Exploring the Role of Community Health Workers in Providing Cancer Navigation: Perceptions of African American Older Adults

Abstract

Purpose/Objectives To obtain experiential data regarding African American older adult survivors’ perceptions of and recommendations on the role of community health workers (CHWs) in providing a cancer navigation intervention. Research Approach Focus groups. Setting Rural Virginia and urban Maryland. Participants 48 African American solid-tumor cancer survivors, aged 65 years or older, with Medicare insurance. Methodologic Approach Analysis was accomplished through a reflexive process of transcript review, categorization, and interpretation. Findings Themes and accompanying categories identified were uneasiness surrounding the CHW role (disconnect between identified support needs and CHW role, essential CHW characteristics, and potential application of CHWs), recommendations to adequately address cancer needs (coordinating cancer treatment and unmet needs during cancer), and the importance of individualized interventions. Participants provided specific recommendations regarding the role of the CHW and how to develop supportive interventions. Conclusions Study participants had surprisingly limited prior exposure to the CHW role. However, they stated that, in certain circumstances, CHWs could effectively assist older adult African Americans undergoing cancer diagnosis or treatment. Interpretation Study findings can be helpful to researchers and to healthcare providers engaged in assisting older African Americans during cancer diagnosis and treatment. The results lay a foundation for developing culturally appropriate interventions to assist this at-risk population.

Mobilizing social support networks to improve cancer screening: the COACH randomized controlled trial study design

“…These include bridging health care systems and racial/ethnic minority communities in various settings, including for cancer screening [ 15 – 19 ] and diagnostic follow up [ 18 , 20 – 23 ]. However, prior patient data revealed that trusted social network members play an even more integral role in caring for patients and may be the most effective at helping to coordinate care and address their cancer-related needs [ 24 , 25 ]. As care has shifted from the hospital to the home, caregivers have been tasked with complex, multifaceted responsibilities that many are ill prepared to assume [ 24 ].…”

“…As care has shifted from the hospital to the home, caregivers have been tasked with complex, multifaceted responsibilities that many are ill prepared to assume [ 24 ]. Furthermore, our work with African American older adults suggest that 1) this population considers family and friends as trusted sources of cancer information and 2) both urban and rural African American cancer survivors preferred to work through healthcare access issues with people with whom they already had a relationship (vs. CHWs whom they did not know and who did not have formal health education training) [ 25 , 26 ]. Additionally, older adult patients are frequently accompanied by family members or other support persons to medical appointments; companions who are verbally active in these visits are generally effective in improving patient-physician communication [ 27 ].…”

A Synthesis of Clinical Recommendations and Primary Research for Survivors of Prostate or Breast Cancer

“…Studies ( Kim, 2007 ; Klimmek et al, 2010 ; Wenzel, Jones, Klimmek, Krumm, et al, 2012 ; Wenzel, Jones, Klimmek, Szanton, & Krumm, 2012 ) have documented the burden of financial stress on the cancer survivor and have also examined the association between high financial burden and decreased chance of cancer survival ( Ward et al, 2008 ). However, few of these studies have outlined resources that APRNs may use to assist patients who experience financial challenges.…”

Working Toward Normalcy Post-Treatment: A Qualitative Study of Older Adult Breast and Prostate Cancer Survivors

“…The analysis reported in the current article was embedded within a larger randomized, controlled trial of a nurse-led supportive intervention for rural-dwelling cancer survivors and the people who support them (Wenzel, Jones, Klimmek, Krumm, et al, 2012; Wenzel, Jones, Klimmek, Szanton, & Krumm, 2012). The research reported in the current article used an intensive, multiple case study design (Stake, 1995) and grounded theory analysis techniques (Charmaz, 2006) to evaluate the fit between existing theoretical knowledge related to the process of managing recovery and to generate new theoretical knowledge about that process.…”

“…Cognitively intact, community-dwelling adults aged 60 years or older who had been recently diagnosed with early-stage breast or prostate cancer were selected from an ongoing randomized, controlled trial of a nurse-led patient navigation intervention being delivered to patient–support person dyads in a rural setting in central Virginia (Jones, Steeves, & Williams, 2009; Wenzel, Jones, Klimmek, Szanton, et al, 2012). For the current substudy, the authors collected data through daily written journals, multiple in-depth interviews lasting one to two hours each, and notes on telephone calls between research team members and participants (patient participants and their support people) conducted at least once every two weeks from the time of enrollment through at least one month post-treatment completion.…”