Patient navigator reported patient barriers and delivered activities in two large federally-funded cancer screening programs

Wendy E Barrington; Amy DeGroff; Stephanie Melillo; Thuy Vu; Allison Cole; Cam Escoffery; Natoshia Askelson; Laura Seegmiller; Sarah Koopman Gonzalez; Peggy Hannon

doi:10.1016/j.ypmed.2019.105858

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Patient navigator reported patient barriers and delivered activities in two large federally-funded cancer screening programs

Journal article

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Patient navigator reported patient barriers and delivered activities in two large federally-funded cancer screening programs

Wendy E Barrington, Amy DeGroff, Stephanie Melillo, Thuy Vu, Allison Cole, Cam Escoffery, Natoshia Askelson, Laura Seegmiller, Sarah Koopman Gonzalez and Peggy Hannon

Preventive medicine, Vol.129, pp.105858-105858

12/2019

DOI: 10.1016/j.ypmed.2019.105858

PMCID: PMC7055651

PMID: 31647956

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Abstract

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.

Navigation

Breast

Cancer

Cervical

Colorectal

Screening

Details

Title: Subtitle: Patient navigator reported patient barriers and delivered activities in two large federally-funded cancer screening programs
Creators: Wendy E Barrington - University of Washington, Seattle, WA, United States of America
Amy DeGroff - Centers for Disease Control and Prevention, Atlanta, GA, United States of America
Stephanie Melillo - Centers for Disease Control and Prevention, Atlanta, GA, United States of America
Thuy Vu - University of Washington, Seattle, WA, United States of America
Allison Cole - University of Washington, Seattle, WA, United States of America
Cam Escoffery - Emory University, Atlanta, GA, United States of America
Natoshia Askelson - University of Iowa, Iowa City, IA, United States of America
Laura Seegmiller - University of Iowa, Iowa City, IA, United States of America
Sarah Koopman Gonzalez - Case Western Reserve University, Cleveland
Peggy Hannon - University of Washington, Seattle, WA, United States of America
Resource Type: Journal article
Publication Details: Preventive medicine, Vol.129, pp.105858-105858
DOI: 10.1016/j.ypmed.2019.105858
PMID: 31647956
PMCID: PMC7055651
NLM abbreviation: Prev Med
ISSN: 0091-7435
eISSN: 1096-0260
Publisher: Elsevier Inc
Grant note: name: University of Washington Health Promotion Research Center, award: # U48DP005013; DOI: 10.13039/100008893, name: University of Iowa, award: # U48 DP005021; DOI: 10.13039/100008136, name: Case Western Reserve University, award: # U48 DP005030; name: Cancer Prevention and Control Network; DOI: 10.13039/100007890, name: University of North Carolina at Chapel Hill; DOI: 10.13039/100008136, name: Case Western Reserve University; DOI: 10.13039/100006668, name: Oregon Health & Science University; DOI: 10.13039/100008899, name: University of South Carolina; DOI: 10.13039/100008893, name: University of Iowa; DOI: 10.13039/100007472, name: University of Kentucky; name: University of Pennsylvania and University of Washington
Language: English
Date published: 12/2019
Academic Unit: Injury Prevention Research Center; Public Policy Center (Archive); Community and Behavioral Health
Record Identifier: 9984214947302771

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