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Rohan E, Kuiper N, Bowen SA, Mast DK, House M, French C, Tharpe FS, Henley SJ, Wanliss E, Puckett M. Pairing Project ECHO and patient navigation as an innovative approach to improving the health and wellness of cancer survivors in rural settings. J Rural Health 2022; 38:855-864. [PMID: 35611881 PMCID: PMC10961889 DOI: 10.1111/jrh.12682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE We conducted a 12-month pilot study of 2 complementary strategies for improving rural cancer survivorship outcomes: (1) Project ECHO, a telementoring model to increase knowledge and skills about cancer survivorship among multidisciplinary health care provider teams in rural areas and (2) patient navigation (PN) services to connect rural cancer survivors with resources for enhancing health and wellness. METHODS We recruited 4 CDC-funded National Comprehensive Cancer Control Program sites to implement Project ECHO and PN interventions for a defined rural population in each of their jurisdictions. Sites received ongoing technical assistance and a stipend to support implementation. We conducted a mixed-methods evaluation consisting of quantitative performance monitoring data and qualitative interviews with site staff to assess implementation. FINDINGS Site teams delivered 21 cancer survivorship ECHO sessions to rural providers resulting in 329 participant encounters. Almost all (93%) ECHO participants reported enhanced knowledge of cancer survivorship issues, and 80% reported intent to apply learnings to their practices. Site teams engaged 16 patient navigators who navigated 164 cancer survivors during the study period. Successful implementation required strong partnerships, clear avenues for recruitment of rural providers and cancer survivors, and activities tailored to local needs. Fostering ongoing relationships among sites through community of practice calls also enhanced implementation. CONCLUSIONS Sites successfully implemented a novel approach for enhancing care for cancer survivors in rural communities. Pairing Project ECHO to address structural barriers and PN to address individual factors affecting survivorship may help bridge the health equity gap experienced by cancer survivors in rural communities.
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Affiliation(s)
- Elizabeth Rohan
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | | | | | - Cynthia French
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Felicia Solomon Tharpe
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - S. Jane Henley
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ena Wanliss
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mary Puckett
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Kokorelias KM, Shiers-Hanley JE, Rios J, Knoepfli A, Hitzig SL. Factors Influencing the Implementation of Patient Navigation Programs for Adults with Complex Needs: A Scoping Review of the Literature. Health Serv Insights 2021; 14:11786329211033267. [PMID: 34349519 PMCID: PMC8287353 DOI: 10.1177/11786329211033267] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/28/2021] [Indexed: 11/15/2022] Open
Abstract
Patient navigation is a model of care that aims to improve access to care by reducing the complexity of navigating health, education, and social services across the continuum of care and care settings. Little is known about the processes that facilitate or impede the implementation of patient navigation programs (PNPs). We conducted a scoping review to identify and summarize the current state of knowledge regarding the implementation and outcomes of existing implemented PNPs. We employed a 6-stage scoping review framework to identify and review eligible articles. Sixty-articles met the inclusion criteria (58 peer-reviewed and 2 grey literature). The Consolidated Framework for Implementation Research served as the theoretical framework during analysis to help extract factors relevant to implementation of navigator programs. Results of the scoping review are reported thematically. Influences on implementation were identified: (a) planning to ensure alignment with organizational need (b) funding (c) multidisciplinary engagement (d) establishing workflow (e) mechanisms for communication (f) stakeholders to encourage buy-in (g) appropriate caseload (h) in kind resources. PNPs improve the experiences of patients and families. The findings of this scoping review provides implementation considerations of PNPs across global care settings. Strategies for overcoming pragmatic and logistical issues must be developed for optimal implementation.
