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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Published in:Preventive medicine Vol. 129; p. 105858
Main Authors: Barrington, Wendy E., DeGroff, Amy, Melillo, Stephanie, Vu, Thuy, Cole, Allison, Escoffery, Cam, Askelson, Natoshia, Seegmiller, Laura, Gonzalez, Sarah Koopman, Hannon, Peggy
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.12.2019
Subjects:
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
Breast
Screening
Navigation
Colorectal
Cervical
Cancer
ISSN:0091-7435, 1096-0260, 1096-0260
Online Access:Get full text
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Summary: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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ISSN:0091-7435
1096-0260
1096-0260
DOI:10.1016/j.ypmed.2019.105858