B32

Background: Despite advances in screening and treatment, racial/ethnic minority and low-income women suffer worse outcomes for breast and cervical cancer in part due to delays in screening and treatment. Our previous pilot work suggested that patient navigation may address these concerns.

Objective: To design, implement, and evaluate a patient navigator intervention in community health centers with the following aims:

  1. To reduce time to diagnosis after an abnormal mammogram or Pap smear;

  2. To reduce time to initiate treatment after a cancer diagnosis;

  3. To improve patient satisfaction with health services;

  4. Be cost-effective

Methods: The intervention is based on the Care Management Model; aided by an Electronic Medical Record tracking system and theory based cultural competency training, patient navigators will identify cases, identify individual barriers to care, implement a care plan, and track through completion. We have block allocation of six community health centers in Boston neighborhoods. Each site has been assigned to Breast or Cervical Patient Navigation and will serve as a comparison site for the other disease. All women with an abnormal cancer screening at the respective site are eligible for navigation. Prior to the intervention, we collected baseline data at each site on timely resolution of screening abnormalities, defined as 1 month for BIRADS 0, 4 and 5 mammograms, 7 months for BIRADS 3, 4 months for HPV positive ASCUS, and LGSIL, and HGSIL lesions.

Expected Results: Our baseline findings indicate that only half of the women achieve timely resolution to their abnormal screenings within our community health center sites. We currently have over 600 participants in the study and expect 2400 before study completion. The majority of participants are low income Black or Hispanic racial ethnic backgrounds.

Expected Conclusions: In collaboration with eight other NCI Patient Navigation Research Program sites, we expect the results of this study will inform the design of a generalizable, effective, and cost efficient patient navigation model that will eliminate barriers to timely, quality cancer care among racial/ethnic minority and lower income populations

First AACR International Conference on the Science of Cancer Health Disparities-- Nov 27-30, 2007; Atlanta, GA

American Association for Cancer Research
2007