Association Between Spanish-Language Patient Navigation and Adherence to Multi-Target Stool DNA Testing Among Spanish-Speaking Patients at Sanitas Medical Center.
Mallik Greene, Timo Pew, Shrey Gohil, A Burak Ozbay, Juliana Vanessa Rincón López, Paul Limburg, Martha Duarte
{"title":"Association Between Spanish-Language Patient Navigation and Adherence to Multi-Target Stool DNA Testing Among Spanish-Speaking Patients at Sanitas Medical Center.","authors":"Mallik Greene, Timo Pew, Shrey Gohil, A Burak Ozbay, Juliana Vanessa Rincón López, Paul Limburg, Martha Duarte","doi":"10.1007/s13187-025-02742-8","DOIUrl":null,"url":null,"abstract":"<p><p>Colorectal cancer (CRC) screening rates remain low among Spanish-speaking populations, in part due to language barriers. This study examined the association between Spanish-language patient navigation on adherence to multi-target stool DNA (mt-sDNA) testing among Spanish-speaking patients at Sanitas Medical Center (SMC). This retrospective analysis utilized data from Exact Sciences Laboratories LLC. It included Spanish-speaking individuals aged 45 to 75 years who received an mt-sDNA test kit between October 1, 2021, and August 1, 2022. Patients were categorized based on Spanish-language outreach (SLO) or English-language outreach (ELO). Adherence was defined as the percentage of kits that were returned with completed tests and successful results within 365 days of the initial shipment date. Chi-square tests and multivariable logistic regression were used to compare adherence between groups and identify factors associated with adherence. The final sample included 3,101 patients in the SLO group and 1,331 in the ELO group. The SLO group showed a 4.4% absolute increase in adherence compared to the ELO group (64.3% vs. 59.9%, p = 0.006). At 30 days, adherence was already higher among SLO patients (45.1% vs. 41.5%), and this difference persisted throughout the 12-month follow-up period. The increase in adherence was consistent across subgroups, including patients aged 50-64 years (64.4% vs. 58.5%, p = 0.002), males (62.2% vs. 55.5%, p = 0.008), and those seen by primary care providers (64.9% vs. 59.8%, p = 0.029). In adjusted logistic regression, SLO was associated with 20% higher odds of adherence compared to ELO (OR = 1.20, 95% CI 1.05-1.37, p = 0.007). Spanish-language patient navigation was associated with a 4.4% higher adherence to mt-sDNA CRC screening among Spanish-speaking patients. These findings suggest that culturally and linguistically tailored communication may support improved screening participation in underserved populations.</p>","PeriodicalId":50246,"journal":{"name":"Journal of Cancer Education","volume":" ","pages":""},"PeriodicalIF":1.3000,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cancer Education","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s13187-025-02742-8","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"EDUCATION, SCIENTIFIC DISCIPLINES","Score":null,"Total":0}
引用次数: 0
Abstract
Colorectal cancer (CRC) screening rates remain low among Spanish-speaking populations, in part due to language barriers. This study examined the association between Spanish-language patient navigation on adherence to multi-target stool DNA (mt-sDNA) testing among Spanish-speaking patients at Sanitas Medical Center (SMC). This retrospective analysis utilized data from Exact Sciences Laboratories LLC. It included Spanish-speaking individuals aged 45 to 75 years who received an mt-sDNA test kit between October 1, 2021, and August 1, 2022. Patients were categorized based on Spanish-language outreach (SLO) or English-language outreach (ELO). Adherence was defined as the percentage of kits that were returned with completed tests and successful results within 365 days of the initial shipment date. Chi-square tests and multivariable logistic regression were used to compare adherence between groups and identify factors associated with adherence. The final sample included 3,101 patients in the SLO group and 1,331 in the ELO group. The SLO group showed a 4.4% absolute increase in adherence compared to the ELO group (64.3% vs. 59.9%, p = 0.006). At 30 days, adherence was already higher among SLO patients (45.1% vs. 41.5%), and this difference persisted throughout the 12-month follow-up period. The increase in adherence was consistent across subgroups, including patients aged 50-64 years (64.4% vs. 58.5%, p = 0.002), males (62.2% vs. 55.5%, p = 0.008), and those seen by primary care providers (64.9% vs. 59.8%, p = 0.029). In adjusted logistic regression, SLO was associated with 20% higher odds of adherence compared to ELO (OR = 1.20, 95% CI 1.05-1.37, p = 0.007). Spanish-language patient navigation was associated with a 4.4% higher adherence to mt-sDNA CRC screening among Spanish-speaking patients. These findings suggest that culturally and linguistically tailored communication may support improved screening participation in underserved populations.
