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- Title
Cost-Effectiveness of Community Interventions for Colorectal Cancer Screening: Low-Income Hispanic Population.
- Authors
Lairson, David R.; Kim, Junghyun; Byrd, Theresa; Salaiz, Rebekah; Shokar, Navkiran K.
- Abstract
Objective: To assess the cost-effectiveness of interventions to increase colorectal cancer (CRC) screening among low-income uninsured Hispanics in El Paso, Texas. Method: Participants 50 to 75 years old who were due for screening, were uninsured, and had a Texas address were randomized to promotora, video, or promotora and video interventions. High-risk participants were offered colonoscopy, while others were offered fecal immunochemical testing. A nonintervention comparison group was recruited from a similar Texas U.S.–Mexico border county. Screening was determined at 6 months postintervention. Resources were tracked prospectively to determine cost. Incremental cost-effectiveness ratios were assessed with “intention to treat” methods. Uncertainty in the estimates was analyzed with sensitivity analysis and nonparametric bootstrap methods. Results: The interventions achieved screening rates of between 75% and 87% compared to 10% in the comparison group. The cost per participant ranged from $72 for group sessions to $93 for individual video sessions with video and promotora. The group video sessions cost $104 per additional person screened. Conclusion: The CRC screening interventions were effective for increasing CRC screening. Compared to the experience in the control county, the group-based video-only intervention was the most cost-effective CRC screening promotion intervention.
- Subjects
TEXAS; RECTUM tumors; TUMOR prevention; COLON tumor prevention; COLON tumors; COLONOSCOPY; COMPARATIVE studies; COST effectiveness; HISPANIC Americans; IMMUNOCHEMISTRY; RESEARCH methodology; MEDICALLY uninsured persons; NONPARAMETRIC statistics; STATISTICAL sampling; VIDEO recording; SOCIOECONOMIC factors; COMMUNITY-based social services; RANDOMIZED controlled trials; DESCRIPTIVE statistics; EARLY detection of cancer; DIAGNOSIS
- Publication
Health Promotion Practice, 2018, Vol 19, Issue 6, p863
- ISSN
1524-8399
- Publication type
Article
- DOI
10.1177/1524839917750815