Nurse Practitioner Knowledge of and Experienced Barriers to High-Risk Colorectal Cancer Screenings

2016 ◽  
Vol 9 (2) ◽  
pp. 229-235
Author(s):  
Lecia Reardon
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
Health Outcomes ◽  
Nurse Practitioners ◽  
Practice Patterns ◽  
Screening Guidelines ◽  
Targeted Interventions ◽  
Crc Screening ◽  
Screening Barriers ◽  
Improve Health

Problem: Evidence supports earlier preventive colorectal cancer (CRC) screening for high-risk individuals. Awareness of high-risk factors and application to screening guidelines can enable nurse practitioners (NPs) to positively impact screening rates. Application of this knowledge can transform high-risk CRC screenings from tertiary CRC diagnosis to primary and secondary prevention to improve health outcomes. Purpose: To survey NP knowledge, perceived barriers, and current practice patterns in referring high-risk individuals for CRC screenings. Methods: A 16-question Qualtrics Internet survey designed, tested, and emailed to 2,155 primary care NPs in North Carolina. Results: One hundred eighty respondents (8.3%) completed the survey, with 57.5% (n = 104) rating themselves knowledgeable of high-risk CRC screening guidelines. Screening barriers included uninsured status, patient refusal, and lack of access. Aggregate practice screening pattern questions were related to self-perceived knowledge of high-risk CRC guidelines (χ2 = 4.1918, df = 1, p = .04). Conclusion: Over half (57.8%) of the respondents reporting knowledge of high-risk CRC guidelines had statistically significant relationship in aggregate practice patterns. Reduction of screening barriers using targeted interventions may improve health outcomes.

scholarly journals Effect of Neighborhood and Individual-Level Socioeconomic Factors on Colorectal Cancer Screening Adherence

2021 ◽  
Vol 18 (9) ◽  
pp. 4398
Author(s):  
Kiara N. Mayhand ◽  
Elizabeth A. Handorf ◽  
Angel G. Ortiz ◽  
Evelyn T. Gonzalez ◽  
Amie Devlin ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Study Participant ◽  
Socioeconomic Indicators ◽  
Cross Sectional ◽  
Mixed Effect ◽  
Total Study Population ◽  
Screening Guidelines ◽  
Individual Level ◽  
Crc Screening ◽  
Screening Adherence

Despite the effectiveness of screenings in reducing colorectal cancer (CRC) mortality, ~25% of US adults do not adhere to screening guidelines. Prior studies associate socioeconomic status (SES) with low screening adherence and suggest that neighborhood deprivation can influence CRC outcomes. We comprehensively investigated the effect of neighborhood SES circumstances (nSES), individual SES, and race/ethnicity on adherence to CRC screening in a multiethnic cross-sectional study. Participant surveys assessing 32 individual-level socioeconomic and healthcare access measures were administered from 2017 to 2018. Participant data were joined with nine nSES measures from the US Census at the census tract level. Univariate, LASSO, and multivariable mixed-effect logistic regression models were used for variable reduction and evaluation of associations. The total study population included 526 participants aged 50–85; 29% of participants were non-adherent. In the final multivariable model, age (p = 0.02) and Non-Hispanic Black race (p = 0.02) were associated with higher odds of adherence. Factors associated with lower adherence were home rental (vs. ownership) (p = 0.003), perception of low healthcare quality (p = 0.006), no routine checkup within two years (p = 0.002), perceived discrimination (p = 0.02), and nSES deprivation (p = 0.02). After comprehensive variable methods were applied, socioeconomic indicators at the neighborhood and individual level were found to contribute to low CRC screening adherence.

scholarly journals Knowledge and Awareness about Colorectal Cancer and Its Screening Guidelines among Doctors in Al Ahsa, Eastern Province, Kingdom of Saudi Arabia

2016 ◽  
Vol 9 (6) ◽  
pp. 145
Author(s):  
Bathula Surendra ◽  
Muhammad Mujtaba Hashir ◽  
Fahad Salman Al Harbi ◽  
Mohammed Jassim Al Nuwaysir ◽  
Khalid Majed Al Khaldi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Saudi Arabia ◽  
High Risk ◽  
Public Health Problem ◽  
Screening Tests ◽  
High Risk Population ◽  
Major Public Health Problem ◽  
Eastern Province ◽  
Risk Population ◽  
Screening Guidelines

