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Randomized Controlled Trial
. 2022 Sep;36(7):1083-1093.
doi: 10.1177/08901171211041276. Epub 2022 May 5.

Evaluation of a 2-1-1 Telephone Navigation Program to Increase Cancer Control Behaviors: Results From a Randomized Controlled Trial

Maria E Fernandez  1 , Lara S Savas  1 , John S Atkinson  1 , Katherine Ball Ricks  2 , Lynn N Ibekwe  1 , Inimfon Jackson  3 , Philip E Castle  4   5 , David Jobe  6 , Sally W Vernon  1
Affiliations
Randomized Controlled Trial

Evaluation of a 2-1-1 Telephone Navigation Program to Increase Cancer Control Behaviors: Results From a Randomized Controlled Trial

Maria E Fernandez et al. Am J Health Promot. 2022 Sep.

Abstract

Purpose: To evaluate the effectiveness of a telephone navigation intervention for increasing use of cancer control services among underserved 2-1-1 callers.

Design: Randomized controlled trial.

Setting: 2-1-1 call centers in Houston and Weslaco, Texas (located in the Rio Grande Valley near the Mexican border).

Participants: 2-1-1 callers in need of Pap test, mammography, colorectal cancer screening, smoking cessation counseling, and/or HPV vaccination for a daughter (n = 1,554). A majority were low-income and described themselves as Black or Hispanic.

Intervention: Participants were randomly assigned to receive either a cancer control referral for the needed service(s) with telephone navigation from a trained cancer control navigator (n = 995) or a referral only (n = 559).

Measures: Uptake of each individual service and any needed service.

Analysis: Assessed uptake in both groups using bivariate chi-square analyses and multivariable logistic regression analyses, adjusted for sociodemographic covariates. Both per-protocol and intent-to-treat approaches were used.

Results: Both interventions increased cancer control behaviors. Referral with navigation intervention resulted in significantly greater completion of any needed service (OR = 1.38; p = .042), Pap test (OR = 1.56; p = .023), and smoking cessation counseling (OR = 2.66; p = .044), than referral-only condition. Other outcomes showed the same trend although the difference was not statistically significant: mammography (OR = 1.53; p = .106); colorectal cancer screening (OR = 1.80; p = .095); and HPV vaccination of a daughter (OR = 1.61; p = .331).

Conclusion: Adding cancer control referrals and navigation to an informational service like the 2-1-1 program can increase overall participation in cancer control services.

Trial registration: ClinicalTrials.gov NCT04638010.

Keywords: HPV vaccination; cancer disparities; cancer prevention and screening; health promotion; low income; patient navigation; population health; racial minority groups; social support; tobacco control.

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Conflict of interest statement

Conflict of Interest Statement:

The authors have no conflicts of interest to declare.

Ethical Approval:

This study received approval for all study procedures from the Committee for the Protection of Human Subjects at The University of Texas Health Science Center at Houston (Study HSC-SPH-10–0241). All study participants verbally provided informed consent to participate in the study.

Figures

Figure 1:
Figure 1:
Study Enrollment for Need of Any Service
See this image and copyright information in PMC

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