Predicting and Addressing Colonoscopy in Safety Net Settings

The prospective cohort study will evaluate the effectiveness of patient navigation in community health center settings. The investigators will collaborate with the advisory board, composed of key clinicians and patients, researchers, and policymakers, to establish a procedure to conduct and evaluate a patient navigation program that aims to increase rates of follow-up colonoscopy among diverse patient populations served by safety net clinics. Phase 1 will be a milestone-driven planning process in which the investigators will validate the risk prediction model and apply the risk prediction model to stratify the patients and adapt patient navigation materials for the local context. Phase II will be a large-scale, patient randomized-controlled trial that will include 1200 patients at a large 34-clinic community health center in Washington State.

本前瞻性队列研究旨在评估社区卫生中心场景下患者导航（patient navigation）的有效性。研究团队将与由核心临床医师、患者、研究者及政策制定者组成的咨询委员会开展合作，制定一套患者导航项目的实施与评估流程，该项目旨在提升安全网诊所服务覆盖的多样化患者群体的结肠镜随访检查率。第一阶段为里程碑驱动的规划流程，研究团队将在此阶段验证风险预测模型，将该模型应用于患者分层，并针对本地场景适配患者导航相关材料。第二阶段为大规模患者随机对照试验，将在华盛顿州一家拥有34家诊所的大型社区卫生中心招募1200名患者参与。