在讲西班牙语的人群中，结直肠癌（CRC）筛查率仍然很低，部分原因是语言障碍。本研究在Sanitas医学中心（SMC）的西班牙语患者中调查了西班牙语患者导航与坚持多靶点粪便DNA （mt-sDNA）测试之间的关系。这项回顾性分析利用了Exact Sciences Laboratories LLC的数据。它包括在2021年10月1日至2022年8月1日期间接受mt-sDNA检测试剂盒的45至75岁的西班牙语个体。根据西班牙语外展（SLO）或英语外展（ELO）对患者进行分类。依从性的定义是在首次发货日期后365天内返回完成测试并取得成功结果的试剂盒的百分比。采用卡方检验和多变量logistic回归比较各组间的依从性，并确定与依从性相关的因素。最终样本包括SLO组3101例患者和ELO组1331例患者。与ELO组相比，SLO组的依从性绝对增加了4.4% （64.3% vs. 59.9%, p = 0.006）。在30天，SLO患者的依从性已经更高（45.1%对41.5%），并且这种差异在12个月的随访期间持续存在。依从性的增加在各个亚组中是一致的，包括50-64岁患者（64.4% vs. 58.5%, p = 0.002），男性（62.2% vs. 55.5%, p = 0.008）和初级保健提供者（64.9% vs. 59.8%, p = 0.029）。在调整后的逻辑回归中，与ELO相比，SLO与20%高的依从率相关（OR = 1.20, 95% CI 1.05-1.37, p = 0.007）。在说西班牙语的患者中，西班牙语患者导航与mt-sDNA CRC筛查依从性高4.4%相关。这些发现表明，在文化和语言上量身定制的沟通可能有助于改善服务不足人群的筛查参与。
期刊介绍：
The Journal of Cancer Education, the official journal of the American Association for Cancer Education (AACE) and the European Association for Cancer Education (EACE), is an international, quarterly journal dedicated to the publication of original contributions dealing with the varied aspects of cancer education for physicians, dentists, nurses, students, social workers and other allied health professionals, patients, the general public, and anyone interested in effective education about cancer related issues.
Articles featured include reports of original results of educational research, as well as discussions of current problems and techniques in cancer education. Manuscripts are welcome on such subjects as educational methods, instruments, and program evaluation. Suitable topics include teaching of basic science aspects of cancer; the assessment of attitudes toward cancer patient management; the teaching of diagnostic skills relevant to cancer; the evaluation of undergraduate, postgraduate, or continuing education programs; and articles about all aspects of cancer education from prevention to palliative care.
We encourage contributions to a special column called Reflections; these articles should relate to the human aspects of dealing with cancer, cancer patients, and their families and finding meaning and support in these efforts.
Letters to the Editor (600 words or less) dealing with published articles or matters of current interest are also invited.
Also featured are commentary; book and media reviews; and announcements of educational programs, fellowships, and grants.
Articles should be limited to no more than ten double-spaced typed pages, and there should be no more than three tables or figures and 25 references. We also encourage brief reports of five typewritten pages or less, with no more than one figure or table and 15 references.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