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Affiliation(s)
- Kristina M Kokorelias
- St. John’s Rehab Research Program,
Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON,
Canada
| | - Jessica E Shiers-Hanley
- Hazel McCallion Academic Learning
Centre, University of Toronto, Toronto, ON, Canada
- Department of Occupational Science
& Occupational Therapy, Temerty Faculty of Medicine, University of Toronto
| | - Jorge Rios
- St. John’s Rehab Research Program,
Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON,
Canada
| | - Amanda Knoepfli
- Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
- SPRINT Senior Care, Toronto, ON,
Canada
| | - Sander L Hitzig
- St. John’s Rehab Research Program,
Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON,
Canada
- Department of Occupational Science
& Occupational Therapy, Temerty Faculty of Medicine, University of Toronto
- Rehabilitation Sciences Institute,
Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Sharma N, Harris E, Lloyd J, Mistry SK, Harris M. Community health workers involvement in preventative care in primary healthcare: a systematic scoping review. BMJ Open 2019; 9:e031666. [PMID: 31852698 PMCID: PMC6937114 DOI: 10.1136/bmjopen-2019-031666] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 11/04/2019] [Accepted: 11/25/2019] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To review effective models of community health worker (CHW) involvement in preventive care for disadvantaged culturally and linguistically diverse (CALD) patients in primary healthcare (PHC) that may be applicable to the Australian context. DESIGN Systematic scoping review. DATA SOURCES The studies were gathered through searching Medline, EMBASE, EMCARE, PsycINFO, CINAHL and online portals of relevant organisations. ELIGIBILITY CRITERIA All selected studies were original research studies which essentially evaluated preventive intervention undertake by CHWs in PHC. The intervened population were adults with or without diagnosed chronic health disease, culturally and linguistically diverse, or vulnerable due to geographic, economic and/or cultural characteristics that impede or compromise their access to healthcare. DATA EXTRACTION AND SYNTHESIS Data extraction was undertaken systematically in an excel spreadsheet while the findings were synthesised in a narrative manner. The quality appraisal of the selected studies was performed using effective public health practice project quality assessment tool. RESULTS A total of 1066 articles were identified during the initial search of six bibliographic databases. After screening the title, abstract and full text, 37 articles met the selection and methodological criteria and underwent data extraction. A high-quality evidence-base supporting the positive impact of CHWs supporting patients' access to healthcare and influencing positive behaviour change was found. Positive impacts of CHW interventions included improvements in clinical disease indicators, screening rates and behavioural change. Education-focused interventions were more effective in improving patient behaviour, whereas navigation interventions were most effective in improving access to services. Implementation was enhanced by cultural and linguistic congruence and specific training of CHWs in the intervention but reduced by short duration interventions, dropouts and poor adherence of patients. CONCLUSION The evidence generated from this systematic scoping review demonstrates the contribution of CHWs to improving access to preventive care for patients from CALD and disadvantaged backgrounds by providing both education and navigational interventions. More research is needed on CHW training and the incorporation of CHWs into primary health care (PHC) teams.
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Affiliation(s)
- Nila Sharma
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
| | - Elizabeth Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
| | - Jane Lloyd
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
| | - Sabuj Kanti Mistry
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
| | - Mark Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, New South Wales, Australia
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Rohan EA, McDougall R, Townsend JS. An Exploration of Patient Navigation and Community Health Worker Activities Across National Comprehensive Cancer Control Programs. Health Equity 2018; 2:366-374. [PMID: 30569028 PMCID: PMC6299797 DOI: 10.1089/heq.2018.0053] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose: Health disparities persist across the cancer care continuum. Patient navigator (PN) and community health worker (CHW) interventions are designed to increase health equity. National Comprehensive Cancer Control Program (NCCCP) awardees develop and implement plans to coordinate cancer prevention and control activities, including supporting PN and CHW interventions. This content analysis examined NCCCP action plans to assess the extent to which jurisdictions report engaging in PN and/or CHW activities. Methods: We abstracted PN and CHW content from NCCCP action plans and coded content according to specific areas of PN and/or CHW intervention (e.g., screening, survivorship, and cancer type), used descriptive statistics to characterize overall results, and calculated chi-squares to determine whether programs engaged PNs and CHWs differently. Results: Eighty-two percent (n=53) of 65 NCCCP action plans had content related to PN and/or CHW activities, with more PN language (83%) than CHW (58%). These action plans described engaging PNs and CHWs in activities across the cancer continuum, but particularly for screening (60%) and survivorship (55%). Eighty-one percent of these plans described activities related to workforce development, such as training and standardizing roles and competencies. Programs engaged CHWs more often than PNs for outreach and in community settings. Conclusion: The majority of NCCCP awardees reported engaging in PN and/or CHW activities. Understanding how NCCCP awardees engage PNs and CHWs, including awardees' needs for workforce development in this area, can help Centers for Disease Control and Prevention provide more focused technical assistance as programs increase engagement of PNs and CHWs to improve health equity.
