Mira L Katz1, Gregory S Young2, Paul L Reiter2, Tracy A Battaglia3, Kristen J Wells4, Mechelle Sanders5, Melissa Simon6, Donald J Dudley7, Steven R Patierno8, Electra D Paskett2. 1. The Ohio State University, Columbus, Ohio. Electronic address: mira.katz@osumc.edu. 2. The Ohio State University, Columbus, Ohio. 3. Boston University School of Medicine, Boston, Massachusetts. 4. San Diego State University, San Diego, California. 5. University of Rochester, Rochester, New York. 6. Northwestern University, Chicago, Illinois. 7. University of Texas Health Science Center at San Antonio, San Antonio, Texas. 8. The George Washington University, Washington, DC.
Abstract
BACKGROUND: Patient navigation (PN) is a system-level strategy to decrease cancer mortality rates by reducing barriers to cancer care. Barriers to resolution among participants in the PN intervention arm with a breast or cervical abnormality in the Patient Navigation Research Program and navigators' actions to address those barriers were examined. METHODS: Data from seven institutions (2005-2010) included 1,995 breast and 1,194 cervical patients. A stratified Cox proportional hazards regression model was used to examine the effects of barriers on time to resolution of an abnormal screening test or clinical finding. FINDINGS: The range of unique barriers was 0 to 12 and 0 to 7 among participants with breast and cervical abnormalities, respectively. About two thirds of breast and one half of cervical participants had at least one barrier resulting in longer time to diagnostic resolution among breast (adjusted hazard ratio [HR], 0.744; p < .001) and cervical (adjusted HR, 0.792; p < .001) participants. Patient- and system-level barriers were most common. Frequent navigator actions were making arrangements, scheduling appointments, referrals, and education. CONCLUSIONS: Having a barrier resulted in a delay in diagnostic resolution of an abnormal screening test or clinical finding. Health care systems can use these findings to improve existing PN programs or when developing new programs.
BACKGROUND:Patient navigation (PN) is a system-level strategy to decrease cancer mortality rates by reducing barriers to cancer care. Barriers to resolution among participants in the PN intervention arm with a breast or cervical abnormality in the Patient Navigation Research Program and navigators' actions to address those barriers were examined. METHODS: Data from seven institutions (2005-2010) included 1,995 breast and 1,194 cervical patients. A stratified Cox proportional hazards regression model was used to examine the effects of barriers on time to resolution of an abnormal screening test or clinical finding. FINDINGS: The range of unique barriers was 0 to 12 and 0 to 7 among participants with breast and cervical abnormalities, respectively. About two thirds of breast and one half of cervical participants had at least one barrier resulting in longer time to diagnostic resolution among breast (adjusted hazard ratio [HR], 0.744; p < .001) and cervical (adjusted HR, 0.792; p < .001) participants. Patient- and system-level barriers were most common. Frequent navigator actions were making arrangements, scheduling appointments, referrals, and education. CONCLUSIONS: Having a barrier resulted in a delay in diagnostic resolution of an abnormal screening test or clinical finding. Health care systems can use these findings to improve existing PN programs or when developing new programs.
Authors: Ninez A Ponce; Neetu Chawla; Susan H Babey; Melissa S Gatchell; David A Etzioni; Benjamin A Spencer; E Richard Brown; Nancy Breen Journal: Med Care Date: 2006-11 Impact factor: 2.983
Authors: John F Dovidio; Louis A Penner; Terrance L Albrecht; Wynne E Norton; Samuel L Gaertner; J Nicole Shelton Journal: Soc Sci Med Date: 2008-05-26 Impact factor: 4.634
Authors: Edward H Wagner; Susan M Bennett; Brian T Austin; Sarah M Greene; Judith K Schaefer; Michael Vonkorff Journal: J Altern Complement Med Date: 2005 Impact factor: 2.579
Authors: Karen M Freund; Tracy A Battaglia; Elizabeth Calhoun; Donald J Dudley; Kevin Fiscella; Electra Paskett; Peter C Raich; Richard G Roetzheim Journal: Cancer Date: 2008-12-15 Impact factor: 6.860
Authors: Danielle S Bitterman; David Grew; Ping Gu; Richard F Cohen; Nicholas J Sanfilippo; Cynthia G Leichman; Lawrence P Leichman; Harvey G Moore; Heather T Gold; Kevin L Du Journal: J Gastrointest Oncol Date: 2015-10
Authors: Jesus G Ulloa; Marian Hemmelgarn; Lori Viveros; Patience Odele; Nancy R Feldman; Patricia A Ganz; Melinda Maggard-Gibbons Journal: Surgery Date: 2015-05-29 Impact factor: 3.982
Authors: Elizabeth M Whitley; Peter C Raich; Donald J Dudley; Karen M Freund; Electra D Paskett; Steven R Patierno; Melissa Simon; Victoria Warren-Mears; Frederick R Snyder Journal: Cancer Date: 2016-09-20 Impact factor: 6.860
Authors: Rebecca Selove; Barbara Kilbourne; Mary Kay Fadden; Maureen Sanderson; Maya Foster; Regina Offodile; Baqar Husaini; Charles Mouton; Robert S Levine Journal: Womens Health Issues Date: 2016-10-20
Authors: Julia R Trosman; Ruth C Carlos; Melissa A Simon; Debra L Madden; William J Gradishar; Al B Benson; Bruce D Rapkin; Elisa S Weiss; Ilana F Gareen; Lynne I Wagner; Seema A Khan; Mikele M Bunce; Art Small; Christine B Weldon Journal: J Oncol Pract Date: 2016-10-31 Impact factor: 3.840
Authors: Simon Craddock Lee; Robin T Higashi; Joanne M Sanders; Hong Zhu; Stephen J Inrig; Caroline Mejias; Keith E Argenbright; Jasmin A Tiro Journal: Cancer Causes Control Date: 2018-08-23 Impact factor: 2.506
Authors: Mona N Fouad; Aras Acemgil; Sejong Bae; Andres Forero; Nedra Lisovicz; Michelle Y Martin; Gabriela R Oates; Edward E Partridge; Selwyn M Vickers Journal: J Oncol Pract Date: 2016-05-17 Impact factor: 3.840
Authors: Naomi Y Ko; Frederick R Snyder; Peter C Raich; Electra D Paskett; Donald J Dudley; Ji-Hyun Lee; Paul H Levine; Karen M Freund Journal: Cancer Date: 2016-05-26 Impact factor: 6.860