Patient navigation for colorectal cancer screening in deprived areas: the COLONAV cluster randomized controlled trial

BMC Cancer

Research

J. Ramone-Louis¹  V. Buthion¹  A. Bourmaud²  A. Dumas³  P. Amiel³  N. Lechopier⁴  F. Tinquaut⁵  V. Dutertre⁵  M. Oriol⁵  C. Allary⁵  J. Kalecinski⁶  V. Regnier⁶  F. Chauvin⁶  S. Rousseau⁷  M. Pommier⁸  Y. Benoist⁹ 

[1] COACTIS EA 4161 - Centre de Recherche en Gestion - Research Center in Management Science ISH and Faculty of Economics and Management, Lumière Lyon 2 University, Lyon, France;Clinical Epidemiology Unit, Robert Debré Hospital, AP-HP, and INSERM CIC-EC 1426 and INSERM ECEVE 1123, University of Paris, 48 Bd Sérurier, 75 019, Paris, France;Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055, Saint-Etienne, France;Quality Safety Performance in Health (HESPER) EA7425, Lyon 1 University, Lyon, France;Clinical Epidemiology Unit, Robert Debré Hospital, AP-HP, and INSERM CIC-EC 1426 and INSERM ECEVE 1123, University of Paris, 48 Bd Sérurier, 75 019, Paris, France;Unité de Recherche en Sciences Humaines Et Sociales (URSHS) Institut Gustave Roussy, Paris, France;Lyon1 University, Lyon, France;UMR S2HEP, French Education Institute, Ecole Normale Supérieure de Lyon, Lyon, France;Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055, Saint-Etienne, France;Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055, Saint-Etienne, France;Quality Safety Performance in Health (HESPER) EA7425, Lyon 1 University, Lyon, France;Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France and Inserm, Clinical Investigation Center 1408, 42055, Saint-Etienne, France;Unité de Recherche en Sciences Humaines Et Sociales (URSHS) Institut Gustave Roussy, Paris, France;UMR S2HEP, French Education Institute, Ecole Normale Supérieure de Lyon, Lyon, France;Unité de Recherche en Sciences Humaines Et Sociales (URSHS) Institut Gustave Roussy, Paris, France;

关键词: Colorectal cancer screening;    Patient navigation;    Complex interventions;    Health inequalities;    Randomized control trial;    Population health intervention research;   

DOI  :  10.1186/s12885-022-10169-3

 received in 2022-05-13, accepted in 2022-09-29,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundThe objective of this study was to assess the effectiveness of a Patient Navigation Intervention targeting deprived patients for Colo-Rectal Cancer (CRC) screening participation.MethodsA cluster randomized controlled trial was conducted in 5 districts. Peer Lay Patient Navigators were recruited to operate in deprived areas. Eligible participants had to be between 50 and 74 years old, live in these deprived areas and receive an invitation to the nationally organized Colo-Rectal Cancer (CRC) screening during the study period. The theory-driven navigation intervention was deployed for 18 months. A population Health Intervention Research assessment method was used to assess effectiveness and context interaction. The primary criterion was screening participation at 12 months.ResultsTwenty-four thousand two hundred eighty-one individuals were included inside 40 clusters. The increase in participation in the intervention group was estimated at 23%, (ORa = 1.23, CI95% [1.07–1.41], p = 0.003). For the subgroup of individuals who participated, the time delay to participating was reduced by 26% (ORa = 0.74, CI95% [0.57–0.96], p = 0.021). Main factors modulating the effect of the intervention were: closeness of navigator profiles to the targeted population, navigators’ abilities to adapt their modus operandi, and facilitating attachment structure.ConclusionThe ColoNav Intervention succeeded in demonstrating its effectiveness, for CRC screening. Patient Navigation should be disseminate with broader health promotion goals in order to achieve equity in health care.Trial registrationclinicaltrials.gov NCT02369757 24/02/2015.

【 授权许可】

CC BY   
© The Author(s) 2023

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