Title

Intervention during wait time: Identification and referral of individuals nonadherent for colorectal screening

Document Type

Conference Proceeding

Publication Date

2019

Publication Title

Acad Emerg Med

Abstract

Background: This study examined the extent to which volunteer pre-health professions students, (research associates; RAs), could identify patients and their visitors non-adherent for recommended colorectal screening and refer non-adherent individuals. Methods: Patients and their visitors 50-75 years were questioned on their history of colorectal screening by RAs using a standardized interview in REDCap. A convenience sample of participants was enrolled from 7 EDs around the country, ranging from community hospitals to academic institutions. Participants were excluded for high acuity or inability to communicate with the RAs. Those found to be non-adherent to US Preventive Services Task Force recommendations received information on how to obtain colorectal screening through options in each hospital's system. Results: RAs approached 24,411 individuals; 10,041 (41%) were eligible. Of these, 8,530 (85%) consented: 6,333 patients and 2,197 visitors. 54% were women, 63% self-identified as White and 26% Black, and Hispanic/Latino ethnicity was reported for 13%. The vast majority (88%) had a PCP. 5,816 individuals (68%) reported they had previously received a colonoscopy, sigmoidoscopy, or recent (i.e., w/i 12 mos.) fecal occult blood test. Of previously screened individuals, 327 (6%) reported their last colonoscopy was > 10 years ago (i.e., non-adherent), and 68 (1%) reported their last sigmoidoscopy was > 5 years ago (non-adherent; 35 non-adherent for both). The total rate of non-adherence or uncertainty about adherence to recommended colorectal screening in this sample was 36%. Non-Hispanic participants were more likely to be adherent than Hispanic participants (65% vs 58%, p < 0.001), and White participants were more likely than non-White participants (68% vs 58%, p < 0.001). Greater education was associated with greater likelihood of screening (p < 0.001), as was private insurance (71% vs 57%), Medicare insurance (70% vs. 61%), and having a PCP (69% vs. 35%; p's < 0.001). Conclusion: RAs are an effective resource for identifying patients and visitors in need of colorectal screening and referring non-adherent individuals. Distinct demographic associations were observed with adherence status, such that tailored interventions may need to be developed in order to effectively improve adherence.

Volume

26

First Page

S183

Last Page

S184

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