Abstract
Purpose: To report the different models of patient navigation programs utilized and the experiences of the Cancer Disparities Research Partnership (CDRP) program.
Background: The CDRP Program was developed to address U.S. cancer health disparities among minority/underserved populations by increasing participation in cancer clinical trials and one of the main components was the development of a PN program at each site, which addressed the specific needs of its disparity populations.
Methods: The 6 different CDRP sites across the country implemented different models for a patient navigation program, including a lay navigator model, a professional model, and a combination of both. Centinela Freeman Hospital used a lay navigator model consisting of locally trained community lay health workers as navigators. Four sites (Laredo Medical Center, New Hanover Regional Medical Center, Singing River Health System and UPMC McKeesport Hospital) used a professional approach with navigators who were either registered nurses and/or social workers. Rapid City Regional Hospital used a combination and novel approach by combining both community members and health professionals. The community navigators served as a liaison between the health professionals and the community.
Results: Within these 3 models of patient navigation, a total of 3,480 cancer patients were navigated (65% were Non-Hispanic Whites, while only 35% were ethnic minorities). A total of 1,644 patients enrolled in clinical trials and only 264 (16%) patients had been navigated, but the majority of these navigated patients participating in clinical trials were racial/ethnic minorities (58% were American Indian, black/African American, and Hispanic/Latino). Most grantees felt that patient navigation improved the overall cancer care experience for patients, by increasing the likelihood that patients would successfully complete treatment, improving patient's understanding of their disease, establishing rapport between patients and their healthcare providers, and also guiding patients to choose between various cancer treatment options (including clinical trials). The patient navigators built trust in the community, and in certain situations, such as in the Native American population, the navigators were able to address the concerns of tribal health councils to help endorse clinical trials and encourage enrollment. Although the specific duties of the navigators differed across sites, the primary role of the navigators remained the same - to help guide patients through the cancer screening and treatment process, assist patients in overcoming various barriers to care, and facilitate participation in clinical trials.
Conclusions: There are various models of the patient navigation program which is one strategy used to address cancer disparities, and the type of model that works best is dependent on the patient population being served, specific goals of the program, the existing infrastructure of the hospital, and sources of funding available. A successful patient navigation program may improve access and accrual of racial/ethnic minority patients into cancer clinical trials.
Citation Format: Melissa K. Yee, Rosemary Wong, Dwight E. Heron. Models of patient navigation programs: Experience from the Cancer Disparities Research Partnership (CDRP) grantees. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A72. doi:10.1158/1538-7755.DISP13-A72
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