{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T04:52:18Z","timestamp":1774932738534,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T00:00:00Z","timestamp":1719446400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["1K07CA211971"],"award-info":[{"award-number":["1K07CA211971"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Patient navigation is a recommended practice to improve cancer screenings among underserved populations including those residing in rural areas with care access barriers. We report on patient navigation programme adaptations to increase follow\u2010up colonoscopy rates after abnormal fecal testing in rural primary care practices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participating clinics delivered a patient navigation programme to eligible patients from 28 affiliated clinics serving rural communities in Oregon clustered within 3 Medicaid health plans. Patient navigation adaptations were tracked using data sources including patient navigation training programme reflections, qualitative interviews, clinic meetings, and periodic reflections with practice facilitators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Initial, planned (proactive) adaptations were made to address the rural context; later, unplanned (reactive) adaptations were implemented to address the impact of the COVID\u201019 global pandemic. Initial planned adaptations to the patient navigation programme were made before the main trial to address the needs of the rural context, including provider shortages and geographic dispersion limiting both patient access to care and training opportunities for providers. Later unplanned adaptations were made primarily in response to COVID\u201019 care suspension and staff redeployments and shortages that occurred during implementation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>While unplanned adaptations were implemented to address the contextual impact of the COVID\u201019 pandemic on care access patterns and staffing, the changes to training content and context were beneficial to the rural setting overall and should be sustained. Our findings can guide future efforts to optimise the success of such programmes in other rural settings and highlight the important role of adaptations in implementation projects.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jep.14068","type":"journal-article","created":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T21:21:24Z","timestamp":1719523284000},"page":"1457-1466","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Adaptations to a patient navigation program for follow\u2010up colonoscopy in rural primary care practices"],"prefix":"10.1111","volume":"30","author":[{"given":"Jamie H.","family":"Thompson","sequence":"first","affiliation":[{"name":"Science Programs Department Kaiser Permanente Center for Health Research Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer S.","family":"Rivelli","sequence":"additional","affiliation":[{"name":"Science Programs Department Kaiser Permanente Center for Health Research Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer L.","family":"Schneider","sequence":"additional","affiliation":[{"name":"Science Programs Department Kaiser Permanente Center for Health Research Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin S.","family":"Kenzie","sequence":"additional","affiliation":[{"name":"Oregon Rural Practice\u2010based Research Network Oregon Health &amp; Science University Portland Oregon USA"},{"name":"OHSU\u2010PSU School of Public Health Division Oregon Health &amp; Science University Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Myers","sequence":"additional","affiliation":[{"name":"Oregon Rural Practice\u2010based Research Network Oregon Health &amp; Science University Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Coury","sequence":"additional","affiliation":[{"name":"Oregon Rural Practice\u2010based Research Network Oregon Health &amp; Science University Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melinda","family":"Davis","sequence":"additional","affiliation":[{"name":"Oregon Rural Practice\u2010based Research Network Oregon Health &amp; Science University Portland Oregon USA"},{"name":"OHSU\u2010PSU School of Public Health Division Oregon Health &amp; Science University Portland Oregon USA"},{"name":"Department of Family Medicine Oregon Health &amp; Science University Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priyanka","family":"Gautom","sequence":"additional","affiliation":[{"name":"Science Programs Department Kaiser Permanente Center for Health Research Portland Oregon USA"},{"name":"OHSU\u2010PSU School of Public Health Division Oregon Health &amp; Science University Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gloria D.","family":"Coronado","sequence":"additional","affiliation":[{"name":"Science Programs Department Kaiser Permanente Center for Health Research Portland Oregon USA"},{"name":"Department of Population Sciences University of Arizona Cancer Center Tucson Arizona USA"},{"name":"Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health University of Arizona Tucson Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,6,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.26262"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23815"},{"key":"e_1_2_10_4_1","unstructured":"CPSTF Recommends Patient Navigation Services to Increase Cancer Screening and Advance Health Equity. The Community Guide. Accessed April 4 2023.https:\/\/www.thecommunityguide.org\/news\/cpstf-recommends-patient-navigation-services-increase-cancer-screening-advance-health-equity.html"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2017.05.010"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-014-0505-0"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-020-06020-9"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28682"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.5989"},{"key":"e_1_2_10_10_1","unstructured":"Division of Cancer Prevention and Control.Patient Navigation Model for Increasing Colonoscopy Quality and Completion: a Replication Manual. Published online October2016.https:\/\/www.cdc.gov\/cancer\/crccp\/pn-replication-manual.htm?s_cid=govD_CancerManual_03"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31864"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djad032"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s43058-022-00285-3"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-021-01105-3"},{"key":"e_1_2_10_15_1","unstructured":"KobrinS HooverS McCarthyS et al.Framework for implementing colorectal cancer screening to increase equity.In Preparation."},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1353\/cpr.2024.a922329"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2019.105920"},{"key":"e_1_2_10_18_1","unstructured":"NVivo. Lumivero. Accessed August 22 2023.https:\/\/lumivero.com\/products\/nvivo\/"},{"issue":"1","key":"e_1_2_10_19_1","first-page":"26","article-title":"Applying constant comparative method with multiple investigators and inter\u2010coder reliability","volume":"21","author":"Olson J","year":"2016","journal-title":"The Qualitative Report"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-018-0610-y"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12793"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.6238"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-015-3572-3"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/1524839915616362"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2020.10.009"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.2196\/14191"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.10427.2"}],"container-title":["Journal of Evaluation in Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jep.14068","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T06:03:24Z","timestamp":1727935404000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jep.14068"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,27]]},"references-count":26,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1111\/jep.14068"],"URL":"https:\/\/doi.org\/10.1111\/jep.14068","archive":["Portico"],"relation":{},"ISSN":["1356-1294","1365-2753"],"issn-type":[{"value":"1356-1294","type":"print"},{"value":"1365-2753","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,27]]},"assertion":[{"value":"2024-03-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}