Background

Colorectal cancer (CRC) is the third leading cause of cancer-related death in the United States. Despite improvements in screening, testing for CRC is underutilized in some populations, suggesting a need to identify efficient test promotion strategies.

Methods

Our intervention guided individuals from low-income, underserved communities into primary care clinics to receive CRC screening referrals. Community sites were randomized to education or education plus navigation. The Phase I community-to-clinic navigation outcome was clinic attendance; the Phase II clinic-to-screening navigation outcome was screening completion. We used micro-costing to determine costs necessary to replicate our project in a similar, non-research setting.

Results

Over the 4-year project, startup costs tended to decrease as implementation costs increased. The largest component of startup costs (32 % of total) was community site recruitment. Implementation costs per class attendee were higher in the navigation group ($1084) than control ($798). But costs per participant who made a clinic appointment ($3573 versus $6292) and per participant who completed screening ($4083 versus $7640) were lower in the navigation group.

Conclusions

Our description of startup and implementation costs for this intervention provides decision makers with information needed to plan and budget for a similar project to guide individuals from community into clinics.

中文翻译：

---

结直肠癌筛查定制导航研究的启动和实施成本

背景

结直肠癌 (CRC) 是美国癌症相关死亡的第三大原因。尽管筛查有所改进，但在某些人群中，CRC 检测并未得到充分利用，这表明需要确定有效的检测推广策略。

方法

我们的干预指导来自低收入、服务欠缺社区的个人进入初级保健诊所接受 CRC 筛查转诊。社区网站被随机分配到教育或教育加导航。第一阶段的社区到诊所导航结果是就诊；II 期临床到筛查导航结果是筛查完成。我们使用微成本法来确定在类似的非研究环境中复制我们的项目所需的成本。

结果

在为期 4 年的项目中，随着实施成本的增加，启动成本趋于下降。启动成本的最大组成部分（占总成本的 32%）是社区网站招聘。导航组每位学员的实施成本（1084 美元）高于对照组（798 美元）。但在导航组中，每位进行诊所预约的参与者（3573 美元对 6292 美元）和每位完成筛查的参与者（4083 美元对 7640 美元）的成本较低。

结论

我们对这种干预的启动和实施成本的描述为决策者提供了规划和预算类似项目所需的信息，以指导个人从社区进入诊所。