INTRODUCTION: Cancer is a major public health problem. Worldwide, colorectal cancer (CRC) is a leading cause of deaths due to cancer in both men and women. Among, Saudi men, CRC is the most common malignancy while it is the third most common among Saudi women. Over, two decades the incidence and deaths due to CRC have been steadily increasing in Saudi Arabia. Regular and timely screening has the potential in reducing the incidence and deaths due to colorectal cancer. The present study is conducted to evaluate the knowledge and awareness about colorectal cancer and its screening among the doctors.OBJECTIVES: To measure the frequency of knowledge and awareness about colorectal cancer and its screening guidelines among doctors in Al-Ahssa.METHODS: A questionnaire based survey of the doctors (Specialists & residents), working in different hospitals and primary health centers under the Ministry of Health in Al Ahssa region, Eastern province, KSA.  Knowledge and awareness about colorectal cancer and its screening among the doctors is evaluated.RESULTS: Over 80% of the doctors knew, screening reduces deaths due to CRC. Only 60% were aware about the risk factors and less than 50% knew the clinical features of CRC. About 60% doctors agreed Colonoscopy is gold standard screening test. While, less than 60% knew the ideal age to initiate screening and the actual interval of screening tests in the standard risk and high-risk population. Fewer than 25% doctors were aware about the American cancer society recommended screening guidelines. Majority of the doctors expressed keen interest to know and receive information about CRC and its screening guidelines. CONCLUSIONS: Regular and timely screening reduces deaths due to CRC. There is a need for improving knowledge and awareness of doctors about CRC and its screening. Awareness among the doctors improves uptake of screening by the general and high-risk population.

The Impact of Socioeconomic Status on Perceived Barriers to Colorectal Cancer Testing

2008 ◽  
Vol 23 (2) ◽  
pp. 97-100 ◽  
Author(s):  
Aimee S. James ◽  
Sandra Hall ◽  
K. Allen Greiner ◽  
Dan Buckles ◽  
Wendi K. Born ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Socioeconomic Status ◽  
Low Income ◽  
Fecal Occult Blood ◽  
Low Ses ◽  
National Guidelines ◽  
Convenience Sample ◽  
Crc Screening ◽  
Screening Barriers ◽  
The Impact

Purpose. Colorectal cancer (CRC) screening is effective, but only one-half of age-eligible adults adhere to national guidelines. Lower socioeconomic status (SES) groups are less likely to be screened. Methods. Baseline data from a prospective study were used to examine the associations among CRC screening screening barriers, and SES. A convenience sample of adults (N = 291) aged 40 years and older was recruited from a federally qualified health center. Questionnaires were administered orally and included demographics, health, health behavior, and screening barriers. Results. In logistic regression, having health insurance was associated with greater odds of screening. Bivariate analyses detected few differences in fecal occult blood test (FOBT) barriers, but several endoscopy barriers were more common among the lowest SES groups. For example, fear of injury from endoscopy was more likely among low-income and uninsured participants. Discussion. The impact of SES on cancer screening is complex, but low-SES participants more often reported certain barriers than their higher-SES counterparts. This was more evident for endoscopy than for FOBT. Programs targeted at low-SES patients may need to focus on barriers that are not fully addressed in traditional promotion efforts.

An Electronic Questionnaire to Survey Colorectal Cancer Screening Status and Identify High-Risk Cohorts in Large Health Care Organizations

2020 ◽  
pp. 106286062093723
Author(s):  
Christopher T. Soriano ◽  
Thomas J. McGarrity ◽  
Junjia Zhu ◽  
Justin Loloi ◽  
Laurie P. Peiffer ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
High Risk ◽  
Human Resources ◽  
Health Care Organizations ◽  
Response Rate ◽  
Patient Questionnaire ◽  
Screening Practices ◽  
Crc Screening ◽  
Incidence And Mortality

Though improved screening practices have reduced the incidence and mortality of colorectal cancer (CRC), screening rates continue to be suboptimal. This is especially true of high-risk individuals, who are difficult for clinicians to identify during a typical health care encounter. The authors developed an electronic patient questionnaire that determined an individual’s CRC screening status and identified high-risk individuals. The questionnaire was administered to employees through the Department of Human Resources. The response rate was 44.7%; 81.2% of respondents aged ≥50 years were up-to-date on CRC screening; 878 high-risk individuals were identified, 77.7% of whom were up-to-date on CRC screening. However, among high-risk individuals aged 40 to 49 years, only 45.8% reported up-to-date CRC screening. The questionnaire was effective in measuring CRC screening rates and identifying high-risk individuals. Dissemination by the Department of Human Resources was novel, effective, and was not dependent on a health care encounter to assess screening or high-risk status.

