The elimination of cancer disparities is a national imperative that requires the creation of accessible and beneficial interventions. The Tampa Bay region of west central Florida epitomizes this challenge, with low levels of education (20% without a high school education), high levels of poverty (12.5% living below the poverty line), a culturally diverse population (18 percent Hispanic and 15 percent African American), and high cancer incidence and mortality rates. Our hypothesis is that a culturally appropriate patient navigator program can be implemented in the Tampa Bay region of Florida that .will decrease delay in diagnosis and delivery of cancer care in an acceptable and cost-effective manner. Our plan is based upon a partnership that includes an NCI designated comprehensive cancer center (H. Lee Moffitt Cancer Center &Research Institute), community hospitals and clinics, the American Cancer Society, and HealthChoice Network. In Phase I we will work closely with our community partners to conduct formative research for the development of an acceptable, appealing, and appropriate Patient Navigator Program/During Phase I we will also obtain baseline data, through chart abstraction, on timeliness and cost of cancer care. Phase II is a group randomized controlled trial to evaluate the Patient Navigator Program. We will focus on patients diagnosed with a breast or colorectal cancer screening abnormality within our participating network. Four centers will receive the Navigator Program, and three will receive the intervention, but delayed. Data will be collected at the time of an abnormal screening finding, and at 1 month, 6 month, 1 year and 2 years to monitor timeliness of care, appropriateness of care, and patient satisfaction and quality of life. Phase III calls for the dissemination of the findings from this research outside the Tampa Bay region. We will Use study outcome data, including results of cost-effectiveness analyses plus input from key stakeholders (participants and providers) to develop a plan for long-term dissemination and sustainability of the program. This study is expected to result in a comprehensive evaluation of a Patient Navigator Program on quality of cancer care, patient satisfaction, quality of life and cost-effectiveness. Such knowledge is essential to improvements in reducing the mortality and suffering from cancer by 2015
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