Social vs. practical problems in attaining a colonoscopy: Different patient profiles?

Authors

Barbara A. Curbow, University of Maryland, College Park, Department of Behavioral and Community HealthFollow
Evelyn C. King-Marshall, University of Maryland, College Park, Department of Behavioral and Community HealthFollow
Nora Mueller, University of Maryland, College Park, Department of Behavioral and Community HealthFollow
travis hyams, University of Maryland, College Park, Department of Behavioral and Community HealthFollow
Shahnaz Sultan, North Florida/South Georgia Veterans Affairs Medical Center, Department of Medicine, University of FloridaFollow
Thomas J. George Jr, University of Florida, Department of medicineFollow

Keywords

Colorectal cancer, colonoscopy, health disparities

Disciplines

Community Health and Preventive Medicine | Epidemiology | Public Health Education and Promotion

Abstract

Background: Colonoscopy is an effective procedure for identifying precancerous polyps and cancerous lesions, but it is unlike other cancer screening tools in that it requires sedation and thus assistance from at least one other individual. The intent of this paper was to identify logistical problems in completing the colonoscopy and to examine their relationships with sociodemographic characteristics.

Methods: All eligible patients (n = 2500) from two academic-affiliated colonoscopy centers (one free standing, one hospital-based) were invited to participate in an onsite, pre-colonoscopy survey; patients agreeing to participate (n = 1841, RR = 73.6%) received a $5.00 gift card. Multiple correspondence analysis (MCA) was used to identify the underlying dimensional structure of the problems. Bivariate statistics were performed to compare demographic variables and health literacy levels among patients reporting problems. Multivariate logistic regression with a backwards conditional solution was used to determine the demographic variables independently associated with problems.

Results: Multiple correspondence analyses indicated two dimensions of problems (social and practical). Using logistic regression, social problems (e.g., finding someone to accompany the patient) were associated with not living in the same home as the driver, not working due to disability, and younger age. Practical problems (e.g., making an appointment) were associated with “other” minority race, poorer health, lower health literacy, and younger age.

Conclusion: Patients experience different problems completing the colonoscopy based on socio-demographics. Particularly at risk are patients who find it difficult to navigate the system, are of younger age, or who may have smaller social networks.

Recommended Citation

Curbow, Barbara A.; King-Marshall, Evelyn C.; Mueller, Nora; hyams, travis; Sultan, Shahnaz; and George, Thomas J. Jr (2018) "Social vs. practical problems in attaining a colonoscopy: Different patient profiles?," Journal of Health Disparities Research and Practice: Vol. 12: Iss. 1, Article 11.
Available at: https://digitalscholarship.unlv.edu/jhdrp/vol12/iss1/11