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Affiliation(s)
- Elizabeth A Rohan
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Renee McDougall
- Surgery Department, Animal Medical Center, Manhattan, New York
| | - Julie S Townsend
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Estrada E, Ramirez AS, Gamboa S, Amezola de Herrera P. Development of a Participatory Health Communication Intervention: An Ecological Approach to Reducing Rural Information Inequality and Health Disparities. JOURNAL OF HEALTH COMMUNICATION 2018; 23:773-782. [PMID: 30307838 PMCID: PMC10069293 DOI: 10.1080/10810730.2018.1527874] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A strong and diverse communication infrastructure is essential for communication to improve health. When that infrastructure is weak, health information fails to reach appropriate audiences; this is a component of information inequality that contributes to health disparities. Approaches to addressing information inequality have either focused on individual-level barriers or exclusively on changing the information environment. Largely missing from information inequality interventions is a multilevel, ecological approach consistent with the ways in which information inequality affects health. This study addresses that gap by describing a participatory intervention in a rural, majority-Latino community. Previous work identified a weak information infrastructure as a major barrier to health: Residents struggled to find timely, relevant information, while stakeholders faced challenges knowing how to reach diverse audiences with critical health-related information. We employed participatory health communication asset mapping to identify health communication resources - safe, trusted spaces, and places - that served three distinct communication functions: informational (i.e., where health information can be provided), conversational (i.e., where residents feel comfortable discussing health issues), and connection (i.e., where a relationship exists). Through a six-step process, community leaders and residents identified communication resources and collaborated to create a communication resource map. We discuss how this study advances the theoretical understanding of integration of culture-centered and ecological approaches for communication to reduce health disparities.
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Affiliation(s)
- Erendira Estrada
- a Merced County Department of Public Health , University of California , Merced
| | - A Susana Ramirez
- a Merced County Department of Public Health , University of California , Merced
| | - Stephanie Gamboa
- a Merced County Department of Public Health , University of California , Merced
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Fleming K, Simmons VN, Christy SM, Sutton SK, Romo M, Luque JS, Wells KJ, Gwede CK, Meade CD. Educating Hispanic Women about Cervical Cancer Prevention: Feasibility of a Promotora-Led Charla Intervention in a Farmworker Community. Ethn Dis 2018; 28:169-176. [PMID: 30038478 DOI: 10.18865/ed.28.3.169] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Hispanic women suffer disproportionately from cervical cancer incidence and mortality compared with non-Hispanic Whites in the United States. Peer-led health education and coaching via charlas (talking circles) may improve cervical cancer screening and early detection rates among specific sub-groups such as farmworker communities. This pilot study sought to collect preliminary evaluation data about the feasibility of implementing a promotora-led cervical cancer education intervention among women from a farmworker community. The study took place between April 2014 and November 2014. Created based on an established network (Tampa Bay Community Cancer Network, TBCCN), in partnership with a local farmworker organization (Farmworkers Self-Help, Inc.), the project entailed refinement of a curriculum guide including Spanish-language educational resources (teaching cards). Social Cognitive Theory and the Health Belief Model provided the conceptual framework for the study. Six women from the farmworker community helped to refine the intervention and were trained as promotoras. They successfully delivered the program via charlas to a total of 60 participants who completed baseline and post-intervention measures on knowledge (cervical cancer/HPV), beliefs, self-efficacy, and intentions. Findings demonstrated gains in knowledge and self-efficacy among charla participants (P<.0001), and support the promise of a community-driven intervention that is delivered by promotoras who use their cultural knowledge and trustworthiness to educate women about cancer screening practices. Results also add to the literature on the use of a charla approach for cancer prevention education within a farmworker community to prompt discussions about health. Future research should evaluate peer-led programs on a larger scale and among other at-risk groups in other community settings.
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Affiliation(s)
- Khaliah Fleming
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Vani N Simmons
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Shannon M Christy
- College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.,Formerly with H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Steven K Sutton
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Morsani College of Medicine, University of South Florida, Tampa, Florida
| | | | | | - Kristen J Wells
- San Diego State University, San Diego, California.,University of California, San Diego Moores Cancer Center, San Diego, California
| | - Clement K Gwede
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Cathy D Meade
- Division of Population Science, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Morsani College of Medicine, University of South Florida, Tampa, Florida
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Mendu S, Boukhechba M, Gordon JR, Datta D, Molina E, Arroyo G, Proctor SK, Wells KJ, Barnes LE. Design of a Culturally-Informed Virtual Human for Educating Hispanic Women about Cervical Cancer. INTERNATIONAL CONFERENCE ON PERVASIVE COMPUTING TECHNOLOGIES FOR HEALTHCARE : [PROCEEDINGS]. INTERNATIONAL CONFERENCE ON PERVASIVE COMPUTING TECHNOLOGIES FOR HEALTHCARE 2018; 2018:360-366. [PMID: 30555731 DOI: 10.1145/3240925.3240968] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Significant health disparities exist between Hispanics and the general US population, complicated in part by communication, literacy, and linguistic factors. There are few available Spanish-language interactive, technology-driven health education programs that engage patients who have a range of health literacy levels. We describe the development of an interactive virtual patient educator for educating and counseling Hispanic women about cervical cancer and human papillomavirus. Specifically, we describe the iterative design methodology and rationale, usability evaluation, and pilot testing of the system with Hispanic women in a rural community in Florida. The pilot study findings provide preliminary evidence of the feasibility of the proposed patient education approach. The proposed application and the lessons learned will prove beneficial for future work targeted towards different cultural populations.
