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Evaluation of a 2-1-1 Telephone Navigation Program to Increase Cancer Control Behaviors: Results From a Randomized Controlled Trial

2022; SAGE Publishing; Volume: 36; Issue: 7 Linguagem: Inglês

10.1177/08901171211041276

2168-6602

María E. Fernández, Lara S. Savas, John S. Atkinson, Katherine Ball Ricks, Lynn N. Ibekwe, Inimfon Jackson, Philip E. Castle, David Jobe, Sally W. Vernon,

Health Literacy and Information Accessibility

Purpose: To evaluate the effectiveness of a telephone navigation intervention for increasing use of cancer control services among underserved 2-1-1 callers. Design: Randomized controlled trial. Setting: 2-1-1 call centers in Houston and Weslaco, Texas (located in the Rio Grande Valley near the Mexican border). Participants: 2-1-1 callers in need of Pap test, mammography, colorectal cancer screening, smoking cessation counseling, and/or HPV vaccination for a daughter (n = 1,554). A majority were low-income and described themselves as Black or Hispanic. Intervention: Participants were randomly assigned to receive either a cancer control referral for the needed service(s) with telephone navigation from a trained cancer control navigator (n = 995) or a referral only (n = 559). Measures: Uptake of each individual service and any needed service. Analysis: Assessed uptake in both groups using bivariate chi-square analyses and multivariable logistic regression analyses, adjusted for sociodemographic covariates. Both per-protocol and intent-to-treat approaches were used. Results: Both interventions increased cancer control behaviors. Referral with navigation intervention resulted in significantly greater completion of any needed service (OR = 1.38; p = .042), Pap test (OR = 1.56; p = .023), and smoking cessation counseling (OR = 2.66; p = .044), than referral-only condition. Other outcomes showed the same trend although the difference was not statistically significant: mammography (OR = 1.53; p = .106); colorectal cancer screening (OR = 1.80; p = .095); and HPV vaccination of a daughter (OR = 1.61; p = .331). Conclusion: Adding cancer control referrals and navigation to an informational service like the 2-1-1 program can increase overall participation in cancer control services.