County-Level Poverty and Barriers to Breast and Cervical Cancer Screening in a Health Education and Patient Navigation Program for Rural and Border Texas Residents

Falk, Derek; Cubbin, Catherine; Jones, Barbara

doi:10.1007/s13187-020-01832-z

Cited by 7 publications

(7 citation statements)

References 22 publications

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“…Existing literature on interventions to improve prevention, screening and chronic disease management among people living with poverty has shown success for patient navigators trained to help address patient-identified screening barriers [26] and address the SDOH that impact screening uptake [27] and for health coaches trained to support participants to accomplish short-term self-identified health and wellness goals [28,29]. Qualitative research as a part of BETTER HEALTH will explore which components of the intervention led to its success from both the participant and prevention practitioner perspectives and how to make BETTER HEALTH sustainable, and future research will adapt, and explore the effectiveness of, the BETTER intervention for adults under 40 years of age living with social disadvantage, for whom the potential to reduce premature morbidity and mortality is substantial [24,30].…”

Section: Discussionmentioning

confidence: 99%

Building on existing tools to improve chronic disease prevention and screening in public health: a cluster randomized trial

et al. 2021

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Background The BETTER (Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care) intervention was designed to integrate the approach to chronic disease prevention and screening in primary care and demonstrated effective in a previous randomized trial. Methods We tested the effectiveness of the BETTER HEALTH intervention, a public health adaptation of BETTER, at improving participation in chronic disease prevention and screening actions for residents of low-income neighbourhoods in a cluster randomized trial, with ten low-income neighbourhoods in Durham Region Ontario randomized to immediate intervention vs. wait-list. The unit of analysis was the individual, and eligible participants were adults age 40–64 years residing in the neighbourhoods. Public health nurses trained as “prevention practitioners” held one prevention-focused visit with each participant. They provided participants with a tailored prevention prescription and supported them to set health-related goals. The primary outcome was a composite index: the number of evidence-based actions achieved at six months as a proportion of those for which participants were eligible at baseline. Results Of 126 participants (60 in immediate arm; 66 in wait-list arm), 125 were included in analyses (1 participant withdrew consent). In both arms, participants were eligible for a mean of 8.6 actions at baseline. At follow-up, participants in the immediate intervention arm met 64.5% of actions for which they were eligible versus 42.1% in the wait-list arm (rate ratio 1.53 [95% confidence interval 1.22–1.84]). Conclusion Public health nurses using the BETTER HEALTH intervention led to a higher proportion of identified evidence-based prevention and screening actions achieved at six months for people living with socioeconomic disadvantage. Trial registration NCT03052959, registered February 10, 2017.

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Section: Discussionmentioning

confidence: 99%

Building on existing tools to improve chronic disease prevention and screening in public health: a cluster randomized trial

et al. 2021

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“…Studies assessing the efficacy of patient navigation on cancer screening reported marked improvements in screening rates 103–109 . Multicomponent patient navigation interventions (navigation combined with education and media) proved to be effective in promoting screening in both general and underserved populations, with higher screening uptakes 103,105,107,109,110 .…”

Section: Resultsmentioning

confidence: 99%

“…Multicomponent patient navigation interventions (navigation combined with education and media) proved to be effective in promoting screening in both general and underserved populations, with higher screening uptakes 103,105,107,109,110 . Evidence from the studies suggests that culturally tailored or community‐based programs with a focus on education, assistance with payments, transportation, and social networks with underserved populations (e.g., high‐poverty rural counties in Texas, low‐income Latina women, African American patients) were equally effective in improving screening rates 104,106,108,111–113 . Furthermore, the collaboration with a local health system through the inclusion of a community health worker navigator led to better screening knowledge and attitudes toward screening along with a reduction in cancer stigma 114 .…”

Section: Resultsmentioning

confidence: 99%

Patient navigation across the cancer care continuum: An overview of systematic reviews and emerging literature

Chan,

Milch,

Crawford‐Williams

et al. 2023

CA A Cancer J Clinicians

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Patient navigation is a strategy for overcoming barriers to reduce disparities and to improve access and outcomes. The aim of this umbrella review was to identify, critically appraise, synthesize, and present the best available evidence to inform policy and planning regarding patient navigation across the cancer continuum. Systematic reviews examining navigation in cancer care were identified in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Cumulative Index of Nursing and Allied Health (CINAHL), Epistemonikos, and Prospective Register of Systematic Reviews (PROSPERO) databases and in the gray literature from January 1, 2012, to April 19, 2022. Data were screened, extracted, and appraised independently by two authors. The JBI Critical Appraisal Checklist for Systematic Review and Research Syntheses was used for quality appraisal. Emerging literature up to May 25, 2022, was also explored to capture primary research published beyond the coverage of included systematic reviews. Of the 2062 unique records identified, 61 systematic reviews were included. Fifty‐four reviews were quantitative or mixed‐methods reviews, reporting on the effectiveness of cancer patient navigation, including 12 reviews reporting costs or cost‐effectiveness outcomes. Seven qualitative reviews explored navigation needs, barriers, and experiences. In addition, 53 primary studies published since 2021 were included. Patient navigation is effective in improving participation in cancer screening and reducing the time from screening to diagnosis and from diagnosis to treatment initiation. Emerging evidence suggests that patient navigation improves quality of life and patient satisfaction with care in the survivorship phase and reduces hospital readmission in the active treatment and survivorship care phases. Palliative care data were extremely limited. Economic evaluations from the United States suggest the potential cost‐effectiveness of navigation in screening programs.

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“…However, it has been well documented that community socioeconomic stressors can relate to behaviors that increase cancer risk, such as tobacco use initiation, and poor diet ( Kollman 2018 ), while also being associated with lower rates of cancer screening ( Davis et al, 2017 , Fedewa et al, 2017 ). Successful interventions, such as patient navigation and providing cancer education, can help to address the disparity between high and low poverty communities ( Falk, Cubbin, and Jones 2020 ). Sustained policy and community-based efforts are required to address challenges suffered by all communities of poverty, both rural and urban.…”

Section: Discussionmentioning

confidence: 99%

Cancer disparities related to poverty and rurality for 22 top cancers in Florida

Hall

Szurek

Cho

et al. 2022

Preventive Medicine Reports

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County-Level Poverty and Barriers to Breast and Cervical Cancer Screening in a Health Education and Patient Navigation Program for Rural and Border Texas Residents

Cited by 7 publications

References 22 publications

Building on existing tools to improve chronic disease prevention and screening in public health: a cluster randomized trial

Building on existing tools to improve chronic disease prevention and screening in public health: a cluster randomized trial

Patient navigation across the cancer care continuum: An overview of systematic reviews and emerging literature

Cancer disparities related to poverty and rurality for 22 top cancers in Florida

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