From Patient Navigation to Cancer Justice: Toward a Culture-Centered, Community-Owned Intervention Addressing Disparities in Cancer Prevention

Abstract

In this study, we analyze data from an ongoing academic-community collaboration targeted at conceptualization and delivery of a patient navigation intervention for cancer prevention. Echoing overall United States trends, the region under study is earmarked by significant socioeconomic and racial disparities in cancer outcomes. While there is a large body of research on the use of patient navigation across the continuum of cancer care, the role of communication in shaping navigation is unclear in the literature. Responding to this gap, we use the culture-centered approach to document how community-based "lay" patient navigators' local knowledge and cultural expertise shaped the scope and meanings of patient navigation for a predominantly African-American population. Qualitative data in the form of navigator interviews, participant observation of navigation, and research team members' reflexive journals were used to document how the definition and scope of navigation were re-inscribed by community navigators. While navigation was initially equated with screening promotion, interaction with community members led to the development of more listening-focused and structural barrierfocused conceptualization of patient navigation. Finally, we discuss the implications and contributions and limitations of this study.

Racial and Ethnic Differences in the Financial Consequences of Cancer-Related Employment Disruption

“…As programs and policies are instituted to address patient financial and employment concerns, we must pay explicit attention to racial equity to avoid exacerbating documented racial/ethnic disparities in financial toxicity (4,13,29). This may include developing policies to increase employment protections and expand insurance access and designing patient-centered navigation programs to overcome structural barriers to resources and employment protections (30,31).…”

Navigation programs relevant for African American men with prostate cancer: a scoping review protocol

“…Previous reviews have investigated patient navigation programs for underserved populations across the cancer care continuum, noting more research is needed beyond screening and diagnosis, and outside of breast and colorectal cancers [ 27 ]. Furthermore, few reviews having taken a culturally centered approach to identify and examine how navigation models shape programs within the context of cultural humility and tailoring [ 37 ]. Our review will comprehensively synthesize existing navigation programs culturally tailored for African American men with PCa, filling a contemporary gap in the literature.…”

“…However, there is a dearth of published data on detailed components of patient navigation programs that include cultural context in content and training to meet the unique needs of specific racial/ethnic populations. While we identified an article that reviewed navigation from a culturally centered approach to address general cancer disparities [ 37 ] and another review article that examined metrics for cultural competency in navigation in lung cancer [ 38 ], to our knowledge, there are no scoping reviews focused on patient navigation in PCa care that examines cultural context for eliminating disparities among African American men.…”