207669 Using a lay patient navigator to improve care of newly diagnosed underserved patients: An application of the Cognitive-Social Health Information-Processing (C-SHIP) model

Tuesday, November 10, 2009

Linda Fleisher, MPH , Health Communications and Health Disparities, Fox Chase Cancer Center, Cheltenham, PA
Suzanne M. Miller, PhD , Fox Chase Cancer Center, Cheltenham, PA
Kuang-Yi Wen, PhD , Fox Chase Cancer Center, Cheltenham, PA
Venk Kandadai, MPH , Health Communications and Health Disparities, Fox Chase Cancer Center, Cheltenham, PA
Danielle M. Crookes, MPH , Health Communications and Health Disparities Department, Fox Chase Cancer Center, Cheltenham, PA
Patient navigation has become an important component of quality cancer care, especially for underserved populations. Guided by the cognitive-social health information processing (C-SHIP) model, this demonstration project implemented a theory-driven, bilingual (English-Spanish) patient navigation program in an urban healthcare setting.

Newly diagnosed cancer patients from five sites (breast, cervical, colorectal, prostate, and lung) were recruited, established a baseline and followed to assess their satisfaction and intervention impact on the C-SHIP variables (cognition, expectancy, goals and values, affects, and self-regulatory strategies). Relying on a community-based participatory research principle, a non-clinical navigator model was used to address patient issues and needs. Paired t-tests with Bonferroni adjustments were used to examine the changes in C-SHIP variables and patient's satisfaction over time.

A total of 44 patients enrolled, consented and completed the baseline assessment. Approximately 63% of the patients recruited earned less than $15,000 per year, nearly 82% were women, 82% were African American, and 25% spoke Spanish and had their assessments translated in Spanish. Both affect and self-regulatory scores significantly improved from baseline to 4-weeks. The increase in mean satisfaction scores from 4-weeks to 12-weeks was also significant.

The results of the demonstration project suggest a positive impact on patient satisfaction and the psychosocial load on the patient regarding their cancer diagnosis. Future and larger-scale patient navigation studies should consider the psychosocial impact of cancer on patients and tailor these interventions accordingly.

Learning Objectives:
1) Identify psychosocial issues in regards to cancer diagnoses among underserved populations. 2) Analyze psychosocial variables using a patient navigation intervention. 3) Evaluate the effectiveness of a non-clinical patient navigation program on patient satisfaction.

Keywords: Public Health Research, Community Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Ms. Fleisher, MPH, PhD (c) is the Assistant Vice-President of the Department of Health Communications and Health Disparities at Fox Chase Cancer Center in Philadelphia, PA. She is the Principal Investigator on a number of cancer control programs including NCIís Cancer Information Service-Atlantic Region, PA Cancer Education Network, and the PA Patient Navigation Demonstration Project. In addition, she directs a number of Fox Chase programs focused on patient education, health communications, community outreach and cancer screening. She also is the Associate Director of the CIS Research Consortiumís Intervention Development and Measurement Core which has developed three interactive software programs to provide decision making support to cancer patients. Her interests have focused on the integration of service and research, especially in the areas of health communication and community-based initiatives. More specifically, her research has bridged the fields of health communications and public health, with an emphasis on public health planning and evaluation, consumer informatics, health disparities, health education/communication interventions, and community-participatory and dissemination research. She also has an interest in new media, e-health and decision support. She has considerable experience in formative evaluation and intervention development, especially among underserved and at-risk populations. Her research has benefited from strong collaborations with both internal and external researchers. West Chester State College, West Chester, PA 1.0 WEST CHESTER, PA B.A. 1976 Sociology Temple University, Philadelphia, PA MPH 1984 Community Health Education Temple University, Philadelphia, PA PhD Ė (c) 2008 Health Studies
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.