Developing a curriculum to train Southeast Asian community breast health navigators: Perspectives from patients, navigators, and medical providers

Southeast Asian (SEA) women have the lowest rates of breast cancer screening among all women. Our project is the first community-based participatory research study to investigate how community health navigators (CHNs) support patients from four SEA communities in Southern California to obtain breast health services. Our collaborative goal was to identify how CHNs address cultural differences and systemic barriers to navigate immigrant, low-income Cambodian, Laotian, Thai and Vietnamese women journeying through the vast and complex ocean of cancer care services. We gathered the perspectives of three groups: community health navigators, SEA women/patients, and their providers.

Our team conducted 16 focus groups with 110 SEA women representing different stages of the care continuum; and qualitative, semi-structured, in-depth interviews with 15 providers and 10 community navigators to achieve three research aims: 1) Explain how community navigators enable SEA women to seek breast health services, 2) Describe the roles, skills, and personal qualities of community health navigators, and 3) Identify the essential elements needed to develop a navigation training curriculum.

Findings indicate that the important focus areas for a health navigation training curriculum include informational (e.g. knowing pertinent medical information and procedures and how to navigate resources); logistical (providing transportation, interpretation); and interpersonal aspects (understanding the language/cultural beliefs of patients, communicating with providers, knowing navigator roles). From all three group perspectives, community health navigators appear to be the crucial links who help to establish trusting relationships that are key in making healthy practices culturally meaningful, accessible, usable, and acceptable for underserved communities.