Provider- and System-Level Barriers and Facilitators to Colonoscopy and Multi-Target Stool DNA for Colorectal Cancer Screening in Rural/Remote Alaska Native Communities

Diana Redwood (), Melissa Toffolon, Christie Flanagan, John Kisiel, Judith Salmon Kaur, Lauren Jeffries, Manusake Zenku, Jennifer Lent and Joseph Bachtold
Additional contact information
Diana Redwood: Alaska Native Tribal Health Consortium, 3900 Ambassador Dr., Anchorage, AK 99508, USA
Melissa Toffolon: Actionable Data Consulting, P.O. Box 873427, Wasilla, AK 99687, USA
Christie Flanagan: Alaska Native Tribal Health Consortium, 3900 Ambassador Dr., Anchorage, AK 99508, USA
John Kisiel: Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA
Judith Salmon Kaur: Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA
Lauren Jeffries: Alaska Native Tribal Health Consortium, 3900 Ambassador Dr., Anchorage, AK 99508, USA
Manusake Zenku: Yukon-Kuskokwim Health Corporation, 829 Chief Eddy Hoffman Hwy, Bethel, AK 99559, USA
Jennifer Lent: Yukon-Kuskokwim Health Corporation, 829 Chief Eddy Hoffman Hwy, Bethel, AK 99559, USA
Joseph Bachtold: Yukon-Kuskokwim Health Corporation, 829 Chief Eddy Hoffman Hwy, Bethel, AK 99559, USA

IJERPH, 2023, vol. 20, issue 22, 1-13

Abstract: The Alaska Tribal Health System is working to increase colorectal cancer (CRC) screening among Alaska Native people, who experience the highest CRC rates in the world. This study examined CRC screening provider- and system-level barriers and facilitators from the perspective of healthcare providers serving Alaska Native people in rural/remote communities. A total of 28 provider (physicians, advanced practice, and Community Health Aides/Practitioners) interviews were held from 1 February to 30 November 2021. Colonoscopy provider-level barrier themes included time, competing priorities, and staffing, while system-level barriers included travel costs, weather, and the COVID-19 pandemic. Multi-target stool DNA (mt-sDNA) barrier themes included test viability and unfamiliarity, and previous stool tests experiences. For both tests, limited medical record reminders was a major barrier. Facilitator themes for both tests included community outreach, cultural competency and patient navigation, and clinic/system improvements. In-depth interviews with tribal health providers showed that adding mt-sDNA testing may help address system-level colonoscopy barriers such as waitlists and travel costs, but other barriers remain. Further research is needed into patient barriers and facilitators, as well as the effectiveness of integrating mt-sDNA into a geographically dispersed tribal health system to reduce cancer disparities and build equity in CRC prevention among Alaska Native people.

Keywords: Alaska Native; cancer screening; colorectal cancer; health care; provider; screening barriers; colorectal neoplasms/prevention and control; early detection of cancer; health personnel; surveys and questionnaires (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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