Patient navigator reported patient barriers and delivered activities in two large federally-funded cancer screening programs
Few data are available on patient navigators (PNs) across diverse roles and organizational settings that could inform optimization of patient navigation models for cancer prevention. The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and the Colorectal Cancer and Control Progr...
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| Veröffentlicht in: | Preventive medicine Jg. 129; S. 105858 |
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| Format: | Journal Article |
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United States
Elsevier Inc
01.12.2019
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| ISSN: | 0091-7435, 1096-0260, 1096-0260 |
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| Abstract | Few data are available on patient navigators (PNs) across diverse roles and organizational settings that could inform optimization of patient navigation models for cancer prevention. The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and the Colorectal Cancer and Control Program (CRCCP) are two federally-funded screening programs that support clinical- and community-based PNs who serve low-income and un- or underinsured populations across the United States. An online survey assessing PN characteristics, delivered activities, and patient barriers to screening was completed by 437 of 1002 identified PNs (44%). Responding PNs were racially and ethnically diverse, had varied professional backgrounds and practice-settings, worked with diverse populations, and were located within rural and urban/suburban locations across the U.S. More PNs reported working to promote screening for breast/cervical cancers (BCC, 94%) compared to colorectal cancer (CRC, 39%). BCC and CRC PNs reported similar frequencies of individual- (e.g., knowledge, motivation, fear) and community-level patient barriers (e.g., beliefs about healthcare and screening). Despite reporting significant patient structural barriers (e.g., transportation, work and clinic hours), most BCC and CRC PNs delivered individual-level navigation activities (e.g., education, appointment reminders). PN training to identify and champion timely and patient-centered adjustments to organizational policies, practices, and norms of the NBCCEDP, CRCCP, and partner organizations may be beneficial. More research is needed to determine whether multilevel interventions that support this approach could reduce structural barriers and increase screening and diagnostic follow-up among the marginalized communities served by these two important cancer-screening programs.
•Most navigators promoted breast and cervical versus colorectal cancer screening.•Navigators were culturally diverse from varied geographic and practice settings.•Similar patient-level barriers were reported for all types of cancer screening.•Despite reported structural barriers, most navigation focused on patients. |
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| AbstractList | Few data are available on patient navigators (PNs) across diverse roles and organizational settings that could inform optimization of patient navigation models for cancer prevention. The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and the Colorectal Cancer and Control Program (CRCCP) are two federally-funded screening programs that support clinical- and community-based PNs who serve low-income and un- or underinsured populations across the United States. An online survey assessing PN characteristics, delivered activities, and patient barriers to screening was completed by 437 of 1002 identified PNs (44%). Responding PNs were racially and ethnically diverse, had varied professional backgrounds and practice-settings, worked with diverse populations, and were located within rural and urban/suburban locations across the U.S. More PNs reported working to promote screening for breast/cervical cancers (BCC, 94%) compared to colorectal cancer (CRC, 39%). BCC and CRC PNs reported similar frequencies of individual- (e.g., knowledge, motivation, fear) and community-level patient barriers (e.g., beliefs about healthcare and screening). Despite reporting significant patient structural barriers (e.g., transportation, work and clinic hours), most BCC and CRC PNs delivered individual-level navigation activities (e.g., education, appointment reminders). PN training to identify and champion timely and patient-centered adjustments to organizational policies, practices, and norms of the NBCCEDP, CRCCP, and partner organizations may be beneficial. More research is needed to determine whether multilevel interventions that support this approach could reduce structural barriers and increase screening and diagnostic follow-up among the marginalized communities served by these two important cancer-screening programs. Few data are available on patient navigators (PNs) across diverse roles and organizational settings that could inform optimization of patient navigation models for cancer prevention. The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and the Colorectal Cancer and Control Program (CRCCP) are two federally-funded screening programs that support clinical- and community-based PNs who serve low-income and un- or underinsured populations across the United States. An online survey assessing PN characteristics, delivered