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Feasibility of Patient Navigation and Impact on Adherence to Screening Colonoscopy in a Large Diverse Urban Population

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Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

Abstract

Introduction

Disparities observed in colorectal cancer (CRC) incidence and mortality among blacks and Hispanics compared with whites may be in part due to lower screening rates. The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) has implemented a patient navigator (PN) program at NYC hospitals serving lower-income patients to promote high adherence by patients referred for screening colonoscopy. A prior study showed this PN program increased adherence at 3 public hospitals. The aim of this study was to determine the feasibility of expanding the PN program to 10 hospital sites by assessing the impact of the PN program on adherence to screening colonoscopy in a large, urban, lower-income population.

Methods

Data were collected from 2007 through the first quarter of 2012 from PN sites. One site also contributed data from the pilot phase of the project, from 2005 to 2006. Adherence to scheduled screening colonoscopy among those ≥ 50 years was assessed among 10 hospital sites in NYC participating in the colonoscopy PN program.

Results

Among the 37,077 asymptomatic adults ≥ 50 years who were scheduled for a screening colonoscopy from 2005 to the first quarter of 2012, 84.2% (83.2% of black, 84.9% of Hispanic, and 87.5% of white adults) were adherent to scheduled colonoscopy.

Conclusions

Expansion of PN programs to navigate all patients referred for a colonoscopy was feasible in a large, urban setting. This can be implemented resulting in high overall adherence rates to screening colonoscopies. The program likely did not result in large ethnic disparities.

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Acknowledgments

The authors would like to thank the participating Health and Hospitals (H + H) and the non-H + H participating sites for their dedication to working with the Cancer Prevention and Control Program at the New York City Department of Health and Mental Hygiene to improve colorectal cancer screening across all segments of the population in New York City. The authors would like to acknowledge the contributions of our colleagues, Shadi Chamany and Justin List, for their feedback and clinical perspective on the program and the manuscript.

Funding

The program pilot was partially funded by NY Community Trust, a private foundation, and partially funded by New York City. American Cancer Society funded some patient navigators.

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Authors and Affiliations

  1. Memorial Sloan Kettering Cancer Center, Department of Medicine, 1275 York Avenue, New York, NY, 10065, USA

    Robin B. Mendelsohn, Delia Calo & Sidney J. Winawer

  2. NYC Department of Health and Mental Hygiene, New York, NY, USA

    Samantha F. DeLeon, Sonia Villegas & Mari Carlesimo

  3. Hofstra Northwell School of Medicine, Department of Medicine, Hempstead, NY, USA

    Jason J. Wang

Authors
  1. Robin B. Mendelsohn
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  2. Samantha F. DeLeon
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  3. Delia Calo
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Contributions

Robin B. Mendelsohn: Writing (original draft), writing review, and editing

Samantha F. DeLeon: Conceptualization, methodology, formal analysis, writing review and editing, and supervision

Delia Calo: Writing (original draft), writing (review), and editing

Sonia Villegas: Methodology, resources

Mari Carlesimo: Conceptualization, methodology, writing (review) and editing, and supervision Jason J. Wang: Formal analysis, writing (review), and editing

Sidney J. Winawer: Conceptualization, writing (original draft), writing (review) and editing, and supervision

Corresponding author

Correspondence to Robin B. Mendelsohn.

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Mendelsohn, R.B., DeLeon, S.F., Calo, D. et al. Feasibility of Patient Navigation and Impact on Adherence to Screening Colonoscopy in a Large Diverse Urban Population. J. Racial and Ethnic Health Disparities 8, 559–565 (2021). https://doi.org/10.1007/s40615-020-00812-9

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  • DOI: https://doi.org/10.1007/s40615-020-00812-9

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