New Hampshire Colorectal Cancer Screening Program Patient Navigation Model Replication Manual

The New Hampshire Colorectal Cancer Screening Program (NHCRCSP)external icon patient navigation model was shown to be highly effective in increasing the completion and quality of colonoscopy screening among groups that have a low income and do not have adequate health insurance. The results of a comparison group study conducted during the CRCCP funded from 2009–2015 showed that NHCRCSP-navigated patients were 11 times more likely to complete their colonoscopy than non-navigated patients. Given its success, CDC and NHCRCSP developed a manual to help others replicate the model.

This manual provides specific information and tools to replicate the NHCRCSP patient navigation model. Detailed information is provided on implementing a model that improves completion of colonoscopy and follow-up, increases patient knowledge about their tests and results, and improves overall screening quality and patient satisfaction.

Intended Audiences

Any organization that conducts colorectal cancer screening or administers a colonoscopy program may benefit from implementing this intervention. Organizations could include health systems, endoscopy centers, primary care practices (including federally qualified health centers), universities, state or local health departments, and other CDC award recipients. This manual also may be useful for health care providers, pharmacy staff, and other community partners to clarify their roles in the intervention and how it benefits their patients.

Please note: This manual was published in October 2016. In 2021, the United States Preventive Services Task Force expanded its colorectal cancer screening recommendationsexternal icon to include routine screening for those who are 45 to 49 years old; previously, routine screening was recommended for those who are 50 to 75 years old. The current recommendation is not reflected in this manual.

Related Research

DeGroff A, Gressard L, Glover-Kudon R, Rice K, Tharpe FS, Escoffery C, Gersten J, Butterly L. Assessing the implementation of a patient navigation intervention for colonoscopy screening.external icon BMC Health Services Research 2019;19(1):803. DOI: 10.1186/s12913-019-4601-4. external icon

Rice K, Sharma K, Li Chunyu, Gersten J, Butterly L, DeGroff A. Cost-effectiveness of a patient navigation intervention to increase colonoscopy screening among low-income adults in New Hampshire.external icon Cancer 2019;125(4):601–609. DOI: 10.1002/cncr.31864.external icon

Rice K, Gressard L, DeGroff A, Gersten J, Robie J, Leadbetter S, Glover-Kudon R, Butterly L. Increasing colonoscopy screening in disparate populations: results from an evaluation of patient navigation in the New Hampshire Colorectal Cancer Screening Program.external icon Cancer 2017;123(17):3356–3366. DOI: 10.1002/cncr.30761.external icon

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Patient Navigators

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Page last reviewed: February 15, 2022