A community based patient navigation model to improve Latino cancer disparities

BACKGROUND: The Centers for Medicare and Medicaid Services-Cancer Prevention and Treatment Demonstration project (CMS-CPTD) is a congressionally mandated program established to reduce cancer health disparities among minority Medicare populations. UMDNJ-NJMS is one of six sites awarded this demonstration project. Each site targets a different minority population. The overall aim is to institute an innovative cancer care facilitation program for Latinos helping them navigate the health care system, and facilitate screening, diagnosis and treatment of breast, cervical, colorectal, and prostate cancer. RESEARCH DESIGN: This is a randomized intervention trial, built upon a Multilevel Approach to Community Health (MATCH) planning model, integrating outreach, education, access to screening, and patient assistance using Community Health Workers and Patient Navigators. A total of 1384 participants will be enrolled. RESULTS: To date, 1,125 participants have been enrolled, with 563 in the intervention arm, and 562 in the control arm. The most prominent cancer screening barriers identified, leading to non-participation in screenings are: financial, fear, attitude about cancer, other co-morbidities, language, mental status, transportation, health system issues, literacy levels, family issues, and pain. So far, 289 mammograms, 136 Pap Smears, 128 Colonoscopies, and 139 PSA have been completed since the patient navigation program started. DISCUSSION: The CMS-CPTD Projects were established to reduce cancer health disparities among minority Medicare beneficiary populations. Others have demonstrated patient navigation to be successful in the diagnosed patient, to achieve better treatment and survival outcomes. The preliminary results indicate improved cancer screening service utilization. This CMS project will demonstrate Patient Navigation's success in screening outcomes.