? Although Hispanics are the largest ethnic minority population in the United States, Hispanics remain underserved by healthcare systems and are less likely to seek or receive health care, contributing to disparities in health status and mortality. The University of Texas Health Science Center at San Antonio (UTHSCSA) is uniquely positioned to mitigate disparities in health and cancer care for the disadvantaged regional Hispanic population. The UTHSCSA National Center of Excellence in Women's Health (NCoEWH), recently designated by the Office of Women's Health, addresses health disparities in a newly identified population of intense need in conjunction with the San Antonio Metropolitan Health District (SAMHD) and University Health System (UHS) Patient Navigation is a key feature of the NCoEWH and the proposed Patient Navigation Research Project will build on this element to assist patients in gaining access to cancer care in a coordinated manner using SAMHD clinics, UHS clinics, community-based agencies, and University Hospital. The PNRP approach to Navigation is unique in its matrix organization and focus on coordination between community sites and agencies, facilitated through active involvement of clinical oncologists using evidence-based guidelines. Data will be systematically gathered to assess and eliminate barriers through process improvement and community involvement in addressing issues that impede effective cancer care. The project, combining the efforts of Navigators and Promoters, will build cultural competence, optimal communication, community cooperation, interdisciplinary investigation, and sound research to provide solid evidence concerning the cost-effectiveness and clinical efficacy of highly coordinated care. Carefully designed, theoretically sound metrics will be incorporated into the development and implementation of a Program to address questions concerning cost-effectiveness, improving the timeliness of care, and the impact of Navigation on patient satisfaction, cancer outcomes, and the general health of the population ? ?
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