Diverse, vulnerable populations, especially Latinos, have low colon cancer screening rates. These groups are disproportionately affected by the many patient, provider, and system-level barriers that inhibit colon cancer screening. Latinos, the nation’s largest and fastest growing racial/ethnic minority group, face additional language and cultural barriers. Reducing disparities in colon cancer screening among vulnerable populations is a significant cancer control priority. To increase colon cancer screening in vulnerable populations, effective interventions are needed that address multiple screening barriers. Patient-directed, multimedia decision aids effectively enhance colon cancer screening knowledge, self-efficacy, and intent. Patient navigators help address patient-specific barriers to cancer control services. We believe that an intervention combining decision aids and patient navigators will be highly effective in promoting colon cancer screening among vulnerable, primary care patient populations. In this study, we will show patients a computer-based decision aid video (in English or Spanish) before they see their primary care provider. The video explains colon cancer screening using easy-to-understand narrated segments, patient testimonials, graphics, and animations. After the patients watch the video and talk with their provider, they will receive support from a bilingual patient navigator who can help them complete the screening process, overcoming the many barriers to screening completion that currently exist. In this study, we will test the effectiveness of this combined intervention in vulnerable patients, especially Latinos, ages 50 to 75, the age group for which colon cancer screening is recommended. We will conduct the study in primary care patient settings that serve diverse, vulnerable populations in both North Carolina and New Mexico to ensure the intervention is effective in different healthcare settings and in different Latino communities. If this practical and innovative intervention is found to be effective, it has potential to be widely implemented and could contribute substantially to reducing colon cancer mortality.
Principal Investigator: Daniel Reuland, MD, MPH
Funding Source: American Cancer Society
Project Period: 07/01/13-06/30/18