Paper
Monday, November 5, 2007
440
An Interdisciplinary Team of Researchers and Students Develop and Implement a Clinic Reminder System to Improve Colorectal Cancer Screening in Colonias along the U.S.–Mexico Border
Marilyn Nelsen Pase, MSN, RN, School of Nursing, New Mexico State University, Las Cruces, NM, USA and Gloria Coronado, PhD, Cancer Prevention Program, Public Health Services, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
| Learning Objective #1: Decribe a reminder system using health promoters and a three-tiered approach by an interdisciplinary team to improve participation in colorectal cancer screening. |
| Learning Objective #2: Discuss ways this reminder system might be used to increase FOBT screening and teaching for other minority populations. |
Purpose: Latinos are less likely to receive screening services for colorectal cancer. Through an interdisciplinary effort and mentorship program, our purpose was to increase colorectal cancer screening among Latinos residing in two colonias near the US-Mexico border who receive health care at a network of community clinics.
Methodology: Baseline assessment of fecal occult blood testing (FOBT) screening was conducted in two clinics using computerized patient records for patients ages 50 – 79. The clinic reminder system involved clinic mailings, telephone calls, and home visits by health promoters aimed to motivate testing. Nutrition and biology students presented teaching aids for the clinic patients and Promotoras, trained lay health promoters, made home visits. After training, minority nursing student researchers were temporarily employed by the clinic to abstract appropriate data from medical records. Following the one-year intervention, final screening rates were assessed using the clinic computerized record system and baseline and final rates were compared.
Results: Data on FOBT screening prevalence before and after the intervention illustrate intervention success: in one community, 48.7% of 718 patients had received an FOBT in the past year (compared to 7.8% at baseline); 46.2% of 234 patients in a second community had received an FOBT in the past year (compared to 39.4% at baseline).
Implications: A clinic-based reminder system using health promoters and a three-tiered approach successfully improved participation in colorectal cancer screening. One minority student researcher is currently employed by the clinic as a nurse. Since our intervention relied on clinic workers and on health promoters who were permanent clinic staff, efforts to improve colorectal cancer screening and research processes may be sustained. The enthusiasm of the students, clinic nurses, and promotoras under the direction of interdisciplinary faculty researchers were key elements in the success of this project.