Cost-Effectiveness of Community Interventions for Colorectal Cancer Screening: Low-Income Hispanic Population

Objective: To assess the cost-effectiveness of interventions to increase colorectal cancer (CRC) screening among low-income uninsured Hispanics in El Paso, Texas. Method: Participants 50 to 75 years old who were due for screening, were uninsured, and had a Texas address were randomized to promotora,...

Full description

Saved in:
Bibliographic Details
Published in:Health promotion practice 2018-11, Vol.19 (6), p.863-872
Main Authors: Lairson, David R., Kim, Junghyun, Byrd, Theresa, Salaiz, Rebekah, Shokar, Navkiran K.
Format: Article
Language:English
Subjects:
Bootstrap method
Colonoscopy
Colorectal cancer
Cost analysis
High risk
Hispanic Americans
Intervention
Latin American cultural groups
Low income groups
Medical screening
Models and Strategies for Policy, Systems, and Environmental Change
Sensitivity analysis
Uncertainty
Uninsured people
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective: To assess the cost-effectiveness of interventions to increase colorectal cancer (CRC) screening among low-income uninsured Hispanics in El Paso, Texas. Method: Participants 50 to 75 years old who were due for screening, were uninsured, and had a Texas address were randomized to promotora, video, or promotora and video interventions. High-risk participants were offered colonoscopy, while others were offered fecal immunochemical testing. A nonintervention comparison group was recruited from a similar Texas U.S.–Mexico border county. Screening was determined at 6 months postintervention. Resources were tracked prospectively to determine cost. Incremental cost-effectiveness ratios were assessed with “intention to treat” methods. Uncertainty in the estimates was analyzed with sensitivity analysis and nonparametric bootstrap methods. Results: The interventions achieved screening rates of between 75% and 87% compared to 10% in the comparison group. The cost per participant ranged from $72 for group sessions to $93 for individual video sessions with video and promotora. The group video sessions cost $104 per additional person screened. Conclusion: The CRC screening interventions were effective for increasing CRC screening. Compared to the experience in the control county, the group-based video-only intervention was the most cost-effective CRC screening promotion intervention.
ISSN:1524-8399
1552-6372
DOI:10.1177/1524839917750815