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Impact of Patient Navigation Interventions on Timely Diagnostic Follow Up for Abnormal Cervical Screening.

Publication ,  Journal Article
Paskett, ED; Dudley, D; Young, GS; Bernardo, BM; Wells, KJ; Calhoun, EA; Fiscella, K; Patierno, SR; Warren-Mears, V; Battaglia, TA ...
Published in: J Womens Health (Larchmt)
January 2016

OBJECTIVE: As part of the Patient Navigation Research Program, we examined the effect of patient navigation versus usual care on timely diagnostic follow-up, defined as clinical management for women with cervical abnormalities within accepted time frames. METHODS: Participants from four Patient Navigation Research Program centers were divided into low- and high-risk abnormality groups and analyzed separately. Low-risk participants (n = 2088) were those who enrolled with an initial Pap test finding of atypical squamous cells of undetermined significance (ASCUS) with a positive high-risk human papillomavirus (HPV) serotype, atypical glandular cells, or low-grade squamous intraepithelial lesion (LGSIL). High-risk participants were those with an initial finding of high-grade squamous intraepithelial lesion (HGSIL) (n = 229). A dichotomous outcome of timely diagnostic follow-up within 180 days was used for the low-risk abnormality group and timely diagnostic follow-up within 60 days for the high-risk group, consistent with treatment guidelines. A logistic mixed-effects regression model was used to evaluate the intervention effect using a random effect for study arm within an institution. A backward selection process was used for multivariable model building, considering the impact of each predictor on the intervention effect. RESULTS: Low-risk women in the patient navigation arm showed an improvement in the odds of timely diagnostic follow-up across all racial groups, but statistically significant effects were only observed in non-English-speaking Hispanics (OR 5.88, 95% CI 2.81-12.29). No effect was observed among high-risk women. CONCLUSION: These results suggest that patient navigation can improve timely diagnostic follow-up among women with low-risk cervical abnormalities, particularly in non-English-speaking Hispanic women.

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Published In

J Womens Health (Larchmt)

DOI

EISSN

1931-843X

Publication Date

January 2016

Volume

25

Issue

1

Start / End Page

15 / 21

Location

United States

Related Subject Headings

  • Vaginal Smears
  • Uterine Cervical Neoplasms
  • Uterine Cervical Dysplasia
  • United States
  • Time Factors
  • Risk Factors
  • Public Health
  • Pregnancy
  • Patient Navigation
  • Papillomavirus Infections
 

Citation

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Paskett, E. D., Dudley, D., Young, G. S., Bernardo, B. M., Wells, K. J., Calhoun, E. A., … PNRP Investigators, . (2016). Impact of Patient Navigation Interventions on Timely Diagnostic Follow Up for Abnormal Cervical Screening. J Womens Health (Larchmt), 25(1), 15–21. https://doi.org/10.1089/jwh.2014.5094
Paskett, Electra D., Donald Dudley, Gregory S. Young, Brittany M. Bernardo, Kristen J. Wells, Elizabeth A. Calhoun, Kevin Fiscella, et al. “Impact of Patient Navigation Interventions on Timely Diagnostic Follow Up for Abnormal Cervical Screening.J Womens Health (Larchmt) 25, no. 1 (January 2016): 15–21. https://doi.org/10.1089/jwh.2014.5094.
Paskett ED, Dudley D, Young GS, Bernardo BM, Wells KJ, Calhoun EA, et al. Impact of Patient Navigation Interventions on Timely Diagnostic Follow Up for Abnormal Cervical Screening. J Womens Health (Larchmt). 2016 Jan;25(1):15–21.
Paskett, Electra D., et al. “Impact of Patient Navigation Interventions on Timely Diagnostic Follow Up for Abnormal Cervical Screening.J Womens Health (Larchmt), vol. 25, no. 1, Jan. 2016, pp. 15–21. Pubmed, doi:10.1089/jwh.2014.5094.
Paskett ED, Dudley D, Young GS, Bernardo BM, Wells KJ, Calhoun EA, Fiscella K, Patierno SR, Warren-Mears V, Battaglia TA, PNRP Investigators. Impact of Patient Navigation Interventions on Timely Diagnostic Follow Up for Abnormal Cervical Screening. J Womens Health (Larchmt). 2016 Jan;25(1):15–21.
Journal cover image

Published In

J Womens Health (Larchmt)

DOI

EISSN

1931-843X

Publication Date

January 2016

Volume

25

Issue

1

Start / End Page

15 / 21

Location

United States

Related Subject Headings

  • Vaginal Smears
  • Uterine Cervical Neoplasms
  • Uterine Cervical Dysplasia
  • United States
  • Time Factors
  • Risk Factors
  • Public Health
  • Pregnancy
  • Patient Navigation
  • Papillomavirus Infections