Abnormal Mammogram Follow‐up

Ell, Kathleen; Padgett, Deborah K.; Vourlekis, Betsy S.; Nissly, Jan; Pineda, Diana; Sarabia, Olga; Walther, Virginia; Blumenfield, Susan; Lee, Pey Jiuan

doi:10.1046/j.1523-5394.2002.103009.x

Cited by 64 publications

(89 citation statements)

References 33 publications

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“…25,37,38 A number of studies provided detailed descriptions of the design and implementation issues addressed during program development or research study. 19,33,34,37,38 In our qualitative data, navigators and program administrators reported that they addressed barriers by anticipating and resolving patients' problems, often by brokering patient relationships with service providers rather than by providing those services directly. For example, several programs reported helping transport patients to clinics.…”

Section: Do Programs Address Barriers?mentioning

confidence: 92%

“…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%

“…19 Other programs also report addressing cultural, educational, and language impediments to screening and treatment through outreach and education conducted by community health workers. 29,30,[33][34][35][36][37] Many programs report matching patients with navigators of similar ethnic and racial background. Table 1 summarizes the characteristics of 11 navigation programs we found described in the limited published literature and does not represent an exhaustive list of extant navigation programs.…”

Section: How Navigator Programs Are Organizedmentioning

confidence: 99%

“…Navigator programs have developed in response to local barriers to care, and few published studies of navigation include preresearch/postresearch designs or other systematic evaluations of program effects. 19,29,30,33,34,36 Some studies reviewed the services provided by emerging programs or presented limited comparative data on outcomes. 25,37,38 A number of studies provided detailed descriptions of the design and implementation issues addressed during program development or research study.…”

Section: Do Programs Address Barriers?mentioning

confidence: 99%

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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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Section: Do Programs Address Barriers?mentioning

confidence: 92%

Section: How Navigator Programs Are Organizedmentioning

confidence: 99%

Section: How Navigator Programs Are Organizedmentioning

confidence: 99%

Section: Do Programs Address Barriers?mentioning

confidence: 99%

See 2 more Smart Citations

Using navigators to improve care of underserved patients

Dohan

Schrag

2005

Cancer

400

371

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“…In the effort to remove barriers, patient navigators connect patients to resources and support systems, assist in the healthcare provider interaction, and streamline appointments and paperwork. 34 Several studies have found navigation to be efficacious in terms of improving both the timeliness of diagnostic resolution, 22,[35][36][37] and the stage at cancer diagnosis. [38][39][40] The largest effort to date to examine the role and benefits of navigation (i.e., to assess the timeliness of diagnosis and treatment, patient satisfaction and quality of life, and cost effectiveness) is the Patient Navigation Research Program (PNRP), a 10-site study funded by the National Cancer Institute, with additional support from the American Cancer Society.…”

Section: Introductionmentioning

confidence: 99%

Patient Barriers to Follow-Up Care for Breast and Cervical Cancer Abnormalities

Tejeda

Darnell

Cho

et al. 2013

Journal of Women's Health

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Background: Women with breast or cervical cancer abnormalities can experience barriers to timely follow-up care, resulting in delays in cancer diagnosis. Patient navigation programs that identify and remove barriers to ensure timely receipt of care are proliferating nationally. The study used a systematic framework to describe barriers, including differences between African American and Latina women; to determine recurrence of barriers; and to examine factors associated with barriers to follow-up care. Methods: Data originated from 250 women in the intervention arm of the Chicago Patient Navigation Research Program (PNRP). The women had abnormal cancer screening findings and navigator encounters. Women were recruited from a community health center and a publicly owned medical center. After describing proportions of African American and Latina women experiencing particular barriers, logistic regression was used to explore associations between patient characteristics, such as race/ethnicity, and type of barriers. Results: The most frequent barriers occurred at the intrapersonal level (e.g., insurance issues and fear), while institutional-level barriers such as system problems with scheduling care were the most commonly recurring over time (29%). The majority of barriers (58%) were reported in the first navigator encounter. Latinas (81%) reported barriers more often than African American women (19%). Differences in race/ethnicity and employment status were associated with types of barriers. Compared to African American women, Latinas were more likely to report an intrapersonal level barrier. Unemployed women were more likely to report an institutional level barrier. Conclusion: In a sample of highly vulnerable women, there is no single characteristic (e.g., uninsured) that predicts what kinds of barriers a woman is likely to have. Nevertheless, navigators appear able to easily resolve intrapersonal-level barriers, but ongoing navigation is needed to address system-level barriers. Patient navigation programs can adopt the PNRP barriers framework to assist their efforts in assuring timely follow-up care.

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Interventions to improve follow-up of abnormal findings in cancer screening

Bastani

Yabroff

Ph.D.

et al. 2004

Cancer

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The potential reduction in morbidity and mortality through cancer screening cannot be realized without receipt of appropriate follow-up care for abnormalities identified via screening. In this paper, the authors critically examine the existing literature on correlates of receipt of appropriate follow-up care for screen-detected abnormalities, as well as the literature on interventions designed to increase rates of receipt of follow-up care. Lessons learned describe what is known and not known about factors that are related to or predict receipt of follow-up care.Similarly, effective interventions to increase follow-up are described and gaps identified. A conceptual model is developed that categorizes the health care system in the United States as comprising four levels: policy, practice, provider, and patient. Some patient-level factors that influence follow-up receipt are identified, but the lack of data severely limit the understanding of provider, practice, and A long the continuum from cancer screening through diagnosis, treatment, and rehabilitation, little attention has focused on intervening to assure timely, effective diagnosis once an abnormality has been identified. To achieve the goal of reducing cancer morbidity and mortality, it is imperative that patients receive timely and appropriate follow-up for detected abnormalities, as a prerequisite to appropriate treatment. Failure to obtain appropriate diagnostic services can have a significant effect on psychosocial sequelae, morbidity, and mortality, as well as cost implications for the individual and the health care system. A recent review of studies on follow-up of abnormal screening examinations reported that, in the majority of studies, fewer than 75% of patients receive adequate follow-up care. 1 The negative implications of failure to follow-up are substantial, especially at the population level.

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Abnormal Mammogram Follow‐up

Abstract: Study results support the combining of interventions and the practical utility of a clinical decision-making algorithm to determine individualized nonadherence risk and to assign service intensity based on individual need. Problems in locating women for enrollment were experienced.

Cited by 64 publications

References 33 publications

Using navigators to improve care of underserved patients

Using navigators to improve care of underserved patients

Patient Barriers to Follow-Up Care for Breast and Cervical Cancer Abnormalities

Interventions to improve follow-up of abnormal findings in cancer screening

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