ASPO Abstracts
Implementation of Community-Focused Patient Navigation Program to Address Barriers to Care for Underserved Cancer Patients
Category: Cancer Health Disparities
Conference Year: 2020
Abstract Body:
Introduction:
Patient navigators have the potential to reduce cancer health disparities by targeting barriers to care. Success
depends on navigators’ cultural, linguistic, and community knowledge as well as on the receptivity of the clinical
care setting. We use the RE-AIM framework to assess if implementation of a community-focused patient
navigation program at our NCI-designated comprehensive cancer center is: 1) Reaching underrepresented cancer
patients, 2) Effective at reducing barriers to care, 3) Adopted among cancer center clinical teams, 4) Implemented
in a consistent manner, and 5) Maintained sustainably over time.
Methods:
Bilingual patient navigators were trained to address patients’ language, health access, financial, and psychosocial
barriers to cancer care. They met regularly with cancer center staff and health workers at a federally qualified
community health center to improve navigation services. Navigators’ efforts to reduce barriers to care were
documented in REDCap for research purposes, and in Cerner for clinical care coordination.
Results:
In the 17 months since the program began, cancer center clinical teams made 160 referrals, and patient
navigators enrolled 143 patients. Participants were primarily Latino (63%), reported Spanish as their primary
language (43%), and lived in households with incomes <$35,000 (63%). At enrollment, participants reported an
average of 4.2 distinct barriers to cancer care (range 1 – 11). The majority of reported barriers involved health
access (n=154) and finances (n=149). Following a 3-month intervention, participants exhibited significantly fewer
barriers t(70)=15.8, p<0.001, reported greater self-efficacy t(65)=-3.9, p<0.001, and expressed high satisfaction
with the navigator program.
Conclusions:
By framing preliminary results within RE-AIM, evidence suggests that our community-focused patient navigation
program successfully Reached underrepresented cancer patients, was Effective at reducing barriers,
demonstrated Adoption among cancer center clinical teams, and was Implemented in a consistent manner.
Maintenance of the program will require further efforts to document cost-effectiveness to cancer center
administration for sustainability.
Keywords: Patient Navigation Cancer Care Coordination Implementation Science