A Culturally Tailored Navigator Program for Colorectal Cancer Screening in a Community Health Center: A Randomized, Controlled Trial

Percac‐Lima, Sanja; Grant, Richard W.; Green, Alexander R.; Ashburner, Jeffrey M.; Gamba, Gloria B.; Oo, Sarah A.; Richter, James M.; Atlas, Steven J.

doi:10.1007/s11606-008-0864-x

Cited by 290 publications

(396 citation statements)

References 50 publications

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“…25,26 RESULTS Figure 1 presents a PRISMA flow diagram demonstrating the systematic review process and the final 15 articles that were included in the narrative review. The 15 studies were subdivided according to type of cancer screening that was evaluated, including breast (combined with other cancers), [27][28][29][30][31] colorectal cancer, [32][33][34][35][36][37][38][39][40][41][42][43][44] and cervical cancer, [45][46][47] represented in Table 1. Fifteen non-English languages were evaluated in these studies.…”

Section: Quality Appraisalmentioning

confidence: 99%

“…Fifteen non-English languages were evaluated in these studies. Eight articles (53 %) were controlled trials; six of these were randomized 28,33,35,37,41,44 and the remaining two were not. 45,46 Seven (46 %) were cohort studies.…”

Section: Quality Appraisalmentioning

confidence: 99%

“…46 Only one study demonstrated no impact of navigation on breast cancer screening rates for Bengali or Pakistani women. 28 Five of the studies described the level of training received by the patient navigators, 30,31,35,37,43 which ranged from 6-hour trainings 37 to 2-day workshops with an additional follow up training one year later. 42 Two studies described their intervention personnel as Blink workers^who primarily provided interpreting services and education on screening procedures.…”

Section: Quality Appraisalmentioning

confidence: 99%

“…The spoken non-English language skills of the patient navigators were minimally reported in seven, as navigators were described as Bbilingual,^either noted to be originally from a country where the target language was spoken, or the navigator's ethnicity was used as an additional descriptor (i.e., Bbilingual Hispanic woman^). 27,31,35,37,39,41,43 None of the studies formally assessed the language skills of the patient navigators in English or the target language.…”

Section: Quality Appraisalmentioning

confidence: 99%

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Navigating Language Barriers: A Systematic Review of Patient Navigators’ Impact on Cancer Screening for Limited English Proficient Patients

et al. 2016

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OBJECTIVES:To systematically review the literature on the impact of patient navigators on cancer screening for limited English proficient (LEP) patients. DATA SOURCES: Electronic databases (PubMed, PsycINFO via OVID, Web of Science, Cochrane, EMBASE, and Scopus) through 8 May 2015. ELIGIBILITY CRITERIA: Articles in this review had: (1) a study population of LEP patients eligible for breast, cervical or colorectal cancer screenings, (2) a patient navigator intervention to provide services prior to or during cancer screening, (3) a comparison of the patient navigator intervention to either a control group or another intervention, and (4) language-specific outcomes related to the patient navigator intervention. STUDY APPRAISAL:We assessed the quality of the articles using the Downs and Black Scale. RESULTS: Fifteen studies met the inclusion criteria and evaluated the screening rates for breast, colorectal, and cervical cancer in 15 language populations. Fourteen studies resulted in improved screening rates for LEP patients between 7 and 60 %. There was great variability in the patient navigation interventions evaluated. Training received by navigators was not reported in nine of the studies and no studies assessed the language skills of the patient navigators in English or the target language. LIMITATIONS: This study is limited by the variability in study designs and limited reporting on patient navigator interventions, which reduces the ability to draw conclusions on the full effect of patient navigators. CONCLUSIONS: Overall, we found evidence that navigators improved screening rates for breast, cervical and colorectal cancer screening for LEP patients. Future studies should systematically collect data on the training curricula for navigators and assess their English and nonEnglish language skills in order to identify ways to reduce disparities for LEP patients.

