Results

Of 96 patients surveyed (response rate, 68 %), 83 % accurately reported if polyps were detected and 66 % accurately reported their recommended follow-up. The identification of adenomatous polyps on colonoscopy was a predictor of accurate recall of colonoscopy results and follow-up recommendations. Uninsured patients who completed PN (18 of 96) were more likely to accurately report polyp results (100 vs. 80 %; P = 0.036), but the rates of accurate follow-up recall were not statistically significant (44 vs. 71 %; P = 0.053) when compared to usual care patients.

Conclusions

In an AA population, post-colonoscopy polyp recall rates were similar to those described in white populations. Uninsured patients who completed PN were more likely than insured usual care patients to accurately report the presence of polyps on colonoscopy.

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Abbreviations

ADR:

adenoma detection rate

AA:

African American

CRC:

colorectal cancer

CRS:

colorectal screening

CRCSI:

colorectal cancer screening initiative

PN:

patient navigation

PCP:

Primary care physician

UC:

University of Chicago

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Compliance with Ethical Standards

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Conflicts of interest

Cassandra Fritz, Keith Naylor, and Karen Kim declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Author information

Author notes

    Authors and Affiliations

    1. Pritzker School of Medicine, University of Chicago, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA

      Cassandra Fritz

    2. Section of Gastroenterology Hepatology and Nutrition, Department of Medicine, The University of Chicago, 5841 S. Maryland Avenue, MC 4076, Chicago, IL, 60637, USA

      Keith Naylor & Karen Kim

    Authors
    1. Cassandra Fritz
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    2. Keith Naylor
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    3. Karen Kim
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    Corresponding author

    Correspondence to Keith Naylor.

    Additional information

    Cassandra Fritz and Keith Naylor contributed equally to this work.

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    Fritz, C., Naylor, K. & Kim, K. Knowledge of Polyp History and Recommended Follow-Up Among a Predominately African American Patient Population and the Impact of Patient Navigation. J. Racial and Ethnic Health Disparities 3, 403–412 (2016). https://doi.org/10.1007/s40615-015-0152-5

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    • DOI: https://doi.org/10.1007/s40615-015-0152-5

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