activities, and patient barriers to screening was completed by 437 of 1002 identified PNs (44%). Responding PNs were racially and ethnically diverse, had varied professional backgrounds and practice-settings, worked with diverse populations, and were located within rural and urban/suburban locations across the U.S. More PNs reported working to promote screening for breast/cervical cancers (BCC, 94%) compared to colorectal cancer (CRC, 39%). BCC and CRC PNs reported similar frequencies of individual- (e.g., knowledge, motivation, fear) and community-level patient barriers (e.g., beliefs about healthcare and screening). Despite reporting significant patient structural barriers (e.g., transportation, work and clinic hours), most BCC and CRC PNs delivered individual-level navigation activities (e.g., education, appointment reminders). PN training to identify and champion timely and patient-centered adjustments to organizational policies, practices, and norms of the NBCCEDP, CRCCP, and partner organizations may be beneficial. More research is needed to determine whether multilevel interventions that support this approach could reduce structural barriers and increase screening and diagnostic follow-up among the marginalized communities served by these two important cancer-screening programs. •Most navigators promoted breast and cervical versus colorectal cancer screening.•Navigators were culturally diverse from varied geographic and practice settings.•Similar patient-level barriers were reported for all types of cancer screening.•Despite reported structural barriers, most navigation focused on patients. AbstractFew data are available on patient navigators (PNs) across diverse roles and organizational settings that could inform optimization of patient navigation models for cancer prevention. The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and the Colorectal Cancer and Control Program (CRCCP) are two federally-funded screening programs that support clinical- and community-based PNs who serve low-income and un- or underinsured populations across the United States. An online survey assessing PN characteristics, delivered activities, and patient barriers to screening was completed by 437 of 1002 identified PNs (44%). Responding PNs were racially and ethnically diverse, had varied professional backgrounds and practice-settings, worked with diverse populations, and were located within rural and urban/suburban locations across the U.S. More PNs reported working to promote screening for breast/cervical cancers (BCC, 94%) compared to colorectal cancer (CRC, 39%). BCC and CRC PNs reported similar frequencies of individual- (e.g., knowledge, motivation, fear) and community-level patient barriers (e.g., beliefs about healthcare and screening). Despite reporting significant patient structural barriers (e.g., transportation, work and clinic hours), most BCC and CRC PNs delivered individual-level navigation activities (e.g., education, appointment reminders). PN training to identify and champion timely and patient-centered adjustments to organizational policies, practices, and norms of the NBCCEDP, CRCCP, and partner organizations may be beneficial. More research is needed to determine whether multilevel interventions that support this approach could reduce structural barriers and increase screening and diagnostic follow-up among the marginalized communities served by these two important cancer-screening programs. Few data are available on patient navigators (PNs) across diverse roles and organizational settings that could inform optimization of patient navigation models for cancer prevention. The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and the Colorectal Cancer and Control Program (CRCCP) are two federally-funded screening programs that support clinical- and community-based PNs who serve low-income and un- or underinsured populations across the United States. An online survey assessing PN characteristics, delivered activities, and patient barriers to screening was completed by 437 of 1002 identified PNs (44%). Responding PNs were racially and ethnically diverse, had varied professional backgrounds and practice-settings, worked with diverse populations, and were located within rural and urban/suburban locations across the U.S. More PNs reported working to promote screening for breast/cervical cancers (BCC, 94%) compared to colorectal cancer (CRC, 39%). BCC and CRC PNs reported similar frequencies of individual- (e.g., knowledge, motivation, fear) and community-level patient barriers (e.g., beliefs about healthcare and screening). Despite reporting significant patient structural barriers (e.g., transportation, work and clinic hours), most BCC and CRC PNs delivered individual-level navigation activities (e.g., education, appointment reminders). PN training to identify and champion timely and patient-centered adjustments to organizational policies, practices, and norms of the NBCCEDP, CRCCP, and partner organizations may be beneficial. More research is needed to determine whether multilevel interventions that support this approach could reduce structural barriers and increase screening and diagnostic follow-up among the marginalized communities served by these two important cancer-screening programs.Few data are available on patient navigators (PNs) across diverse roles and organizational settings that could inform optimization of