Cancer Patient Navigators -- An Ancillary Service to Improve Minority Cancer Care

Cancer mortality is higher in indigenous and minority Americans than Whites, and research has identified numerous barriers to good cancer care. Cancer navigators provide individualized assistance to patients and family members to overcome barriers, promoting early diagnosis and timely and complete treatment. We designed a curriculum to enhance cancer patient navigation skills of community-based outreach workers serving indigenous and minority residents of Hawai`i. The Ho`okele i ke Ola (Navigating to Health) curriculum was informed by data gathered from Native Hawaiian and minority cancer patients and their family members, outreach workers serving indigenous and minority communities, and cancer care providers. Based on findings, the 64-hour curriculum focused on cancer knowledge, cancer resources, and cancer communications. Three versions were developed—Honolulu training (trainees came to Honolulu for 6 days of training and tours), neighbor island training (training was delivered on a neighbor island, after which trainees came to Honolulu for 2 days of tours), and a 3-credit community college course. Graduates were interviewed at the end of the course about use of navigation skills. In 18 months, 70 health workers were trained—45 in Honolulu training, 23 in neighbor island training, and 2 through Maui Community College. Follow-up data suggest increased knowledge, skills, and feelings of competence among trainees. All three versions of the Ho`okele i ke Ola curriculum, developed with community input, have proven successful in increasing cancer patient navigation skills of trainees and increasing minority access to cancer care.