243586 Patient navigator study: Addressing cancer screening barriers and increasing adherence among LGBT persons

Monday, October 31, 2011

Rebecca Ramsey, MPH , University of Nebraska Medical Center, CityMatCH, Omaha, NE
Alicia Matthews, PhD , College of Nursing, University of Illinois at Chicago, Chicago, IL
Lisa M. Kuhns, PhD, MPH , Division of Research, Howard Brown Health Center, Chicago, IL
Objective: To develop and evaluate a culturally-targeted patient navigation curriculum aimed at increasing cancer screening among lesbian, gay, bisexual and transgender (LGBT) persons.

Methods: In-depth interviews (N = 42) were conducted with providers and medical directors of LGBT-serving clinics, and LGBT persons who were non-adherent to screening guidelines. Data were analyzed to identify general and LGBT-specific barriers and facilitators to screening. An expert panel review, a learner verification trial, and the scientific literature were used to adapt an existing Health Systems Navigation curriculum to address barriers to cancer screening among LGBT persons.

Results: LGBT-specific barriers to cancer screening included mistrust of the health care system (69%) and experiences with discrimination in health care setting (31%). Patient navigation was viewed as an acceptable strategy for reducing barriers to screening (74% agreement). The adapted curriculum includes 9 modules focused on knowledge about LGBT populations and cancer screening needs, cancer risk and protective factors, behavior change approaches, and accessing care.

Conclusions: The Patient Navigator Study findings are consistent with previous reports of institutional and individual-level barriers to screening. This study's findings were used to develop a patient navigator curriculum which will be used to enhance the cultural competency of health educators and lay patient navigators serving LGBT populations. Using a medical standardized patient approach, the feasibility and effectiveness of the curriculum will be evaluated through the training of health educators and lay patient navigators. The final curriculum will be presented and results from the training trials will be discussed during the presentation.

Learning Areas:
Assessment of individual and community needs for health education
Chronic disease management and prevention
Diversity and culture
Planning of health education strategies, interventions, and programs
Public health or related research

Learning Objectives:
1. identify key barriers and facilitators to breast, cervical, and colorectal cancer screening among LGBT individuals 2. discuss the history and purpose of patient navigation as an effective tool to increase cancer screening in non-adherent, minority populations 3. assess the feasibility of the culturally-targeted cancer screening patient navigation curriculum developed as part of this research project

Keywords: Cancer Screening, Health Education Strategies

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the research project coordinator for this study with additional prior research experience with development and testing of educational curricula for health care professionals.
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.