Characteristics of the original patient navigation programs to reduce disparities in the diagnosis and treatment of breast cancer Journal Article


Authors: Vargas, R. B.; Ryan, G. W.; Jackson, C. A.; Rodriguez, R.; Freeman, H. P.
Article Title: Characteristics of the original patient navigation programs to reduce disparities in the diagnosis and treatment of breast cancer
Abstract: BACKGROUND. Patient navigation is an intervention developed to reduce disparities in cancer care that is being widely replicated and receiving considerable support for demonstration projects and research to test its effectiveness. In the current study, the authors present an in-depth descriptive analysis of the original patient navigation programs to inform current and future program development. METHODS. A qualitative multistakeholder case study using interviews and site visits of the first patient navigation site and 2 sites subsequently developed by the leadership of the original site were evaluated. RESULTS. At these sites, patient navigation is a system, as opposed to a person, comprised primarily of navigators and directors that work together to remove barriers and facilitate access in a well-defined course of care; navigators were from the community or were culturally similar to the patient population served but were also paid employees of the clinical care site with detailed knowledge of the clinical course patients must traverse to complete care plans. Directors had administrative authority over the clinical facility and social capital across institutions, and communicated regularly and openly with navigators to implement system level changes to remove barriers to care. Contextual factors such as policies supporting breast cancer care also influenced the implementation of these programs. CONCLUSIONS. The first patient navigation programs combined community and culturally sensitive care-coordination with aspects of disease management programs to reduce racial, ethnic, and poverty-driven disparities in care. Future efforts to replicate and evaluate patient navigation should take into account these unique aspects of the original patient navigation programs. © 2008 American Cancer Society.
Keywords: disease course; cancer diagnosis; breast cancer; breast neoplasms; cancer therapy; health program; health service; patient care; health care personnel; physician; community; clinical effectiveness; disease management; program development; ethnicity; socioeconomics; quality of health care; socioeconomic factors; policy; race; semi structured interview; quality of care; qualitative analysis; poverty; medical staff; patient navigation; community health aides; disparities; case management; access to healthcare; community health; patient navigation program
Journal Title: Cancer
Volume: 113
Issue: 2
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2008-07-15
Start Page: 426
End Page: 433
Language: English
DOI: 10.1002/cncr.23547
PUBMED: 18470906
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 18" - "Export Date: 17 November 2011" - "CODEN: CANCA" - "Source: Scopus"
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