ABSTRACT
This chapter discusses the implementation and results from two specific patient navigation programs implemented in San Antonio, Texas, to improve screening for colorectal and cervical cancer for an underserved Hispanic population. It describes the background and components of each patient navigation program, as well as how these programs incorporated principles of behavioral economics to improve screening rates and patient outcomes. The chapter presents results from the cost-effectiveness analysis of both programs and the sensitivity analyses with regard to several key cost and effectiveness parameters. It conducts the cost-effectiveness analysis of the patient navigation program to improve colonoscopy screening using a stochastic simulation model, based on a widely used modeling framework of the natural history of colorectal cancer. These new approaches focus on understanding the multiple-and oftentimes complex-processes that individuals use to make decisions, addressing biases in cancer risk and decision-making around cancer screening, and optimizing the choice architecture for individuals considering undergoing cancer screening.
