Dataset Information

Startup and implementation costs of a colorectal cancer screening tailored navigation research study.

ABSTRACT:

Background

Colorectal cancer (CRC) is the third leading cause of cancer-related death in the United States. Despite improvements in screening, testing for CRC is underutilized in some populations, suggesting a need to identify efficient test promotion strategies.

Methods

Our intervention guided individuals from low-income, underserved communities into primary care clinics to receive CRC screening referrals. Community sites were randomized to education or education plus navigation. The Phase I community-to-clinic navigation outcome was clinic attendance; the Phase II clinic-to-screening navigation outcome was screening completion. We used micro-costing to determine costs necessary to replicate our project in a similar, non-research setting.

Results

Over the 4-year project, startup costs tended to decrease as implementation costs increased. The largest component of startup costs (32 % of total) was community site recruitment. Implementation costs per class attendee were higher in the navigation group ($1084) than control ($798). But costs per participant who made a clinic appointment ($3573 versus $6292) and per participant who completed screening ($4083 versus $7640) were lower in the navigation group.

Conclusions

Our description of startup and implementation costs for this intervention provides decision makers with information needed to plan and budget for a similar project to guide individuals from community into clinics.

SUBMITTER: Bucho-Gonzalez J

PROVIDER: S-EPMC8715791 | biostudies-literature | 2021 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Startup and implementation costs of a colorectal cancer screening tailored navigation research study.

Bucho-Gonzalez Julie J Herman Patricia M PM Larkey Linda L Menon Usha U Szalacha Laura L

Evaluation and program planning 20210129

<h4>Background</h4>Colorectal cancer (CRC) is the third leading cause of cancer-related death in the United States. Despite improvements in screening, testing for CRC is underutilized in some populations, suggesting a need to identify efficient test promotion strategies.<h4>Methods</h4>Our intervention guided individuals from low-income, underserved communities into primary care clinics to receive CRC screening referrals. Community sites were randomized to education or education plus navigation. ...[more]

PMID: 33561756

Similar Datasets

Project description:BackgroundAmerican Indians (AI) experience major colorectal cancer (CRC) screening disparities with commensurate inequity in CRC mortality and other outcomes. The purpose of this report is to describe the methods and early results of adapting a previously successful intervention for the AI community.MethodsThe educational content and delivery strategy of the parent intervention were adapted for AIs guided by an adaptation framework and cultural consultations with the community and clinicians. As part of the environmental scanning, we identified the need to substantively revise our data entry, collection, and tracking system and develop a REDCap database for this purpose. In this study, we staggered the implementation of the intervention in each facility to inform the process from one clinic to the next, and assess both the clinical outcomes of the tailored intervention and the implementation processes across two clinic settings, Facilities A and B.ResultsThe REDCap database is an indispensable asset, and without it we would not have been able to obtain reliable aggregate screening data while improvements to facility electronic health records are in progress. Approximately 8% (n = 678) of screening-eligible patients have been exposed to the navigator intervention. Of those exposed to the navigator intervention, 37% completed screening.ConclusionsWith the small numbers of patients exposed so far to the intervention, it would be premature to draw any broad conclusions yet about intervention effects. However, early screening completion rates are substantial advances on existing rates, and we have demonstrated that a tailored navigator intervention for facilitating CRC screening was readily adapted with provider and community input for application to AIs. A REDCap database for tracking of CRC screening by navigators using tablets or laptops on- or offline is easy to use and allows for generation of aggregate, anonymized screening data.Trial registrationThere was no health intervention meeting the criteria of a clinical trial. The University of Arizona Institutional Review Board granted exemption from obtaining informed consent from patients undergoing CRC screening after administration of the tailored navigation intervention as usual care.

Project description:ObjectiveColorectal cancer (CRC) screening programmes have been implemented worldwide, but the evidence of the economic consequences of screening programmes relies on data from short-term trials. The aim of this paper was to describe the costs of CRC screening in a population-based screening programme, using administrative real-world data. Specifically, we aimed to estimate the annual costs of the screening programme and the total costs of the full programme over five consecutive screening rounds.MethodsThe CRC screening programme of Stockholm-Gotland, Sweden, targeted all resident men and women aged 60-69 years for biennial screening. The screening strategy was faecal occult blood testing (FOBT) sent to individuals' home addresses, with a positive test result leading to an invitation to diagnostic colonoscopy. The cost description was conducted with a retrospective, bottom-up costing design from a healthcare perspective using (1) a prevalence-based approach and (2) an incidence-based approach, with two different study samples.ResultsAnnual healthcare costs were estimated using a sample of 124 608 individuals who were affected by the screening programme in 2017. Annual healthcare costs of the screening programme summed up to €273 758 per 10 000 people, equivalent to €27.4 per eligible individual. The sum of costs for colonoscopy procedures was more than two times as high as the costs for FOBT. The costs of the full screening programme were estimated using a cohort of 92 689 individuals who were invited to five consecutive rounds of screening between 2009 and 2021. Total healthcare costs over five screening rounds were €960 654 per 10 000 people, equivalent to €96.1 per individual.ConclusionThe costs of diagnostic colonoscopies for a minority of participants were driving the costs of the CRC screening programme. The ongoing population-based screening programme and high-quality individual level data with long-term follow-up provide the opportunity to thoroughly describe the costs of CRC screening.

Dataset Information

Startup and implementation costs of a colorectal cancer screening tailored navigation research study.

Background

Methods

Results

Conclusions

Publications

Startup and implementation costs of a colorectal cancer screening tailored navigation research study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets