Integrating patient activation into patient navigation for cancer treatment Free

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Many patients with newly diagnosed cancer struggle through a health care system that often fails to provide timely, effective, safe, and patient-centered care. Minority, low-income, low health literacy and uninsured patients confront even greater barriers to receiving quality care. Over the past few years, two patient-focused models designed to improve health care quality have emerged: patient navigation and patient activation. Patient navigation represents an adaptation of community health worker models to cancer related care. Lay health care workers from a patient’s community are trained to assist patients in addressing key barriers to obtaining cancer diagnostic testing and treatment. Essentially, these navigators serve as patient guides who assist the patient in accessing needed resources such as insurance coverage, transportation, child care, and timely appointments while also facilitating communication between the patient, different clinicians and community agencies. In contrast, patient activation is based largely on Bandura’s social learning model. Patients are given relevant and understandable information and trained to use it to make key decisions about their care. Thus, patients are coached to assume increasingly greater responsibility for their care and to ask relevant questions during visits with their physicians and other clinicians. In this presentation, we report on our experience in integrating these two models as a means of addressing disparities in receipt of care for breast and colorectal cancer. In this presentation, woutline our conceptual framework, navigator training and supervision, and cite our preliminary experience in using the integrated model as a participating site in the National Cancer Institute Patient Navigation Research Program.