Abnormal Cervical Screen Follow-Up among Low-Income Latinas: Project SAFe

Ell, Kathleen; Vourlekis, Betsy S.; Muderspach, Laila I.; Nissly, Jan; Padgett, Deborah K.; Pineda, Diana; Sarabia, Olga; Lee, Pey Jiuan

doi:10.1089/152460902760360586

Cited by 82 publications

(100 citation statements)

References 38 publications

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“…Prior studies have demonstrated the benefits of navigator programs for cancer prevention in general and for CRC screening in particular. [35][36][37][38][39][40][47][48][49] Tu et al's health educator study among US ethnic Chinese patients focused on FOBT rather than colonoscopy screening and showed a 5.98 increased odds for FOBT screening among intervention patients over the 6-month study. 41 A study using centralized telephone case management among low-income women increased rates of CRC screening by 13% (95% CI 7-20%) in intervention compared to usual care patients.…”

Section: Discussionmentioning

confidence: 99%

A Culturally Tailored Navigator Program for Colorectal Cancer Screening in a Community Health Center: A Randomized, Controlled Trial

et al. 2008

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Section: Discussionmentioning

confidence: 99%

A Culturally Tailored Navigator Program for Colorectal Cancer Screening in a Community Health Center: A Randomized, Controlled Trial

et al. 2008

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“…Work and child-care responsibilities also contribute to missed appointments 32,33 . Inadequate communication, our second most prominent systems barrier, was recognized and targeted in Project SAFe, which was designed to improve abnormal cervical screen follow-up among low-income Latinas 33 .…”

Section: Discussionmentioning

confidence: 99%

Barriers to Follow-Up of an Abnormal Pap Smear in Latina Women Referred for Colposcopy

et al. 2010

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BACKGROUND: Lower rates of follow-up after an abnormal Pap smear in racial and ethnic minorities may contribute to the higher incidence and mortality rates of cervical cancer seen in these groups. OBJECTIVE: To identify patient-perceived barriers to follow-up after an abnormal Pap smear result among Latina women. DESIGN, PARTICIPANTS AND APPROACH: Qualitative, semi-structured, one-on-one interviews were conducted with patients from an academic hospitalaffiliated urban community health center. Three groups of women were interviewed: new colposcopy clinic patients, patients who had previous colposcopies and patients enrolled in the health center's patient navigator program. Open-ended questions explored their knowledge, beliefs and experiences with colposcopy. Content analysis of transcripts was performed using established qualitative techinques. RESULTS: Of 40 Latina women recruited, 75% spoke only Spanish. The average age was 31.5 (range 18-55). Personal and system barriers identified were categorized into four themes: (1) anxiety/fear of procedure and diagnosis; (2) scheduling/availability of appointments interfering with work and/or child care; (3) inadequate communication about appointments, including lack of explanation regarding diagnosis, procedure and results; and (4) pain. New patients more commonly reported problems with scheduling and communication. Followup patients were more concerned about pain, and navigated women most often reported fear of results but had fewer concerns about inadequate communication. CONCLUSION: Anxiety/fear was the most common personal barrier, while difficulty scheduling appointments and inadequate communication were the major systems barriers identified in these Latina women. Interventions to lower these barriers to colposcopy among Latina women may increase adherence to follow-up of abnormal Pap smears.

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“…The particular services provided by navigators depend on the barriers they identify and the strategies they adopt to eliminate or reduce those barriers. 18,19,29,30 This barrier-focused approach emerged clearly in the qualitative data. In the clinic we studied, navigators provided a variety of services, such as locating misplaced charts, interpreting for non-Englishspeaking patients, and providing emotional or educational support for patients and families.…”

Section: Defining Patient Navigationmentioning

confidence: 93%

“…Navigator programs have been established throughout the United States with support from private foundations, 19,31,32 in conjunction with grants from federal, state, and local government, 29,30,33 and through local initiatives by cancer centers, community-based clinics, and philanthropy. 19,34,35 Freeman et al's program in Harlem targeting "high incidence of late-stage cancer and poor prognostic outcomes of low-income and medically underserved minorities" has served as a paradigm for other navigation programs.…”

Section: How Navigator Programs Are Organizedmentioning

confidence: 99%

Using navigators to improve care of underserved patients

Dohan

Schrag

2005

Cancer

400

371

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BACKGROUNDLogistic, cultural, educational, and other barriers can impede the delivery of high‐quality cancer care to underserved patients. Patient navigation services represent one innovation for addressing perceived barriers to care encountered by disadvantaged patients. In this report, the authors have 1) defined patient navigation, distinguishing it from other cancer support services; 2) described how programs are organized; and 3) discussed the need for research on program effectiveness.METHODSInformation was examined on navigation programs published in the scientific literature and on line. Qualitative research also was conducted, consisting of direct observation of patient care in cancer clinics with and without navigators in northern California, in‐person interviews with personnel and patients in the clinics observed, and telephone interviews with navigators at four sites across the United States.RESULTSThe authors found that navigation services have been implemented at all stages of cancer care: prevention, screening, treatment, and survival. Navigators differ from other cancer support personnel in their orientation toward flexible problem solving to overcome perceived barriers to care rather than the provision of a predefined set of services. There are no rigorous demonstrations of the effects and effectiveness of navigation, although such studies are underway.CONCLUSIONSCurrently, patient navigation is understudied, and literature documenting its effects and effectiveness is scant. Rigorous studies are needed of the navigator role and program costs and benefits. Such studies will facilitate an assessment of program effectiveness, feasibility across a range of health care settings, and performance relative to alternative approaches for addressing barriers to care among the underserved. Cancer 2005. © 2005 American Cancer Society.

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Abnormal Cervical Screen Follow-Up among Low-Income Latinas: Project SAFe

Cited by 82 publications

References 38 publications

A Culturally Tailored Navigator Program for Colorectal Cancer Screening in a Community Health Center: A Randomized, Controlled Trial

A Culturally Tailored Navigator Program for Colorectal Cancer Screening in a Community Health Center: A Randomized, Controlled Trial

Barriers to Follow-Up of an Abnormal Pap Smear in Latina Women Referred for Colposcopy

Using navigators to improve care of underserved patients

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