Processes of Change for Colonoscopy: Limited Support for Use Among Navigated Latinos

Abstract

This study assessed the role of the Processes of Change (POC), a construct of the Transtheoretical Model, in colorectal cancer (CRC) screening among Latinos. Latinos participate in CRC screening less often and are diagnosed with CRC at a later stage than whites. POC items were administered to 344 English-and Spanish-speaking Latinos at average risk for CRC who had not had a colonoscopy in the past five years and received a colonoscopy referral. POC were measured at three timepoints: following informed consent (T1) at time of referral; 2 weeks prior to scheduled colonoscopy (T2); and 1 month after scheduled colonoscopy (T3). Participants received patient navigation as part of a randomized controlled trial to promote screening colonoscopy. POC scores were examined for changes during the course of the intervention, and logistic regression models assessed the relationship between POC scores and CRC screening adherence. Total POC scores decreased between T1 and T2 (p = 0.03), but were unchanged between T1 and T3. CRC screening adherence was not significantly associated with POC scores or change in POC scores over time. The POC instrument was not found useful for predicting colonoscopy adherence among Latinos in conjunction with patient navigation. Total POC scores did not increase during a patient navigation intervention despite high colonoscopy completion rates.