Physician’s awareness and practices toward colorectal cancer screening guidelines.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 431-431 ◽  
Author(s):  
Sowjanya Kanna ◽  
Asif Ali ◽  
Kiran Anna ◽  
Thimmaiah Theethira Ganapathi ◽  
Raja Shekhar Reddy Sappati Biyyani ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Text Messaging ◽  
Academic Medical Center ◽  
Screening Colonoscopy ◽  
Study Group ◽  
Screening Guidelines ◽  
Crc Screening ◽  
Phone Calls ◽  
Continued Education ◽  
Attending Physicians

431 Background: Colorectal cancer (CRC) is the second most common cancer with an estimated incidence of 72,090 men and 70,480 women and a cause specific mortality of 51,370 in 2010. Despite promotion of CRC screening by various professional societies ACG /AGA and USPSTF, there seems to be an under utilization of screening colonoscopy for unclear reasons. We aimed to study the awareness of physicians towards CRC screening across various levels of training in different specialities. Methods: A survey questionnaire of 16 questions, assessing awareness of CRC screening guidelines was provided to 100 physicians in our academic medical center who are at various levels of training in Primary Care Group (PCG comprising residents, attending physicians in Internal Medicine and Family Medicine) and Specialty Group (SG comprising fellows, attending physicians in Gastroenterology). Results: Out of 100 questionnaires, we received 59 responses (50 PCG and 9 SG) which are included in the results. About 54% of the study group followed CRC guidelines (32% USPSTF CRC screening guidelines compared to 22 % ACG/AGA guidelines) and 46% did not. All the physicians who did not follow the guidelines belonged to the PCG. Most common screening modality chosen was colonoscopy alone (46% PCG and 100% SG), followed by colonoscopy with FOBT (36% PCG), FOBT (12% PCG) and 3% PCG answered barium enema along with FOBT/ sigmoidoscopy. A 100% response from both SG and PCG was obtained for commencing screening colonoscopy at 50 years of age but only 27% of the PCG compared to 80% SG were aware of the screening cessation guidelines. Interestingly a vast majority of the study group (88%) text messaging as a better way of reminder to improve compliance compared to phone calls and postal letters. About 72% of the respondents themselves would want colonoscopy as screening modality compared to 17% for FOBT and 7% for sigmoidoscopy. An overwhelming majority of the study group (80% of both PCG and SG) felt the need for continued education in regards to guidelines for screening in didactic sessions. Conclusions: Despite clear guidelines for screening colonoscopy, we found a significant lack of awareness amongst PCG compared to SG, and our study emphasizes the need for continued education.

Co-creating a patient-centric digital solution to enhance perioperative health outcomes among colorectal cancer patients and their family caregivers: a theory-based, international, multidisciplinary approach (Preprint)

2021 ◽  
Author(s):  
Su Wei WAN ◽  
Choon Seng CHONG ◽  
Ee-Lin TOH ◽  
Siew Hoon LIM ◽  
Tien Tau LOI ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Outcomes ◽  
Family Caregivers ◽  
Perioperative Period ◽  
Ease Of Use ◽  
Limiting Factors ◽  
Novel Technologies ◽  
Post Surgery ◽  
Patient Centric ◽  
Improve Health

BACKGROUND Elective colorectal cancer (CRC) surgeries offer enhanced surgical outcomes but demand high self-efficacy in prehabilitation and competency in self-care and disease management post-surgery. Conventional strategies to meet perioperative needs have not been pragmatic and there remains a pressing need for novel technologies that could improve health outcomes. OBJECTIVE To describe the development of a smartphone-based interactive colorectal cancer self-management enhancement psychosocial programme (iCanManage) to improve health outcomes among family caregivers and patients who undergo elective colorectal cancer surgeries. METHODS A multidisciplinary international team comprising of physicians, specialist nurses, a psychologist, software engineers, academic researchers, cancer survivors, patient ambassadors, and ostomy care medical equipment suppliers was formed to facilitate the development of this patient-centric digital solution. The process occurred in several stages: (i) review of current practice through clinic visits and on-site observations; (ii) review of literature and findings from preliminary studies; (iii) content development grounded in an underpinning theory; (iv) integration of support services; and (v) optimize user experience through improving interface aesthetics and customisation. RESULTS Several limiting factors were identified despite efforts to promote engagement and ensure ease of use of the mobile application. To overcome such barriers, additional app training sessions, an instruction manual and regular telephone calls will be incorporated into the iCanManage programme during the trial period. CONCLUSIONS This form of multidisciplinary collaboration is advantageous as it can potentially streamline existing care paths and allow the delivery of more holistic care to the colorectal cancer population during the perioperative period. Should the programme be found to be effective and sustainable, hospitals adopting this digital solution may achieve better resource allocation and reduce overall healthcare costs in the long run. CLINICALTRIAL NCT04159363 (https://clinicaltrials.gov/)

scholarly journals Primary Care Provider Perceptions of Colorectal Cancer Screening Barriers: Implications for Designing Quality Improvement Interventions

