Cancer is the second-leading cause of death in the United States, yet this burden continues to disproportionately affect vulnerable populations including low-income, minority, and geographically isolated communities. Of all cancers, breast, colorectal, and cervical are those most amenable to early detection via evidence-based screening procedures. Patient navigation is an evidence-based practice to improve adherence to cancer screening as well as diagnostic and treatment guidelines among vulnerable populations. Specifically, several studies show that patient navigation improves mammography, cervical screening, and colonoscopy rates for low-income and/or racial/ethnic minority patients. While cancer prevention and control programs are increasingly using patient navigators (PNs) to facilitate healthcare access as well as continuity and quality of care among vulnerable patients, not enough is known about the scope and context of practice of these PNs nor their background and training, especially within community settings. This information is vital for optimizing the delivery of patient navigation activities both inside and outside of health systems. Identifying training and resource needs as well as disseminating best-practices among PNs may also facilitate reductions in cancer disparities. The purpose of SIP 17-003, Formative Study of Patient Navigators with the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and the Colorectal Cancer Control Program (CRCCP), is to conduct a comprehensive assessment of PNs. The primary aim of this study is to characterize PNs working with the NBCCEDP and CRCCP including their roles and responsibilities, work environment, and training and technical assistance needs. The proposed activities will advance the science of PN interventions and will support efforts to scale-up and optimize the delivery of patient navigation services, especially within the context of NBCCEDP and CRCCP. We will achieve this aim by conducting the following activities in collaboration with CDC and NBCCEDP and CRCCP grantees: 1) identify affiliated PNs; 2) develop and administer an online survey to assess the background, training, roles and responsibilities, work environment, and training and technical assistance needs among affiliated PNs; and 3) interview a subset of approximately 30 survey respondents to elucidate key differences in experiences and training/technical assistance needs by factors such as practice setting (clinical versus non-clinical) and type of training (nurse v. health educator, for example). Our team is well-positioned to work with NBCCEDP and CRCCP grantees to conduct the proposed activities and to disseminate the findings. As part of CDC's Cancer Prevention and Control Research Network, we already collaborate with NBCCEDP and CRCCP to gather evaluation data directly from grantees, share findings with CDC and the grantees, and publish the results. Our investigators also work with federally qualified health centers and other healthcare systems in multiple states and participate in practice networks that provide opportunities for further dissemination of study findings beyond NBCCEDP and CRCCP grantees.
Cancer prevention and control programs are increasingly using patient navigation as an evidence-based approach to facilitate continuity and quality of care among vulnerable patients, but not much is known about patient navigators' scope and context of practice. The primary aim of this study is to characterize patient navigators working with the National Breast and Cervical Early Detection Program and Colorectal Cancer Control Program, including their background, roles and responsibilities, work environment, and training and technical assistance needs. The proposed activities will advance the science of patient navigator interventions and support efforts to scale-up and optimize delivery of navigation activities.
