Lay patient navigator program implementation for equal access to cancer care and clinical trials: essential steps and initial challenges.

Full Abstract

BACKGROUND:
Disparities in cancer detection, treatment, and outcomes among racial/ethnic minorities and low-income patients are well documented. One way to reduce these disparities is to use patient navigators to address barriers to care. However, little information about optimal characteristics of navigator programs or considerations for those interested in setting up such programs is available.

METHODS:
The design and implementation of a patient navigator program for underserved cancer patients in an urban, nonacademic community hospital setting is described. The program, which used lay navigators, was conceived as a component of the Urban Latino African American Cancer (ULAAC) Disparities Project in South Los Angeles, a National Cancer Institute (NCI)-sponsored project to improve cancer care and clinical trial access for minority and low-income patients.

RESULTS:
Careful initial planning, including input from a community advisory committee, was essential to smooth program implementation. Thirty-one volunteers completed navigator training in the program's first year of operation. Of 135 patients offered navigation services, 75 (56%) accepted, and preliminary feedback from patients, navigators, and providers suggests high levels of satisfaction with navigation. Standardized templates used by navigators and staff to record key information are proving helpful for monitoring quality and outcomes (such as effectiveness in addressing specific barriers to care) and continually improving the program.

CONCLUSIONS:
The ULAAC program represents a viable model for developing lay navigator programs in community hospitals. Preliminary assessments suggest that the program has a positive effect on minority and low-income cancer patients' experience with care and reduces barriers to care. Additional time and research are needed, however, to fully assess the impact on care and outcomes.(c) 2006 American Cancer Society.

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Author information

Author/s: Steinberg, Michael L (ML); Fremont, Allen (A); Khan, David C (DC); Huang, David (D); Knapp, Herschel (H); Karaman, Deborah (D); Forge, Nell (N); Andre, Keith (K); Chaiken, Lisa M (LM); Streeter, Oscar E (OE);

Affiliation: Radiation Oncology, Centinela Freeman Regional Medical Center, Inglewood, California, USA.

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Cancer (Cancer), published in United States. (Language: eng)

Reference: 2006-Dec; vol 107 (issue 11) : pp 2669-77

Dates: Created 2006/11/27; Completed 2006/12/19; Revised 2007/11/15;

PMID: 17078056, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Minority Groups
Neoplasms - diagnosis; ethnology; therapy
Patient Advocacy
Social Class

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