218629 Racial/ethnic concordance between patients and patient navigators in identification of barriers to care

Monday, November 8, 2010 : 1:30 PM - 1:45 PM

M. Christina Santana, MPH , Section of Internal and General Medicine, Women's Health Unit, Boston Medical Center, Boston, MA
Karen Freund, MD, MPH , Chief, Women's Health Unit, Professor of Medicine and Epidemiology, Boston, MA
Sharon M. Bak, MPH , Section of Internal and General Medicine, Women's Health Unit, Boston Medical Center, Boston, MA
Kristine Beaver, MPH , Section of Internal and General Medicine, Women's Health Unit, Boston Medical Center, Boston, MA
Stephen Evans, MPH , Data Coordinating Center, Boston University School of Public Health, Boston, MA
Tracy Battaglia, MD, MPH , Boston University School of Medicine, Assistant Professor of Medicine and Epidemiology, Boston, MA
Introduction: Patient Navigation aims to reduce cancer health disparities by addressing barriers to care. No studies have looked at whether racial/ethnic concordance between patient and navigators improves care. We examine the role of racial/ethnic concordance on the identification of barriers to care in the Boston Patient Navigation Research Program. Methods: Eligible women had abnormal breast cancer screening during the study period. Patients and navigators were categorized into one of 4 mutually exclusive racial/ethnic categories and then matched for racial/ethnic concordance (yes/no). The outcome was whether navigators identified barriers to care (yes/no). We initially examined the outcome by patient race/ethnicity and then by racial/ethnic concordance, stratifying analyses by white and non-white participants. Results: Preliminary analyses include 503 women, mean age 49 years; 15% Black, 20% Asian, 23% Hispanic and 42% White; 63% speak English and 65% had public health insurance. 10 navigators (7 white, 1 African American, 1 Latina, 1 Asian) provided services. Overall, non-white women had more barriers identified compared with white women (79% vs. 50%, p <0.0001). In stratified analyses, among non-white participants there were no difference in barrier identification for concordant pairs compared with discordant pairs (81% vs. 78%, p =0.838). Among white participants, however, concordant pairs were less likely than discordant pairs to have barriers identified (41% vs. 72%, p <0.0001). Conclusion: Racial/ethnic minorities are more likely to have barriers documented compared to white women. We did not find racial/ethnic concordance to predict barrier identification.

Learning Areas:
Diversity and culture
Public health or related research

Learning Objectives:
Define the racial/ethnic concordance concept as it relates to patient care. Discuss racial/ethnic concordance in outcomes of patient navigation. Describe Patient Navigation Programs as an intervention to improve quality care among underserved communities.

Keywords: Cancer, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I have been involved in the development of this studies aims.
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.