Abstract A10: Community navigators for breast and cervical cancer screening and follow up

Purpose: Recent multi-site trials evaluating the efficacy of patient navigation programs have found only modest effects on reducing follow-up time among patients with abnormal breast and cervical cancer screening tests. However, patient navigators in these efficacy trials have primarily been situated within a hospital or clinic – not nested within the community. We sought to further elucidate the potential impact of patient navigation by exploring how patient navigation initiatives in various community settings can address complex barriers to care.

Methods: We present four case studies to provide insight on the value of community-nested navigators in increasing breast and cervical cancer screening and follow-up. Case studies include: (1) a community-level adaptation of patient navigation to Chicago's Chinatown; (2) a community navigation and outreach program in the racially/ethnically diverse Chicago Lawn; (3) a county-wide dissemination of navigation in suburban DuPage County; and (4) a state-wide scaling of a patient navigation model to the Illinois Department of Health and Family Services. Case study data were derived from focus groups, key informant interviews, medical records review, and patient surveys.

Results: Case studies describe the roles of community navigators and the challenges of navigating immigrant, non-English proficient patients in particular. Translating clinic-based patient navigators into community navigators to guide women through clinics, specialty referrals, diagnostic/testing sites, and wrap around services (e.g., transportation, housing, support groups, legal counseling) may help alleviate complex barriers to care in resource-thin environments.

Conclusion: Community navigators are promising connectors and advocates for health care services delivery and prevention for culturally and linguistically isolated populations as well as communities with limited health care safety net systems. The community, county, and state-wide scaling of patient navigation described in these case studies serve as viable models for future patient navigation initiatives in low-resource settings to reduce cancer disparities.

Citation Format: Melissa A. Simon, Laura S. Tom, Erika E. de la Riva, Emily L. Malin. Community navigators for breast and cervical cancer screening and follow up. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr A10.