Case Management Intervention in Cervical Cancer Prevention: The Boston REACH Coalition Women’s Health Demonstration Project

Clark, Cheryl R.; Baril, Nashira; Hall, Angela; Kunicki, Marycarmen; Johnson, Natacha; Soukup, Jane; Lipsitz, Stuart R.; Bigby, JudyAnn

doi:10.1353/cpr.2011.0029

Cited by 1 publication

(2 citation statements)

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“…In previous studies, lack of insurance was reported to delay follow-up care. 5,[20][21][22] Whereas low-income African American women in this study may have access to Medicaid, immigration status may impede eligibility for Latina women. Navigators enrolled women in Stand Against Cancer, a state program that finances cancer screenings and treatment for uninsured, low-income women regardless of immigration status.…”

Section: Discussionmentioning

confidence: 95%

“…4 These observed mortality and survival disparities are attributed to a number of factors, including delayed follow-up to abnormal cancer screening. 3,[5][6][7][8][9][10][11][12][13] Studies have reported individual factors associated with delays, including minority ethnicity; 5,11,[14][15][16][17][18][19] lack of health insurance or limitations of public insurance; 5,[20][21][22] younger age; 17,20,22 having less than a high school diploma; 18,23,24 and lack of regular access to a healthcare provider. 16 Medical-related factors associated with delay include absence of breast symptoms; 15,25 less severe test findings; 5,26 or previous abnormal test findings.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 95%