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8
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Jones AR, Moser DK, Hatcher J. Using text messages to promote health in African-Americans: #HeartHealthyandCancerFree. ETHNICITY & HEALTH 2018; 23:307-320. [PMID: 27897049 DOI: 10.1080/13557858.2016.1263289] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVES African-Americans are vulnerable to both cancer and cardiovascular disease (CVD) due to intricately connected risk factors. Use of text messages is an innovative method to provide health information to reduce these risks. The aim of this study was to test the feasibility and acceptability of a text messaging intervention to reduce CVD and cancer risk factors in African-Americans. DESIGN We developed an intervention using text messages culturally tailored for African-Americans over age 50 who were at risk (one or more modifiable risk factors) for CVD and/or cancer. Sociodemographic data, biologic measures, cancer screening practices, and general health status were assessed. Group interviews were conducted to assess feasibility and acceptability. RESULTS Participants were primarily female (69%), aged 58 ± 5 years, who were married (59%) and worked full time (56%). In terms of feasibility and acceptability, themes of encouragement through text messages received and a desire for a longer study period emerged from group interviews with participants. Participants experienced significant decreases in waist circumference (41 ± 5 vs 40 ± 5, p = .002), systolic blood pressure (147 ± 25 mmHg vs 138 ± 20 mmHg, p = .009), diastolic blood pressure (87 ± 16 mmHg vs 82 ± 10 mmHg, p = .02), total cholesterol (194 ± 35 mg/dL vs 173 ± 32 mg/dL, p < .001), and low-density lipoprotein levels (100 ± 32 mg/dL vs 86 ± 29 mg/dL, p = .015). Five participants had colorectal cancer screening, two had prostate cancer screening, and four had mammograms. CONCLUSIONS Use of text messages was widely accepted among participants. Significant CVD risk reductions and increased cancer screenings were noted. Future studies should incorporate innovative strategies such as text messaging in promoting health in vulnerable populations.
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Affiliation(s)
- Allison R Jones
- a School of Nursing , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Debra K Moser
- b College of Nursing , University of Kentucky , Lexington , KY , USA
| | - Jennifer Hatcher
- b College of Nursing , University of Kentucky , Lexington , KY , USA
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Wells KJ, Vàzquez-Otero C, Bredice M, Meade CD, Chaet A, Rivera MI, Arroyo G, Proctor SK, Barnes LE. Acceptability of a Virtual Patient Educator for Hispanic Women. HISPANIC HEALTH CARE INTERNATIONAL 2016; 13:179-85. [PMID: 26671558 DOI: 10.1891/1540-4153.13.4.179] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
There are few Spanish language interactive, technology-driven health education programs. Objectives of this feasibility study were to (a) learn more about computer and technology usage among Hispanic women living in a rural community and (b) evaluate acceptability of the concept of using an embodied conversational agent (ECA) computer application among this population. A survey about computer usage history and interest in computers was administered to a convenience sample of 26 women. A sample video prototype of a hospital discharge ECA was administered followed by questions to gauge opinion about the ECA. Data indicate women exhibited both a high level of computer experience and enthusiasm for the ECA. Feedback from community is essential to ensure equity in state of the art dissemination of health information.
