Research

Using a mixed-methods approach, this study aims to identify the potentially modifiable patient, provider, and system-level barriers to colonoscopy to inform interventions to improve colonoscopy completion in a safety-net population with abnormal FIT results. Analysis of qualitative patient data and finalization of a multilevel intervention are ongoing.

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Perceptions on Barriers and Facilitators to Colonoscopy Completion After Abnormal Fecal Immunochemical Test Results in a Safety Net System
Barriers associated with inadequate follow-up of abnormal fecal immunochemical test results in a safety-net system: A mixed-methods analysis

Through stakeholder engagement, we determined the barriers and facilitators to implementing a rideshare transportation program for colonoscopy completion in a safety-net health system. A pilot of the rideshare transportation intervention to improve colorectal cancer screening and follow-up screening is ongoing.

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Operationalizing a Rideshare Intervention for Colonoscopy Completion: Barriers, Facilitators, and Process Recommendations
Health System-Provided Rideshare Is Safe and Addresses Barriers to Colonoscopy Completion

In Western Washington, colorectal cancer mortality is highest In American Indian/Alaska Natives and Black people. We found that delays in diagnostic evaluation after presenting with symptoms suggestive of colorectal cancer alone, unlikely explains this disparity. An evaluation of surveillance colonoscopy after patients have been diagnosed and treated for colorectal cancer  that might explain this disparity is ongoing.

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Racial Disparities in Colorectal Cancer Mortality: The Role of Endoscopy Wait-Time and Stage at Diagnosis