Community Cancer Control in a Rural, Underserved Population: The Appalachian Leadership Initiative on Cancer Project

Friedell, Gilbert H.; Rubio, Ángel; Maretzki, Audrey N.; Garland, Barbara C.; Brown, Pamela; Crane, Michael; Hickman, Peggy

doi:10.1353/hpu.2010.0523

Cited by 35 publications

(39 citation statements)

References 11 publications

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“…The Lower Mississippi Delta and Appalachia are diverse geographic regions distinguished by longstanding challenges that include high unemployment, low levels of education and health literacy, and inadequate access to health care (15)(16)(17)(18). The Lower Mississippi Delta has been classified as persistently poor (!20% poverty) since 1970 by the U.S. Department of Agriculture's Economic Research Service and has county-level poverty rates that are two standard deviations above the national median (19,20).…”

Section: Discussionmentioning

confidence: 99%

Where Can Colorectal Cancer Screening Interventions Have the Most Impact?

Siegel

Sahar

Robbins

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

105

112

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Background: Although colorectal cancer death rates in the United States have declined by half since 1970, large geographic disparities persist. Spatial identification of high-risk areas can facilitate targeted screening interventions to close this gap.Methods: We used the Getis-Ord Gi Ã statistic within ArcGIS to identify contemporary colorectal cancer "hotspots" (spatial clusters of counties with high rates) based on county-level mortality data from the national vital statistics system. Hotspots were compared with the remaining aggregated counties (non-hotspot United States) by plotting trends from 1970 to 2011 and calculating rate ratios (RR). Trends were quantified using joinpoint regression.Results: Spatial mapping identified three distinct hotspots in the contemporary United States where colorectal cancer death rates were elevated. The highest rates were in the largest hotspot, which encompassed 94 counties in the Lower Mississippi Delta

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Section: Discussionmentioning

confidence: 99%

Where Can Colorectal Cancer Screening Interventions Have the Most Impact?

Siegel

Sahar

Robbins

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

105

112

View full text Add to dashboard Cite

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“…19,29,30,33,36 Process evaluations and program descriptions suggest that navigation services improve the clinic's ability to engage, track, and support patients and to develop communication and trust between clinics and disadvantaged populations. 19,23,24,29,33,37 However, these results are interpreted best as suggestive of opportunities for future research. Studies to date have not employed sufficiently rigorous research designs to allow for any conclusions about the true effects of navigation programs.…”

Section: Do Programs Address Barriers?mentioning

confidence: 90%

“…19 Other programs also report addressing cultural, educational, and language impediments to screening and treatment through outreach and education conducted by community health workers. 29,30,[33][34][35][36][37] Many programs report matching patients with navigators of similar ethnic and racial background. Table 1 summarizes the characteristics of 11 navigation programs we found described in the limited published literature and does not represent an exhaustive list of extant navigation programs.…”

Section: How Navigator Programs Are Organizedmentioning

confidence: 99%

“…19,29,30,33,34,36 Some studies reviewed the services provided by emerging programs or presented limited comparative data on outcomes. 25,37,38 A number of studies provided detailed descriptions of the design and implementation issues addressed during program development or research study. 19,33,34,37,38 In our qualitative data, navigators and program administrators reported that they addressed barriers by anticipating and resolving patients' problems, often by brokering patient relationships with service providers rather than by providing those services directly.…”

Section: Do Programs Address Barriers?mentioning

confidence: 99%

“…25,37,38 A number of studies provided detailed descriptions of the design and implementation issues addressed during program development or research study. 19,33,34,37,38 In our qualitative data, navigators and program administrators reported that they addressed barriers by anticipating and resolving patients' problems, often by brokering patient relationships with service providers rather than by providing those services directly. For example, several programs reported helping transport patients to clinics.…”

Section: Do Programs Address Barriers?mentioning

confidence: 99%

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Using navigators to improve care of underserved patients

Dohan

Schrag

2005

Cancer

402

371

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BACKGROUNDLogistic, cultural, educational, and other barriers can impede the delivery of high‐quality cancer care to underserved patients. Patient navigation services represent one innovation for addressing perceived barriers to care encountered by disadvantaged patients. In this report, the authors have 1) defined patient navigation, distinguishing it from other cancer support services; 2) described how programs are organized; and 3) discussed the need for research on program effectiveness.METHODSInformation was examined on navigation programs published in the scientific literature and on line. Qualitative research also was conducted, consisting of direct observation of patient care in cancer clinics with and without navigators in northern California, in‐person interviews with personnel and patients in the clinics observed, and telephone interviews with navigators at four sites across the United States.RESULTSThe authors found that navigation services have been implemented at all stages of cancer care: prevention, screening, treatment, and survival. Navigators differ from other cancer support personnel in their orientation toward flexible problem solving to overcome perceived barriers to care rather than the provision of a predefined set of services. There are no rigorous demonstrations of the effects and effectiveness of navigation, although such studies are underway.CONCLUSIONSCurrently, patient navigation is understudied, and literature documenting its effects and effectiveness is scant. Rigorous studies are needed of the navigator role and program costs and benefits. Such studies will facilitate an assessment of program effectiveness, feasibility across a range of health care settings, and performance relative to alternative approaches for addressing barriers to care among the underserved. Cancer 2005. © 2005 American Cancer Society.

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Reflections on programs designed to reduce cancer disparities

Haynes

2006

Cancer

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Community Cancer Control in a Rural, Underserved Population: The Appalachian Leadership Initiative on Cancer Project

Cited by 35 publications

References 11 publications

Where Can Colorectal Cancer Screening Interventions Have the Most Impact?

Where Can Colorectal Cancer Screening Interventions Have the Most Impact?

Using navigators to improve care of underserved patients

Reflections on programs designed to reduce cancer disparities

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