Domingo Jermy-Leigh B, Braun Kathryn L
J Health Care Poor Underserved. 2017;28(1):108-126. doi: 10.1353/hpu.2017.0013.
In the U.S., colorectal cancer (CRC) incidence and mortality have declined due to screening and improvements in early detection; however, racial/ethnic disparities in screening and mortality persist. Patient navigation has been shown to be effective in increasing CRC screening prevalence. This systematic review answered three questions about navigation in federally qualified community health centers (FQHCs): 1) Which navigation activities increased CRC screening prevalence? 2) What were the challenges to implementing these programs in FQHCs? 3) Which clinic protocols supported screening completion? Findings suggest that navigation services must be tailored to the specific screening test provided. Federally qualified community health centers report difficulty maintaining a current electronic medical records system and sustaining funding; they should establish excellent patient tracking systems (for follow-up and annual rescreening) and establish multiple protocols to facilitate screening completion. With the movement toward patient-centered care models, patient navigation will be integral to FQHCs and their clients.
在美国，由于筛查和早期检测的改善，结直肠癌（CRC）的发病率和死亡率有所下降；然而，筛查和死亡率方面的种族/民族差异仍然存在。患者导航已被证明在提高CRC筛查普及率方面是有效的。本系统综述回答了关于联邦合格社区卫生中心（FQHCs）中导航的三个问题：1）哪些导航活动提高了CRC筛查普及率？2）在FQHCs中实施这些项目面临哪些挑战？3）哪些诊所方案支持筛查完成？研究结果表明，导航服务必须根据所提供的特定筛查测试进行调整。联邦合格社区卫生中心报告称，在维护当前的电子病历系统和维持资金方面存在困难；它们应建立完善的患者跟踪系统（用于随访和年度重新筛查），并建立多种方案以促进筛查完成。随着向以患者为中心的护理模式的转变，患者导航对于FQHCs及其客户将不可或缺。
