Culturally Relevant “Navigator”Patient Support The Native Sisters

Burhansstipanov, Linda; Wound, Della Bad; Capelouto, Nina; Goldfarb, Fran D.; Harjo, Lisa D.; Hatathlie, Lenora; Vigil, Gaylene; White, M D

doi:10.1046/j.1523-5394.1998.006003191.x

Cited by 71 publications

(66 citation statements)

References 5 publications

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“…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. 19 That program seeks to address perceived barriers stemming from mistrust and system complexity by training and employing lay individuals to provide one-on-one follow-up and case management.…”

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%

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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: How Navigator Programs Are Organizedmentioning

confidence: 99%

Section: How Navigator Programs Are Organizedmentioning

confidence: 99%

Using navigators to improve care of underserved patients

Dohan

Schrag

2005

Cancer

400

371

View full text Add to dashboard Cite

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“…3,[12][13][14][15][16][17][18] Specific barriers to care were identified for each patient and addressed by the PN through a combination of strategies including organizing the participants' transport, scheduling multiple appointments on one day, facilitating child-care, looking into insurance issues or financial support and facilitating communication both in terms of translation and explaining health terminology. 3,[12][13][14][15][16][17][18] Furthermore, the PN built personal relationships with the participants, thus providing emotional support; they talked to the participants about all aspects of their cancer care and informed them about different support group and counselling options. 3,12,[14][15][16][17][18] There was a clear distinction between the roles of the community-based PN and the hospital-based PN.…”

Section: The Patient Navigators' Role and Trainingmentioning

confidence: 99%

“…3,[12][13][14][15][16][17][18] Furthermore, the PN built personal relationships with the participants, thus providing emotional support; they talked to the participants about all aspects of their cancer care and informed them about different support group and counselling options. 3,12,[14][15][16][17][18] There was a clear distinction between the roles of the community-based PN and the hospital-based PN. Community-based PN largely focused on awareness and prevention of cancer, networking and the maintenance of relationships with local health agencies, whereas hospital-based PN primarily assisted Indigenous people with cancer through their cancer-related treatment and social and emotional issues.…”

Section: The Patient Navigators' Role and Trainingmentioning

confidence: 99%

Navigating the cancer journey: A review of patient navigator programs for Indigenous cancer patients

Whop

Valery

Beesley

et al. 2012

Asia-Pac J Clncl Oncology

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Patient navigator programs have evolved to facilitate access to care and improve outcomes for Indigenous cancer patients. We reviewed the scientific literature on patient navigator programs in Indigenous people with cancer. We conducted a review of the published literature up to 13 April 2011. PubMed, MEDLINE and CINAHL databases were searched for original articles on Indigenous patient navigation programs. The review produced eight relevant articles covering two specific programs, the Native Sisters Program and the Walking Forward Program. Program descriptions, patient navigator's roles, cultural aspects and the impact of the programs were described. Patient navigators' roles in the programs varied, as did their qualifications, but importantly, all were Indigenous. Both programs aimed to increase participation in screening, remove barriers to treatment and decrease mortality. The Native Sisters Program documented an increase in adherence to breast screening among navigated American Indian participants, although there were substantial differences in the baseline screening adherence between navigated and non-navigated participants. The Walking Forward Program yielded on average 3 fewer days of treatment delays for navigated American Indians than for non-navigated American Indians. However, adjustments for socioeconomic characteristics and disease characteristics were not described. Although preliminary outcomes are seemingly positive, further rigorous evaluation of quantitative impacts are needed.

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“…[17][18][19] These barriers are commonly reported among older African American women, who also report difficulty accessing health care and high levels of mistrust of the health care system. 20 A growing body of literature has shown the success of patient navigation in improving breast cancer screening ; [21][22][23][24][25][26][27][28][29] however, most of these studies were restricted to patients recruited in clinical settings, 22,26,27 lacked a control group, and/or did not use a randomized controlled design. 21,22,25,26,28,29 Furthermore, few studies have examined the effect of patient navigation on breast cancer screening in the Medicare population (adults 65 years of age and over), focused exclusively on African American women, 30 or used a community-informed research design.…”

Section: Introductionmentioning

confidence: 99%

Effect of Patient Navigation on Breast Cancer Screening Among African American Medicare Beneficiaries: A Randomized Controlled Trial

et al. 2015

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BACKGROUND:There is growing evidence that patient navigation improves breast cancer screening rates; however, there are limited efficacy studies of its effect among African American older adult women. OBJECTIVE: To evaluate the effect of patient navigation on screening mammography among African American female Medicare beneficiaries in Baltimore, MD. DESIGN: The Cancer Prevention and Treatment Demonstration (CPTD), a multi-site study, was a randomized controlled trial conducted from April 2006 through December 2010. SETTING: Community-based and clinical setting. PARTICIPANTS: The CPTD Screening Trial enrolled 1905 community-dwelling African American female Medicare beneficiaries who were ≥65 years of age and resided in Baltimore, MD. Participants were recruited from health clinics, community centers, health fairs, mailings using Medicare rosters, and phone calls. INTERVENTIONS: Participants were randomized to either: printed educational materials on cancer screening (control group) or printed educational materials + patient navigation services designed to help participants overcome barriers to cancer screening (intervention group). MAIN MEASURE: Self-reported receipt of mammography screening within 2 years of the end of the study. KEY RESULTS: The median follow-up period for participants in this analysis was 17.8 months. In weighted multivariable logistic regression analyses, women in the intervention group had significantly higher odds of being up to date on mammography screening at the end of the follow-up period compared to women in the control group (odds ratio [OR] 2.26, 95 % confidence interval [CI]1.59-3.22). The effect of the intervention was stronger among women who were not up to date with mammography screening at enrollment (OR 3.63, 95 % CI 2.09-6.38). CONCLUSION: Patient navigation among urban African American Medicare beneficiaries increased self-reported mammography utilization. The results suggest that patient navigation for mammography screening should focus on women who are not up to date on their screening.

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Culturally Relevant “Navigator”Patient Support The Native Sisters

Cited by 71 publications

References 5 publications

Using navigators to improve care of underserved patients

Using navigators to improve care of underserved patients

Navigating the cancer journey: A review of patient navigator programs for Indigenous cancer patients

Effect of Patient Navigation on Breast Cancer Screening Among African American Medicare Beneficiaries: A Randomized Controlled Trial

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