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Affiliation(s)
- Kristen J Wells
- San Diego State University and Moores Cancer Center, San Diego, California, USA
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10
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Braun KL, Thomas WL, Domingo JLB, Allison AL, Ponce A, Haunani Kamakana P, Brazzel SS, Emmett Aluli N, Tsark JU. Reducing cancer screening disparities in medicare beneficiaries through cancer patient navigation. J Am Geriatr Soc 2015; 63:365-70. [PMID: 25640884 PMCID: PMC4850231 DOI: 10.1111/jgs.13192] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Significant racial disparities in cancer mortality are seen between Medicare beneficiaries. A randomized controlled trial tested the use of lay navigators (care managers) to increase cancer screening of Asian and Pacific Islander Medicare beneficiaries. The study setting was Moloka'i General Hospital on the island of Moloka'i, Hawai'i, which was one of six sites participating in the Cancer Prevention and Treatment Demonstration sponsored by the Centers for Medicare and Medicaid Services. Between 2006 and 2009, 488 Medicare beneficiaries (45% Hawaiian, 35% Filipino, 11% Japanese, 8% other) were randomized to have a navigator help them access cancer screening services (experimental condition, n = 242) or cancer education (control condition, n = 246). Self-reported data on screening participation were collected at baseline and exit from the study, and differences were tested using chi-square. Groups were similar in demographic characteristics and baseline screening prevalence of breast, cervical, prostate, and colorectal cancers. At study exit, 57.0% of women in the experimental arm and 36.4% of controls had had a Papanicolaou test in the past 24 months (P = .001), 61.7% of women in the experimental arm and 42.4% of controls had had a mammogram in the past 12 months (P = .003), 54.4% of men in the experimental arm and 36.0% of controls had had a prostate-specific antigen test in the past 12 months (P = .008), and 43.0% of both sexes in the experimental arm and 27.2% of controls had had a flexible sigmoidoscopy or colonoscopy in the past 5 years (P < .001). Findings suggest that navigation services can increase cancer screening in Medicare beneficiaries in groups with significant disparities.
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Affiliation(s)
- Kathryn L Braun
- Office of Public Health Studies, University of Hawai'i, Honolulu, Hawai'i; Imi Hale Native Hawaiian Cancer Network, Honolulu, Hawai'i
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Braun KL, Stewart S, Baquet C, Berry-Bobovski L, Blumenthal D, Brandt HM, Buchwald DS, Campbell JE, Coe K, Cooper LC, Espinoza P, Henry-Tillman R, Hargreaves M, James A, Salmon Kaur J, Viswanath K, Ma GX, Mandelblatt J, Meade C, Ramirez A, Scarinci I, Park Tanjasiri S, Thompson B, Vines AI, Dignan M. The National Cancer Institute's Community Networks Program Initiative to Reduce Cancer Health Disparities: Outcomes and Lessons Learned. Prog Community Health Partnersh 2015; 9 Suppl:21-32. [PMID: 26213401 PMCID: PMC4698458 DOI: 10.1353/cpr.2015.0017] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND We describe reach, partnerships, products, benefits, and lessons learned of the 25 Community Network Programs (CNPs) that applied community-based participatory research (CBPR) to reduce cancer health disparities. METHODS Quantitative and qualitative data were abstracted from CNP final reports. Qualitative data were grouped by theme. RESULTS Together, the 25 CNPs worked with more than 2,000 academic, clinical, community, government, faith-based, and other partners. They completed 211 needs assessments, leveraged funds for 328 research and service projects, trained 719 new investigators, educated almost 55,000 community members, and published 991 articles. Qualitative data illustrated how use of CBPR improved research methods and participation; improved knowledge, interventions, and outcomes; and built community capacity. Lessons learned related to the need for time to nurture partnerships and the need to attend to community demand for sustained improvements in cancer services. IMPLICATIONS Findings demonstrate the value of government-supported, community-academic, CBPR partnerships in cancer prevention and control research.
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Ely GE, White C, Jones K, Feltner F, Gomez M, Shelton B, Slone S, Van Meter E, Desimone C, Schoenberg N, Dignan M. Cervical cancer screening: exploring Appalachian patients' barriers to follow-up care. SOCIAL WORK IN HEALTH CARE 2014; 53:83-95. [PMID: 24483330 PMCID: PMC5603223 DOI: 10.1080/00981389.2013.827149] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This article describes a community-based Patient Navigation (PN) project conducted to identify potential barriers to seeking follow-up cervical cancer care in southeastern Kentucky. Patient navigators (PNs) were placed in cervical cancer programs within county public health departments where they interviewed patients about their perceived barriers to seeking follow-up care after receiving a positive Pap test result. Participants identified various potential barriers at three levels: the individual/personal level, the health care system level and the community/environmental level. One identified barrier that was unique to this study was a lack of consistency between follow-up recommendations and follow-up guidelines for patients under age 21. Implications are discussed.
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Affiliation(s)
- Gretchen E Ely
- a College of Social Work , University of Kentucky , Lexington , Kentucky , USA
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