Process Indicators for the Implementation of Patient Navigation for Colorectal Cancer Screening and Treatment

Authors:

Cam Escoffery (Presenter)
Rollins School of Public Health

Amy DeGroff, CDC
Anamika Satsangi, CDC

Public Health Statement: Patient navigation (PN) has been shown to increase CRC screening completion among underserved populations. Navigators assess patients’ barriers and assist them to successfully complete screening by addressing their needs (e.g., translation, transport). Despite widespread adoption of PN, there is limited consensus on how to measure PN implementation. Process evaluation assesses the implementation of a health intervention through the measurement of various process indicators (recruitment, reach, dose delivered).

Purpose: We conducted a systematic review examining PN implementation and process evaluation measures for CRC screening. We identified common types of process indicators and related data sources reported in the literature.

Methods/Approach: Articles in English focused on PN for CRC screening conducted in the U.S. and published between 2000 and June 2015 were identified from seven databases.

Results: Of the 29 articles found, most PN programs had experimental designs (44.8%) and were conducted in clinical settings. Many reported PN actions (N=28) (e.g., barrier assessment) and mode of navigation (n=20), while 15 reported on navigator training. Process measures of recruitment (n=29), reach (n=21), and dose delivered (n=12) were commonly reported. Resources, fidelity, and dose received were reported infrequently (n=<3). Data sources for process indicators were surveys and program databases.

Conclusions/Implications: Most process data focused on PN implementation, including those related to navigator training, actions, and mode of contact. Indicators addressing resources and fidelity were reported less frequently. Results can inform the development of navigation programs and their process evaluation in the future.