ASPO Abstracts
Barrier Resolution Following Community-Focused Patient Navigation
Category: Cancer Health Disparities
Conference Year: 2022
Abstract Body:
Purpose: To characterize the most common barriers reported by underserved cancer patients and to evaluate which barriers were most amenable to efficient resolution via community-focused patient navigation.Methods: As part of a grant-funded implementation science project, a community-focused patient navigation program was introduced at a NCI-designated Cancer Center between June 2018 and October 2021. Enrolled cancer patients reported on their barriers to care and worked one-on-one with a patient navigator over a 3-month period to resolve those barriers. The navigator systematically documented all efforts to address each barrier (i.e., #actions and time) per patient. At post-intervention, barriers were assessed as 'Addressed' (i.e., navigator able to provide resource) or 'Not Addressed' (i.e., navigator unable to provide resource). Data were then analyzed to evaluate: 1) barrier resolution rates and 2) associations between resolution rates and navigator efforts.Results: To date, 202 participants have completed the intervention. Participants reported an average of 3.47 barriers to cancer care (range 1 - 11). Most commonly reported barriers included: 'Can't Afford Utilities' (n= 82), 'Visual Impairment' (n=76), 'Can't Afford Housing' (n=71), and 'Public Transportation Not Easily Available' (n=55). Of those, 'Visual Impairment' was the barrier with the highest resolution rate (93% 'Addressed'). Barriers with high resolution rates varied in their numbers of average actions required for resolution but did not vary by time (i.e., most actions took < 15 min). For example, 'Can't Afford Cancer Treatment, Test, or Device' (95% addressed) required, on average, 10 actions to address, whereas 'No Dental' (87% 'Addressed') required only 2 actions. Conclusions: Underserved patients face unique challenges in accessing quality cancer care. Our results suggest that certain barriers require different amounts of patient navigator effort to resolve. Detailed analyses of patients' most common barriers to cancer care and calculations of patient navigators' efforts at reducing those barriers represents an innovative step toward enhanced patient navigation efficiency and, ultimately, toward improved resource allocation.
Keywords: patient navigation, barrier resolution, and navigation efficiency