Processes of Change for Colonoscopy: Limited Support for Use Among Navigated Latinos

  • Gina Cotter
  • Katherine DuHamelEmail author
  • Elizabeth Schofield
  • Lina Jandorf


This study assessed the role of the processes of change (POC), a construct of the transtheoretical model, in colorectal cancer (CRC) screening among Latinos. Latinos participate in CRC screening less often and are diagnosed with CRC at a later stage than whites. POC items were administered to 344 English- and Spanish-speaking Latinos at average risk for CRC who had not had a colonoscopy in the past 5 years and received a colonoscopy referral. POC were measured at three timepoints: following informed consent (T1) at time of referral, 2 weeks prior to scheduled colonoscopy (T2), and 1 month after scheduled colonoscopy (T3). Participants received patient navigation as part of a randomized controlled trial to promote screening colonoscopy. POC scores were examined for changes during the course of the intervention, and logistic regression models assessed the relationship between POC scores and CRC screening adherence. Total POC scores decreased between T1 and T2 (p = 0.03) but were unchanged between T1 and T3. CRC screening adherence was not significantly associated with POC scores or change in POC scores over time. The POC instrument was not found useful for predicting colonoscopy adherence among Latinos in conjunction with patient navigation. Total POC scores did not increase during a patient navigation intervention despite high colonoscopy completion rates.


Colorectal cancer Processes of change Transtheoretical model Colonoscopy Latinos 



This study was funded by National Cancer Institute R01 CA140737 ( identifier NCT01569620) and National Institutes of Health Cancer Center Support Grant P30 CA008748.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© W. Montague Cobb-NMA Health Institute 2018

Authors and Affiliations

  1. 1.Department of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew YorkUSA
  2. 2.Department of Psychiatry and Behavioral SciencesMemorial Sloan Kettering Cancer CenterNew YorkUSA
  3. 3.Perelman School of Medicine at the University of PennsylvaniaPhiladelphiaUSA

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