Patient navigation: The team effect

Racial and ethnic disparities in breast and cervical cancer mortality are well-documented. These disparities are attributed to a range of factors, including low socioeconomic status, lack of health insurance, personal and cultural beliefs, and barriers present in the healthcare system, each of which impede the timely receipt of necessary health services. Increasingly "patient navigators" are being embraced as one strategy to reduce racial and ethnic disparities in breast and cervical cancer outcomes. Patient navigators assist patients in overcoming barriers to the timely receipt of healthcare services by eliminating personal and system obstacles to diagnosis and treatment. Despite the proliferation of patient navigation programs across the country, there is no clear understanding about what type of personnel (e.g., professional or lay person; social worker, nurse clinician, health educator, or case manager, etc.; paid worker or volunteer) is best suited to perform the activities. As one of eight controlled studies funded under the National Cancer Institute's $24 million Patient Navigator Research Program, the Chicago patient navigation program utilizes a patient navigator triad composed of a clinical social worker, mid-level clinician, and two lay health navigators to improve the timely receipt of followup care. Investigators will describe the rationale for the composition of the navigator team, the roles and responsibilities of each member, the benefits of using a diverse team, and the implications for patient care based on the experiences of implementing the intervention during the first 12 months.