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

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 Mexic...

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Bibliographic Details
Published in:American journal of health promotion 2022-09, Vol.36 (7), p.1083-1093
Main Authors: Fernandez, Maria E., Savas, Lara S., Atkinson, John S., Ricks, Katherine Ball, Ibekwe, Lynn N., Jackson, Inimfon, Castle, Philip E., Jobe, David, Vernon, Sally W.
Format: Article
Language:English
Subjects:
Call centers
Clinical trials
Colorectal cancer
Colorectal Neoplasms - diagnosis
Colorectal Neoplasms - prevention & control
Counseling
Early Detection of Cancer - methods
Health promotion
Human papillomavirus
Humans
Immunization
Intervention
Mammography
Medical screening
Navigation
Pap smear
Papillomavirus Infections
Referrals
Smoking
Smoking cessation
Smoking Cessation - methods
Sociodemographics
Telephone
Underserved populations
Uptake
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Summary: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.
ISSN:0890-1171
2168-6602
DOI:10.1177/08901171211041276