Characteristics of patient navigation programs in the Cancer Moonshot ACCSIS colorectal cancer screening initiative

Gloria D Coronado¹, Renée M Ferrari², Autumn Barnes³, Sheila F Castañeda⁴, Mark Cromo⁵, Melinda M Davis⁶, Mark P Doescher⁷, Kevin English⁸, Jenna Hatcher⁹, Karen E Kim¹⁰, Sarah Kobrin¹¹, David Liebovitz¹², Shiraz I Mishra¹³, Jesse N Nodora¹⁴, Wynne E Norton¹¹, Jill M Oliveri¹⁵, Daniel S Reuland², Sujha Subramanian³, Jamie H Thompson¹, Electra D Paskett¹⁶

Affiliations

¹ Kaiser Permanente Center for Health Research, Portland, OR, USA.
² Lineberger Comprehensive Cancer Center, Carolina Cancer Screening Initiative, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA.
³ Research Triangle International, Research Triangle Park, NC, USA.
⁴ Department of Psychology, South Bay Latino Research Center, San Diego State University, Chula Vista, CA, USA.
⁵ Department of Internal Medicine, Healthy Kentucky Research Building, University of Kentucky, Lexington, KY, USA.
⁶ Department of Family Medicine and School of Public Health, Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland, OR, USA.
⁷ Department of Family and Preventive Medicine, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, University of Oklahoma, Oklahoma City, OK, USA.
⁸ Albuquerque Area Southwest Tribal Epidemiology Center, Albuquerque Area Indian Health Board, Inc, Albuquerque, NM, USA.
⁹ University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA.
¹⁰ University of Chicago, Chicago, IL, USA.
¹¹ Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA.
¹² Department of Medicine, Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
¹³ University of New Mexico Comprehensive Cancer Center and Departments of Pediatrics and Family and Community Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
¹⁴ Department of Family Medicine and Public Health, Moores UC San Diego Cancer Center, University of California, San Diego, La Jolla, CA, USA.
¹⁵ Comprehensive Cancer Center, Ohio State University, Columbus, OH, USA.
¹⁶ Department of Internal Medicine, College of Medicine and Comprehensive Cancer Center, Ohio State University, Columbus, OH, USA.

PMID: 36810931
PMCID: PMC10248850
DOI: 10.1093/jnci/djad032

Characteristics of patient navigation programs in the Cancer Moonshot ACCSIS colorectal cancer screening initiative

Gloria D Coronado et al. J Natl Cancer Inst. 2023.

. 2023 Jun 8;115(6):680-694.

doi: 10.1093/jnci/djad032.

Authors

Affiliations

¹ Kaiser Permanente Center for Health Research, Portland, OR, USA.
² Lineberger Comprehensive Cancer Center, Carolina Cancer Screening Initiative, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA.
³ Research Triangle International, Research Triangle Park, NC, USA.
⁴ Department of Psychology, South Bay Latino Research Center, San Diego State University, Chula Vista, CA, USA.
⁵ Department of Internal Medicine, Healthy Kentucky Research Building, University of Kentucky, Lexington, KY, USA.
⁶ Department of Family Medicine and School of Public Health, Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland, OR, USA.
⁷ Department of Family and Preventive Medicine, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, University of Oklahoma, Oklahoma City, OK, USA.
⁸ Albuquerque Area Southwest Tribal Epidemiology Center, Albuquerque Area Indian Health Board, Inc, Albuquerque, NM, USA.
⁹ University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA.
¹⁰ University of Chicago, Chicago, IL, USA.
¹¹ Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA.
¹² Department of Medicine, Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
¹³ University of New Mexico Comprehensive Cancer Center and Departments of Pediatrics and Family and Community Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
¹⁴ Department of Family Medicine and Public Health, Moores UC San Diego Cancer Center, University of California, San Diego, La Jolla, CA, USA.
¹⁵ Comprehensive Cancer Center, Ohio State University, Columbus, OH, USA.
¹⁶ Department of Internal Medicine, College of Medicine and Comprehensive Cancer Center, Ohio State University, Columbus, OH, USA.

PMID: 36810931
PMCID: PMC10248850
DOI: 10.1093/jnci/djad032

Abstract

Background: Although patient navigation has shown promise for increasing participation in colorectal cancer screening and follow-up, little evidence is available to guide implementation of patient navigation in clinical practice. We characterize 8 patient navigation programs being implemented as part of multi-component interventions of the National Cancer Institute's Cancer Moonshot Accelerating Colorectal Cancer Screening and Follow-Up Through Implementation Science (ACCSIS) initiative.

Methods: We developed a data collection template organized by ACCSIS framework domains. The template was populated by a representative from each of the 8 ACCSIS research projects. We report standardized descriptions of 1) the socio-ecological context in which the navigation program was being conducted, 2) navigation program characteristics, 3) activities undertaken to facilitate program implementation (eg, training), and 4) outcomes used in program evaluation.

Results: ACCSIS patient navigation programs varied broadly in their socio-ecological context and settings, the populations they served, and how they were implemented in practice. Six research projects adapted and implemented evidence-based patient navigation programs; the remaining projects developed new programs. Five projects began navigation when patients were due for initial colorectal cancer screening; 3 projects began navigation later in the screening process, when patients were due for follow-up colonoscopy after an abnormal stool-test result. Seven projects relied on existing clinical staff to deliver the navigation; 1 hired a centralized research navigator. All project researchers plan to evaluate the effectiveness and implementation of their programs.

Conclusions: Our detailed program descriptions may facilitate cross-project comparisons and guide future implementation and evaluation of patient navigation programs in clinical practice.

PubMed Disclaimer

Conflict of interest statement

From 2020 to present, Dr Coronado has served as a scientific advisor on contracts with Exact Sciences and Guardant Health through the Center for Health Research. Dr Paskett is the MPI on grants to Ohio State University from Merck Foundation, Pfizer, and Genentech for work not related to this study. All other authors declare no conflicts of interest.

References

1. Nelson HD, Cantor A, Wagner J, et al.Effectiveness of patient navigation to increase cancer screening in populations adversely affected by health disparities: a meta-analysis. J Gen Intern Med. 2020;35(10):3026-3035. - PMC - PubMed
1. Bernardo BM, Zhang X, Beverly Hery CM, Meadows RJ, Paskett ED.. The efficacy and cost-effectiveness of patient navigation programs across the cancer continuum: a systematic review. Cancer. 2019;125(16):2747-2761. - PubMed
1. Dougherty MK, Brenner AT, Crockett SD, et al.Evaluation of interventions intended to increase colorectal cancer screening rates in the United States: a systematic review and meta-analysis. JAMA Intern Med. 2018;178(12):1645-1658. - PMC - PubMed
1. Genoff MC, Zaballa A, Gany F, et al.Navigating language barriers: a systematic review of patient navigators' impact on cancer screening for limited English proficient patients. J Gen Intern Med. 2016;31(4):426-434. - PMC - PubMed
1. Domingo JB, Braun KL.. Characteristics of effective colorectal cancer screening navigation programs in federally qualified health centers: a systematic review. J Health Care Poor Underserved. 2017;28(1):108-126. - PMC - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
- PubMed Central
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Characteristics of patient navigation programs in the Cancer Moonshot ACCSIS colorectal cancer screening initiative

Affiliations

Characteristics of patient navigation programs in the Cancer Moonshot ACCSIS colorectal cancer screening initiative

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical