Assessment of patient navigation programs for breast cancer patients across the city of Boston

LeClair, Amy; Battaglia, Tracy A.; Casanova, Nicole; Haas, Jennifer S.; Freund, Karen M.; Moy, Beverly; Parsons, Susan K.; Ko, Naomi; Ross, Jo‐Ellen; Ohrenberger, Ellen; Mullikin, Katelyn; Lemon, Stephenie C.

doi:10.1007/s00520-021-06675-y

Cited by 6 publications

(9 citation statements)

References 27 publications

(49 reference statements)

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“…Addressing these barriers requires greater institutional funding and sustainability of patient navigation efforts to bolster existing personnel resources and hire additional patient navigators, as has been demonstrated in other studies of patient navigation [29]. Given the 2016 Commission on Cancer report that mandated patient navigation programs for accreditation, many clinical sites quickly adopted patient navigation models and programs, albeit in disparate ways with wide variation in implementation and use of navigators across sites [22]. Of note, the guidelines were updated in 2020 and do not mention any requirement for a patient navigation program [30].…”

Section: Discussionmentioning

confidence: 99%

“…Prior to the implementation of TRIP, a rigorous assessment of current patient navigation activities at each participating site was conducted [22]. While navigation services were offered to all patients being treated for breast cancer, sites varied widely on how navigation was funded, patients served by their programs, and the type of services provided [22]. One site ceased providing breast cancer services during the study period and thus no longer contributed data to the study.…”

Section: Settingmentioning

confidence: 99%

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Patient navigator team perceptions on the implementation of a citywide breast cancer patient navigation protocol: a qualitative study

Loo

Mullikin

Robbins

et al. 2022

BMC Health Serv Res

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Background In 2018 Translating Research Into Practice (TRIP), an evidence-based patient navigation intervention aimed at addressing breast cancer care disparities, was implemented across six Boston hospitals. This study assesses patient navigator team member perspectives regarding implementation barriers and facilitators one year post-study implementation. Methods We conducted in-depth qualitative interviews at the six sites participating in the pragmatic TRIP trial from December 2019 to March 2021. Navigation team members involved with breast cancer care navigation processes at each site were interviewed at least 12 months after intervention implementation. Interview questions were designed to address domains of the Consolidated Framework for Implementation Research (CFIR), focusing on barriers and facilitators to implementing the intervention that included 1) rigorous 11-step guidelines for navigation, 2) a shared patient registry and 3) a social risk screening and referral program. Analysis was structured using deductive codes representing domains and constructs within CFIR. Results Seventeen interviews were conducted with patient navigators, their supervisors, and designated clinical champions. Participants identified the following benefits provided by the TRIP intervention: 1) increased networking and connections for navigators across clinical sites (Cosmopolitanism), 2) formalization of the patient navigation process (Goals and Purpose, Access to Knowledge and Information, and Relative Advantage), and 3) flexibility within the TRIP intervention that allowed for diversity in implementation and use of TRIP components across sites (Adaptability). Barriers included those related to documentation requirements (Complexity) and the structured patient follow up guidelines that did not always align with the timeline of existing site navigation processes (Relative Priority). Conclusions Our analysis provides data using real-world experience from an intervention trial in progress, identifying barriers and facilitators to implementing an evidence-based patient navigation intervention for breast cancer care. We identified core processes that facilitated the navigators’ patient-focused tasks and role on the clinical team. Barriers encountered reflect limitations of navigator funding models and high caseload. Trial registration Clinical Trial Registration Number NCT03514433, 5/2/2018.

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Section: Discussionmentioning

confidence: 99%

Section: Settingmentioning

confidence: 99%

Patient navigator team perceptions on the implementation of a citywide breast cancer patient navigation protocol: a qualitative study

Loo

Mullikin

Robbins

et al. 2022

BMC Health Serv Res

Self Cite

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“…In one year, more than 200 patients were seen by a single PN, and all of them had their care coordinated, considered their needs, and wishes, and integrated them with the entire multi-professional team. Finally, among the various strategies used to improve the coordination of care and reduce the challenges arising from the complexity of cancer care, the PN is an intervention that shows considerable benefits for the outcomes of breast cancer patients (20,22,24) , and this was also evidenced by the operationalization of the PN described and the results presented in the report in such a short time of operation. Despite this, it is vital to recommend robust studies so that PNs, especially those led by nurses, are given a better scientific status.…”

Section: Discussionmentioning

confidence: 99%

“…Although there have been important advances in breast cancer diagnosis methods and treatment options in recent years, women who have been diagnosed still face a complex and tortu-ous emotional journey (20)(21) . Even though breast cancer can have a high cure rate and successful treatment, in Brazil, around 12.78 women per 100,000/year still die from the disease, and delay in diagnosis and/or treatment is one of the most plausible causes of this rate (22)(23)(24) .…”

Section: Discussionmentioning

confidence: 99%

Trajetória para implementação de programa de navegação de pacientes na oncologia: relato de experiência

Pautasso,

Trevilato,

Caregnato

et al. 2024

Online braz j nurs

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Objetivo: Descrever a trajetória para a implementação de um Programa de Navegação para pacientes oncológicos. Método: Estudo descritivo, tipo relato de experiência realizado em um Centro de Oncologia do Sul do Brasil. Resultados: O processo de implementação da navegação ocorreu em quatro etapas: a primeira iniciou com implementação da navegação para pacientes privados com câncer de cabeça e pescoço; a segunda envolveu o piloto do programa de navegação de pacientes com câncer de mama para entender as principais barreiras enfrentadas pelas pacientes; a terceira etapa, foi elaborar e aprovar a Política do Programa de Navegação Institucional. Na última, o Programa de Navegação da linha de cuidado da mama foi implementado para pacientes com indicação de neoadjuvância. Obteve-se redução de 70% na mediana de tempo de indicação e primeira consulta oncológica, de 28,6% no tempo entre sintoma e diagnóstico, 26,0% no tempo entre diagnóstico e início de tratamento. Conclusão: A implementação de um Programa de Navegação para pacientes com câncer exige dedicação e comprometimento institucional onde se evidencia um melhor cuidado oncológico, tendo o enfermeiro como protagonista da gestão e efetivação do processo.

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“…Navigators advocate for patients, addressing their concerns, providing information, and facilitating communication with healthcare providers. By offering culturally competent and patient-centered care, patient navigation programs can enhance engagement, decrease missed appointments, and ultimately increase the uptake of breast cancer screening [ 52 ].…”

Section: Reviewmentioning

confidence: 99%

From Awareness to Action: A Review of Efforts to Reduce Disparities in Breast Cancer Screening

Nayyar¹,

Chakole²,

Taksande³

et al. 2023

Cureus

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Breast cancer is a significant public health concern, and addressing disparities in breast cancer screening is crucial for improving early detection and reducing mortality rates. This review article examines efforts to bridge the gap between awareness and action in reducing disparities in breast cancer screening. A systematic approach was employed to gather relevant literature using various databases. The selected studies encompassed a range of interventions, including policy changes, community-based programs, culturally competent interventions, technological advancements, and patient navigation. The review highlights the importance of policies and legislation in improving access to screening services and the impact of community-based initiatives in addressing disparities. Culturally competent interventions, tailored messaging, and language support were found to be effective in improving screening rates among diverse populations. Technological advancements, such as telemedicine and mobile health applications, were identified as promising approaches to increase access to screening services. Patient navigation programs effectively addressed barriers to screening and improved screening rates. The review also discusses evaluating efforts, limitations, and the need for continuous improvement. Future directions and recommendations include addressing gaps in the existing literature, proposing research directions, and providing recommendations for policymakers, healthcare providers, and researchers. By implementing these recommendations and working collaboratively, we can strive for equitable access to breast cancer screening for all populations, ultimately leading to improved outcomes and reduced disparities.

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Assessment of patient navigation programs for breast cancer patients across the city of Boston

Abstract: Lemon SC. Assessment of patient navigation programs for breast cancer patients across the city of Boston.

Cited by 6 publications

References 27 publications

Patient navigator team perceptions on the implementation of a citywide breast cancer patient navigation protocol: a qualitative study

Patient navigator team perceptions on the implementation of a citywide breast cancer patient navigation protocol: a qualitative study

Trajetória para implementação de programa de navegação de pacientes na oncologia: relato de experiência

From Awareness to Action: A Review of Efforts to Reduce Disparities in Breast Cancer Screening

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