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Section: Quality Appraisalmentioning

confidence: 99%

Section: Quality Appraisalmentioning

confidence: 99%

Section: Quality Appraisalmentioning

confidence: 99%

Section: Quality Appraisalmentioning

confidence: 99%

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Navigating Language Barriers: A Systematic Review of Patient Navigators’ Impact on Cancer Screening for Limited English Proficient Patients

et al. 2016

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“…Safety-net hospitals typically have limited resources for new initiatives and professional staff. Less costly community health workers (CHWs) 19 , 20 have increased medical follow-up with primary care and specialists, [21][22][23] improved adherence to medical regimens, 24,25 and provided meaningful social support. 22 These competencies may NIH Trial Registration ClinicalTrials.gov identifier: NCT01619098…”

Section: Introductionmentioning

confidence: 99%

A Patient Navigator Intervention to Reduce Hospital Readmissions among High-Risk Safety-Net Patients: A Randomized Controlled Trial

et al. 2015

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BACKGROUND: Evidence-based interventions to reduce hospital readmissions may not generalize to resourceconstrained safety-net hospitals. OBJECTIVE: To determine if an intervention by patient navigators (PNs), hospital-based Community Health Workers, reduces readmissions among high risk, low socioeconomic status patients. DESIGN: Randomized controlled trial. PARTICIPANTS: General medicine inpatients having at least one of the following readmission risk factors: (1) age≥60 years, (2) any in-network inpatient admission within the past 6 months, (3) length of stay≥3 days, (4) admission diagnosis of heart failure, or (5) chronic obstructive pulmonary disease. The analytic sample included 585 intervention patients and 925 controls. INTERVENTIONS: PNs provided coaching and assistance in navigating the transition from hospital to home through hospital visits and weekly telephone outreach, supporting patients for 30 days post-discharge with discharge preparation, medication management, scheduling of follow-up appointments, communication with primary care, and symptom management. MAIN MEASURES: The primary outcome was in-network 30-day hospital readmissions. Secondary outcomes included rates of outpatient follow-up. We evaluated outcomes for the entire cohort and stratified by patient age >60 years (425 intervention/584 controls) and ≤60 years (160 intervention/341 controls). KEY RESULTS: Overall, 30-day readmission rates did not differ between intervention and control patients. However, the two age groups demonstrated marked differences. Intervention patients >60 years showed a statistically significant adjusted absolute 4.1 % decrease [95 % CI: −8.0 %, -0.2 %] in readmission with an increase in 30-day outpatient follow-up. Intervention patients ≤60 years showed a statistically significant adjusted absolute 11.8 % increase [95 % CI: 4.4 %, 19.0 %] in readmission with no change in 30-day outpatient follow-up. CONCLUSIONS: A patient navigator intervention among high risk, safety-net patients decreased readmission among older patients while increasing readmissions among younger patients. Care transition strategies should be evaluated among diverse populations, and younger high risk patients may require novel strategies.KEY WORDS: care transitions; continuity of care; health care delivery; patient safety; underserved populations. J Gen Intern Med 30(7):907-15

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Colorectal Cancer Screening Among Ethnically Diverse, Low-Income Patients

Lasser¹,

Murillo²,

Lisboa³

et al. 2011

Arch Intern Med

186

236

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A Culturally Tailored Navigator Program for Colorectal Cancer Screening in a Community Health Center: A Randomized, Controlled Trial

Cited by 290 publications

References 50 publications

Navigating Language Barriers: A Systematic Review of Patient Navigators’ Impact on Cancer Screening for Limited English Proficient Patients

Navigating Language Barriers: A Systematic Review of Patient Navigators’ Impact on Cancer Screening for Limited English Proficient Patients

A Patient Navigator Intervention to Reduce Hospital Readmissions among High-Risk Safety-Net Patients: A Randomized Controlled Trial

Colorectal Cancer Screening Among Ethnically Diverse, Low-Income Patients

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