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Jennifer M. Weiss ◽  
Perry J. Pickhardt ◽  
Jessica R. Schumacher ◽  
Aaron Potvien ◽  
David H. Kim ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Primary Care ◽  
Quality Improvement ◽  
Primary Care Providers ◽  
Care Providers ◽  
Provider Perceptions ◽  
Crc Screening ◽  
Improvement Interventions ◽  
Quality Improvement Interventions ◽  
Screening Barriers

Aims. Colorectal cancer (CRC) screening is underutilized. Increasing CRC screening rates requires interventions targeting multiple barriers at each level of the healthcare organization (patient, provider, and system). We examined groups of primary care providers (PCPs) based on perceptions of screening barriers and the relationship to CRC screening rates to inform approaches for conducting barrier assessments prior to designing and implementing quality improvement interventions.Methods. We conducted a retrospective cohort study linking EHR and survey data. PCPs with complete survey responses for questions addressing CRC screening barriers were included (N=166PCPs; 39,430 patients eligible for CRC screening). Cluster analysis identified groups of PCPs. Multivariate logistic regression estimated odds ratios and 95% confidence intervals for predictors of membership in one of the PCP groups.Results. We found two distinct groups: (1) PCPs identifying multiple barriers to CRC screening at patient, provider, and system levels (N=75) and (2) PCPs identifying no major barriers to screening (N=91). PCPs in the top half of CRC screening performance were more likely to identify multiple barriers than the bottom performers (OR, 4.14; 95% CI, 2.43–7.08).Conclusions. High-performing PCPs can more effectively identify CRC screening barriers. Targeting high-performers when conducting a barrier assessment is a novel approach to assist in designing quality improvement interventions for CRC screening.

scholarly journals A64 REVIEW OF PATIENTS REFERRED TO THE DIVISION OF DIGESTIVE CARE AND ENDOSCOPY AT DALHOUSIE UNIVERSITY FOR COLORECTAL CANCER SCREENING BASED ON A FAMILY HISTORY OF COLORECTAL CANCER: HOW MANY UNDERWENT COLONOSCOPY?

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 23-25
Author(s):  
M Miles
Keyword(s):  
Colorectal Cancer ◽  
Family History ◽  
High Risk ◽  
Average Risk ◽  
Cross Sectional ◽  
Crc Screening ◽  
Increased Risk ◽  
Fit Testing ◽  
Quality Assessment Study ◽  
History Of

Abstract Background Nova Scotia has provincial colorectal cancer (CRC) screening for asymptomatic, average risk individuals age 50–74 using fecal immunochemical testing (FIT) every 2 years. However, individuals with 1 or more first degree relatives (FDR) diagnosed with CRC by age 60 have a 2–4 fold increased risk for developing CRC. For these high risk individuals, current guidelines recommend CRC screening with colonoscopy rather than FIT testing. Annually, the Division of Digestive Care & Endoscopy (DCE) at Dalhousie University receives many referrals for patients with a family history of CRC but the percentage of patients who require this procedure is unclear. Aims The objectives of this quality assessment study were to review patients referred to DCE for a family history of CRC to (1) better understand the indication for referral; and (2) determine the percentage of patients undergoing colonoscopy Methods This was a retrospective cross sectional review of a prospectively updated database. The study population was patients referred to DCE from 2012–2019 based on a family history of CRC, as indicated on the referral. Family history of CRC was defined as 1 or more FDRs diagnosed with CRC. High risk patients were those with 2 or more FDRs with CRC or 1 FDR diagnosed by age 60. All patients were reviewed by a single gastroenterologist in clinic. Results A total of 107 referrals from 2012–2019 were reviewed. Of patients age 50 or older, 51/78 (65.4%) had performed at least 1 FIT. The indications for referral were 2 or more FDR diagnosed with CRC for 6/107 (5.6%) patients, 1 FDR diagnosed with CRC by age 60 for 37/107 patients (34.6%) and 1 FDR diagnosed with CRC over age 60 for 33/107 patients (30.8%). The remaining 31/107 patients (29.0%) had no FDR with CRC. Of the 43/107 patients (40.2%) considered high risk based on family history alone, 34/43 (79.1%) underwent colonoscopy and 8/43 (18.6%) opted for FIT testing. Of the 64/107 patients (59.8%) considered average risk based on family history alone, 26/64 (40.6%) had another indication for colonoscopy and 35/64 (54.7%) resumed FIT testing. Conclusions The majority of patients (71.0%) referred to the DCE for a family history of CRC had at least 1 FDR with CRC. Just over half of patients (55.1%) referred to the DCE for a family history of CRC underwent colonoscopy. Strategies to improve the referral process by better capturing high risk individuals are needed. Funding Agencies None

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