DNP Scholarly Projects

Abstract

Background: In 2021, cancer (CRC) screening rates for Latino men (42%) and women (47.5%) remain well below the Health People 2020 target (70.5%). Extensive documentation of barriers for screening include language, insurance status, and other sociocultural barriers which contribute to delays in diagnosis and/or diagnosis at advanced stages of the disease, and worse health outcomes. Latinos need culturally and linguistically appropriate health promotion interventions aimed to increase CRC screening rates with any modality (FIT, Cologuard, or Colonoscopy).

Methods: The Donabedian Structure-Process-Outcome (S-P-O) Model for quality improvement was used to develop and target a provider-driven, language-concordant communication interventions for Hispanic patients who were eligible for CRC screening according to the USPS Task Force Guidelines in a primary care practice in Nashville, TN.

Results: Out of the 458 Latino patients who were eligible for screening between August 2021-November 2022, only 124 were seen for an annual preventative visit in which screening was ordered. Out of the 124 patients who had orders for CRC screening and received the targeted communication intervention, 85 (68.5%) completed the screening and 39 (31.5%) did not complete the screening. Of those who completed the screening, 47 were insured (55.3%) and 38 were uninsured (44.7%).

Conclusion: This study shows that with targeted, linguistically appropriate provider recommendation, Latino patients agree to recommended screening at rates that approach the national benchmark. However most eligible Latino patients are not receiving the recommended screening because they underutilize annual wellness visits during which this counseling/awareness typically takes place. This highlights the need for providers to provide counseling and recommendation for routine cancer screening during any follow-up visits to increase screening uptake in this population.

Keywords: Hispanic/Latinos, insured/uninsured, self-pay, colorectal cancer screening, quality improvement, provider-driven interventions, language and cultural barriers.

Date

Spring 4-21-2023

First Advisor

Elizabeth Morse, DNP, MPH, FNP-BC

Second Advisor

David Phillippi, PhD

Scholarly Project Team Member

Erick Hernandez Campos, MSN, FNP-BC

Scholarly Project Team Member

Elizabeth Morse, DNP, MPH, FNP-BC

Scholarly Project Team Member

David Phillippi, PhD

Department

Nursing, School of

College

Health Sciences & Nursing, Gordon E. Inman College of

Document Type

Scholarly Project

Degree

Doctorate of Nursing Practice (DNP)

Degree Level

Doctoral

Degree Grantor

Belmont University

Keywords

Hispanic/Latinos; insured/uninsured; self-pay; colorectal cancer screening; quality improvement; provider-driven interventions; language barrier; cultural barrier.

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