Increasing Breast and Cervical Cancer Screening in Rural and Border Texas with Friend to Friend Plus Patient Navigation

Abstract

The Friend to Friend plus Patient Navigation Program (FTF+PN) aims to build an effective, sustainable infrastructure to increase breast and cervical screening rates for underserved women in rural Texas. The objective of this paper is to identify factors that (1) distinguish participants who chose patient navigation (PN) services from those who did not (non-PN) and (2) were associated with receiving a mammogram or Papanicolaou (Pap) test. This prospective study analyzed data collected from 2689 FTF+PN participants aged 18-99 years from March 1, 2012 to February 28, 2015 who self-identified as African American (AA), Latina, and non-Hispanic white (NHW). Women who were younger, AA or Latina, had less than some college education, attended a FTF+PN event because of the cost of screening or were told they needed a screening, and who reported a barrier to screening had higher odds of being a PN participant. Women who were PN participants and had more contacts with program staff had greater odds of receiving a mammogram and a Pap compared with their reference groups. Latina English-speaking women had lower odds of receiving a mammogram and a Pap compared with NHW women and Latina Spanish-speaking women had higher odds of receiving a Pap test compared with NHW women. Women with greater need chose PN services, and PN participants had higher odds of getting a screening compared with women who did not choose PN services. These results demonstrate the success of PN in screening women in rural Texas but also that racial/ethnic disparities in screening remain.

The efficacy and cost‐effectiveness of patient navigation programs across the cancer continuum: A systematic review

“…The majority of these studies tested the impact of PN on screening rates for colorectal (n = 32 [67%]), breast (n = 13 [27%]), or cervical cancer (n = 4 [8%]) . Thirty‐nine articles reported a significant favorable increase in cancer screening rates for PN intervention groups versus controls . Thirteen studies (27%) targeted African American, Latino, Korean American, Asian/Pacific Islander, and non–US‐born urban minority populations .…”

“…10, Thirty-nine articles reported a significant favorable increase in cancer screening rates for PN intervention groups versus controls. 10,[32][33][34][35][37][38][39][41][42][43][44][45][47][48][49][50][51][52][53][54][55][56][58][59][60][61][62][64][65][66]69,[71][72][73][74][75][76]78 Thirteen studies (27%) targeted African American, Latino, Korean American, Asian/Pacific Islander, and non-US-born urban minority populations. 42,47,49,50,52,57,58,65,71,72,…”

Access to Care as a Barrier to Mammography for Black Women

“…The use of other members of the health care team such as community health workers and patient navigators has shown to be effective in supporting health care decision making and improving mammography rates, particularly among low-income, minority populations (Kim et al., 2018; Phillips et al., 2011). Strategies to increase screening mammography in Black women must be multifactorial and use culturally congruent care (Alexandraki & Mooradian, 2010; Copeland et al., 2018; Falk et al., 2018; Kim et al., 2018).…”

“…A trusting relationship with a health care provider and knowledge of the mammogram procedure and its risks and benefits have also been shown to increase uptake of screening mammography in minority women (Alexandraki & Mooradian, 2010). Research shows that interventions that increase Black women’s mammography uptake include community health workers (Copeland et al., 2018; Fouad et al., 2010; Hatcher et al., 2016; Russell et al., 2010), phone and multimedia interventions (Copeland et al., 2018; Gathirua-Mwangi et al., 2016; Russell et al., 2010), text messaging, smart phone applications (Coughlin, 2014), media targeting Black audiences (Wallington et al., 2018), and Black community engagement (Copeland et al., 2018; Coughlin, 2014; Falk et al., 2018; Leeks et al., 2012). Patient-centered care, compassionate care that is responsive to the needs and values of the individual patient, has been shown to be effective in improving health outcomes and breast cancer treatment adherence and is an essential component of any strategy aimed at increasing mammography uptake in Black women (Rathert et al., 2013).…”

Comparison Analysis of Linear Discriminant Analysis and Cuckoo-Search Algorithm in the Classification of Breast Cancer from Digital Mammograms

“…The illness effect may be subject to the cancer type, risk level and patients' oldness. In general, the identification of breast cancer is found either by perceiving a lump in the breast or through mammogram screening (Falk et al, 2018). This lump is classified as either benign or malignant tumours; where benign tumours are normal or controllable and malignant tumours are abnormal or vigorous in invading the adjacent tissues.…”