Knowledge of polyp history and recommended follow-up among a predominately african american patient population and the impact of patient navigation

Background and Aims Colorectal screening (CRS) rates in minority and uninsured populations have increased through patient navigation (PN) interventions. However, patient knowledge of colonoscopy results and follow-up recommendations has not been described in an African American (AA) population or following PN. Our objectives were to determine patient knowledge of colonoscopy results and follow-up recommendations within an AA patient population and to compare post-colonoscopy knowledge among patients who received either PN or usual care. Methods This is a prospective observational study of patients who completed a screening colonoscopy in 2014. A semistructured telephone survey was completed by 96 participants (69% AA, 78% female, and mean age 63 years). The survey assessed patient recall of polyp results and follow-up recommendations. Responses were compared with the medical record. Results Of 96 patients surveyed (response rate, 68%), 83% accurately reported if polyps were detected and 66% accurately reported their recommended follow-up. The identification of adenomatous polyps on colonoscopy was a predictor of accurate recall of colonoscopy results and follow-up recommendations. Uninsured patients who completed PN (18 of 96) were more likely to accurately report polyp results (100 vs. 80%; P=0.036), but the rates of accurate follow-up recall were not statistically significant (44 vs. 71%; P=0.053) when compared to usual care patients. Conclusions In an AA population, post-colonoscopy polyp recall rates were similar to those described in white populations. Uninsured patients who completed PN were more likely than insured usual care patients to accurately report the presence of polyps on colonoscopy.