Establishing effective patient navigation programs in oncology

López, Diego B.; Pratt-Chapman, Mandi; Rohan, Elizabeth A.; Sheldon, Lisa Kennedy; Basen-Engquist, Karen; Kline, Ron; Shulman, Lawrence N.; Flores, Efrén J.

doi:10.1007/s00520-019-04739-8

Cited by 30 publications

(21 citation statements)

References 59 publications

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“…Navigation programs have been implemented to address inequitable access to cancer care [2,3]. The goals of most navigation programs include linking patients to primary care services, specialist care, community-based health, and social services, as well as identifying and addressing patient barriers to care.…”

Section: Introductionmentioning

confidence: 99%

A new proactive virtual resource center navigation model identifies patient risk factors to reduce barriers to cancer care during the COVID-19 pandemic

Bigelow

Hart

Shaban

et al. 2021

Support Care Cancer

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Purpose The COVID-19 pandemic has exacerbated cancer treatment disparities, including accessibility to resources. We describe the process and outcomes of a new proactive, virtual nurse-led, resource center navigation model enhanced by using volunteer patient navigators. Using known patient risk factors, this model provides interventions to reduce barriers to care, with an emphasis on non-English-speaking populations. Methods Patients were included if they (1) were in active cancer treatment and (2) had one or more known risk factors: distance from cancer hospital, needing complex care, 65 years or older, malignant hematological diagnosis, new treatment start, lives alone, non-English speaker, or a new hospital discharge . Nurse navigators triaged referrals to appropriate team members who identified and addressed barriers to care. Results The program engaged with 586 adult cancer patients over 1459 encounters. The most common risk factors included distance (59.7%), complex care (48.8%), and new treatment start (43.5%). The most common interventions were core education (69.4%), emotional support (61.2%), and education (35.7%). Statistical differences were found between Spanish-speaking ( n = 118) and non-Spanish-speaking patients ( n = 468). While Spanish-speaking patients had fewer risk factors (1.95 vs. 2.80, p ≤ .0001), they had nearly double the number of visits (4.27 vs. 2.04, p ≤ .0001) and 69% more interventions (8.26 vs. 4.90, p ≤ .0001). Many patients (42.7%) required follow-up visits. Conclusion We successfully established a new navigation model for the resource center during the pandemic that identified and reduced barriers to care, particularly in the Spanish-speaking population. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-021-06147-3.

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Section: Introductionmentioning

confidence: 99%

A new proactive virtual resource center navigation model identifies patient risk factors to reduce barriers to cancer care during the COVID-19 pandemic

Bigelow

Hart

Shaban

et al. 2021

Support Care Cancer

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“…However, fewer than 5% of oncologists have reported providing a written survivorship care plan to their patients [ 34 ]. Past studies have also shown that patient navigators can help survivors navigate the health system, facilitate care coordination, promote healthy behaviors, and overcome patient- and system-level barriers to care, such as limited health literacy, which can lead to more equitable outcomes and smoother post-treatment transitions [ 3 , 10 , 32 , 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…Use of patient navigation services for cancer survivors is one potential intervention that may increase access to appropriate care. Patient navigators serve as liaisons and advocates for patients across the cancer care continuum and are well positioned to link patients with appropriate resources to reduce barriers to care and improve communication between survivors and their HCPs, especially during pivotal transitions in care [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Still Lost in Transition? Perspectives of Ongoing Cancer Survivorship Care Needs from Comprehensive Cancer Control Programs, Survivors, and Health Care Providers

Ross

Townsend

Rohan

2022

IJERPH

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Public health agencies have played a critical role in addressing the complex health and mental health needs of cancer survivors. We conducted a mixed-methods evaluation via a Web-based survey (n = 51) and focus groups (n = 11) with National Comprehensive Cancer Control Program (NCCCP) recipients and interviews (n = 9) with survivors, health care providers (HCPs), and patient navigators to explore these audiences’ cancer survivorship information needs and strategies to improve resource dissemination. Participants revealed a need for tailored resources and support for survivors on healthy lifestyle, post-treatment survivorship concerns, psychosocial health, and navigating the health system. HCP needs included education on survivorship care plans and care coordination to facilitate the transition between oncology and primary care. HCPs were survivors’ most trusted source for information; however, participants noted difficulties engaging HCPs in survivorship care. These findings can help public health practitioners focus their efforts to better meet the needs of cancer survivors and their HCPs.

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“…Navigators assess patients’ needs and, in collaboration with the patient and their family, develop a plan to overcome barriers to care while providing personalized support and in some cases care coordination. Several systematic reviews have shown that patient navigation improves screening rates and timeliness of diagnosis and treatment among cancer patients, and may also reduce healthcare costs [ 23 , 24 , 25 , 26 ]. Training navigators based on core competencies is critical for quality and effectiveness [ 24 , 25 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

Web-Based Peer Navigation for Men with Prostate Cancer and Their Family Caregivers: A Pilot Feasibility Study

et al. 2022

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This study assessed the feasibility, acceptability and potential effects of True North Peer Navigation (PN)—a web-based peer navigation program for men with prostate cancer (PC) and their family caregivers. A one-arm, pre-post pilot feasibility study was conducted at two cancer centres in Canada. Participants were matched through a web-app with a specially trained peer navigator who assessed needs and barriers to care, provided support and encouraged a proactive approach to health for 3 months. Descriptive statistics were calculated, along with paired t-tests. True North PN was feasible, with 57.9% (84/145) recruitment, 84.5% (71/84) pre-questionnaire, 77.5% (55/71) app registration, 92.7% (51/55) match and 66.7% (34/51) post-questionnaire completion rates. Mean satisfaction with Peer Navigators was 8.4/10 (SD 2.15), mean program satisfaction was 6.8/10 (SD 2.9) and mean app usability was 60/100 (SD 14.8). At 3 months, mean ± SE patient/caregiver activation had improved by 11.5 ± 3.4 points (p = 0.002), patient quality of life by 1.1 ± 0.2 points (p < 0.0001), informational support by 0.4 ± 0.17 points (p = 0.03), practical support by 0.5 ± 0.25 points (p = 0.04) and less need for support related to fear of recurrence among patients by 0.4 ± 19 points (p = 0.03). The True North web-based peer navigation program is highly feasible and acceptable among PC patients and caregivers, and the associated improvements in patient and caregiver activation are promising. A randomized controlled trial is warranted to determine effectiveness.

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Establishing effective patient navigation programs in oncology

Cited by 30 publications

References 59 publications

A new proactive virtual resource center navigation model identifies patient risk factors to reduce barriers to cancer care during the COVID-19 pandemic

A new proactive virtual resource center navigation model identifies patient risk factors to reduce barriers to cancer care during the COVID-19 pandemic

Still Lost in Transition? Perspectives of Ongoing Cancer Survivorship Care Needs from Comprehensive Cancer Control Programs, Survivors, and Health Care Providers

Web-Based Peer Navigation for Men with Prostate Cancer and Their Family Caregivers: A Pilot Feasibility Study

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