A community-provider partnership to train cancer patient navigators for Native Hawaiians: Lessons learned

Cancer mortality continues to be higher in Native Hawaiians than Whites, and research has identified numerous barriers to good cancer care. Cancer navigator programs provide individualized assistance to patients and family members to overcome barriers, promoting early diagnosis and timely and complete treatment. Our purpose was to design and test a curriculum to enhance cancer patient navigator skills of Community Health Workers (CHW) serving Native Hawaiians. The 64-hour curriculum was informed by qualitative research with patients, families, and providers. It includes lectures (on all aspects of cancer, support programs, financial aid, etc), facility tours, networking lunches, web-searching, discussions with patients and providers, role-play, communication exercises, and opportunities for reflection. Provider-partners serve as faculty and host site visits. To date, 30 CHW statewide have been trained. Data gathered from a 3-month follow-up indicate increased knowledge, skills, and feelings of competence among the navigators. Trainees have requested continuing education sessions and opportunities to share cases as they actively navigate patients. We learned our curriculum is best offered as a supplement to basic CHW training in assessment and case management, which are essential to cancer care. The complexity of cancer care lent to the time-intensive nature of the training. Still, trainees could not learn everything about cancer, so we facilitated skills in finding answers through the Web and through contacts they made during the training. Provider partners are critical to navigation training programs because hospital contacts are essential to community-based workers in getting their patients into and through care.