ASPO Abstracts
Optimizing content and delivery of mailed fecal immunochemical test (FIT) kit instructions and patient navigation to improve colorectal cancer screening among Spanish-speaking Hispanics/Latinos
Category: Cancer Health Disparities
Conference Year: 2020
Abstract Body:
Purpose: Mailed FIT kit and patient navigation (PN) programs are evidence-based
practices that increase colorectal cancer (CRC) screening. However, these programs
show low utility among Spanish-speaking Hispanics/Latinos. The purpose of this study
was to elicit perspectives on how to optimize the content and delivery of mailed FIT kit
instructions and PN for Spanish-speaking Hispanics/Latinos.
Methods: We conducted four focus groups with 22 Hispanics/Latinos. Eligibility criteria
included self-identification as Hispanic/Latino, age 50-75, and Spanish-speaking. We
recruited through bilingual flyers in primary care clinic waiting rooms, clinician referrals,
and community outreach. The moderator guide explored participants’ perspectives on the
acceptability of the current FIT kit instructions and PN, including their delivery
procedures, as well as initial and reminder letters to complete the mailed FIT kit. Data
analysis was conducted by two coders.
Results: Participants identified two types of patients: first-time FIT kit screeners and
subsequent screeners. Participants reported that the current FIT kit instructions were
difficult to follow for both groups. For the first time FIT kit screeners, participants
emphasized the need for a health educator to walk the patient through the collection
process. For both groups, participants described the need to enumerate the stool
collection steps, add an image of a person, and clarify the amount of stool to be
collected. Some participants reported that reminder letters for FIT kit completion were
interpreted as though the patient is receiving a cancer diagnosis. Phone or in-person
reminders were preferred over letters as patients valued the person-to-person
interaction. Most participants reported not knowing about PN or someone in a similar
role. When the role of a PN was described, participants agreed on the importance of
having access to this support, specifically from a culturally and linguistically concordant
PN.
Conclusion: Spanish-speaking Hispanics/Latinos report a need for tailored approaches to
promote CRC screening for first-time CRC screeners and subsequent screeners. Future
research will focus on optimizing these evidence-based practices to increase CRC
screening rates among Spanish-speaking Hispanics.
Keywords: Colorectal Cancer Screening, FIT, Patient Navigation, Spanish-speaking Hispanics/Latinos