patient navigation models for cancer prevention. The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and the Colorectal Cancer and Control Program (CRCCP) are two federally-funded screening programs that support clinical- and community-based PNs who serve low-income and un- or underinsured populations across the United States. An online survey assessing PN characteristics, delivered activities, and patient barriers to screening was completed by 437 of 1002 identified PNs (44%). Responding PNs were racially and ethnically diverse, had varied professional backgrounds and practice-settings, worked with diverse populations, and were located within rural and urban/suburban locations across the U.S. More PNs reported working to promote screening for breast/cervical cancers (BCC, 94%) compared to colorectal cancer (CRC, 39%). BCC and CRC PNs reported similar frequencies of individual- (e.g., knowledge, motivation, fear) and community-level patient barriers (e.g., beliefs about healthcare and screening). Despite reporting significant patient structural barriers (e.g., transportation, work and clinic hours), most BCC and CRC PNs delivered individual-level navigation activities (e.g., education, appointment reminders). PN training to identify and champion timely and patient-centered adjustments to organizational policies, practices, and norms of the NBCCEDP, CRCCP, and partner organizations may be beneficial. More research is needed to determine whether multilevel interventions that support this approach could reduce structural barriers and increase screening and diagnostic follow-up among the marginalized communities served by these two important cancer-screening programs. |
| ArticleNumber | 105858 |
| Author | Askelson, Natoshia Cole, Allison Escoffery, Cam Barrington, Wendy E. Seegmiller, Laura Vu, Thuy Hannon, Peggy Gonzalez, Sarah Koopman Melillo, Stephanie DeGroff, Amy |
| AuthorAffiliation | d University of Iowa, Iowa City, IA, United States of America a University of Washington, Seattle, WA, United States of America c Emory University, Atlanta, GA, United States of America e Case Western Reserve University, Cleveland b Centers for Disease Control and Prevention, Atlanta, GA, United States of America |
| AuthorAffiliation_xml | – name: b Centers for Disease Control and Prevention, Atlanta, GA, United States of America – name: c Emory University, Atlanta, GA, United States of America – name: e Case Western Reserve University, Cleveland – name: d University of Iowa, Iowa City, IA, United States of America – name: a University of Washington, Seattle, WA, United States of America |
| Author_xml | – sequence: 1 givenname: Wendy E. surname: Barrington fullname: Barrington, Wendy E. email: wendybar@uw.edu organization: University of Washington, Seattle, WA, United States of America – sequence: 2 givenname: Amy surname: DeGroff fullname: DeGroff, Amy organization: Centers for Disease Control and Prevention, Atlanta, GA, United States of America – sequence: 3 givenname: Stephanie surname: Melillo fullname: Melillo, Stephanie organization: Centers for Disease Control and Prevention, Atlanta, GA, United States of America – sequence: 4 givenname: Thuy surname: Vu fullname: Vu, Thuy organization: University of Washington, Seattle, WA, United States of America – sequence: 5 givenname: Allison surname: Cole fullname: Cole, Allison organization: University of Washington, Seattle, WA, United States of America – sequence: 6 givenname: Cam surname: Escoffery fullname: Escoffery, Cam organization: Emory University, Atlanta, GA, United States of America – sequence: 7 givenname: Natoshia surname: Askelson fullname: Askelson, Natoshia organization: University of Iowa, Iowa City, IA, United States of America – sequence: 8 givenname: Laura surname: Seegmiller fullname: Seegmiller, Laura organization: University of Iowa, Iowa City, IA, United States of America – sequence: 9 givenname: Sarah Koopman surname: Gonzalez fullname: Gonzalez, Sarah Koopman organization: Case Western Reserve University, Cleveland – sequence: 10 givenname: Peggy surname: Hannon fullname: Hannon, Peggy organization: University of Washington, Seattle, WA, United States of America |
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| Keywords | Breast Screening Navigation Colorectal Cervical Cancer |
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| Snippet | Few data are available on patient navigators (PNs) across diverse roles and organizational settings that could inform optimization of patient navigation models... AbstractFew data are available on patient navigators (PNs) across diverse roles and organizational settings that could inform optimization of patient... |
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| SubjectTerms | Adult Breast Breast Neoplasms - diagnosis Cancer Cervical Colorectal Colorectal Neoplasms - diagnosis Cross-Sectional Studies Early Detection of Cancer Ethnicity Female Financing, Government - economics Health Knowledge, Attitudes, Practice Humans Internal Medicine Mass Screening Medically Uninsured Middle Aged Navigation Patient Navigation - statistics & numerical data Poverty Screening Surveys and Questionnaires Uterine Cervical Neoplasms - diagnosis |
| Title | Patient navigator reported patient barriers and delivered activities in two large federally-funded cancer screening programs |
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