Online Program

Describing and evaluating cancer patient navigation: Lessons learned from programs at four health centers in Hawaii

Monday, November 4, 2013 : 1:30 p.m. - 1:50 p.m.

Kathryn L. Braun, DrPH, Office of Public Health Studies, University of Hawaii, Honolulu, HI
Amanda Allison, MA, Papa Ola Lokahi, Imi Hale Native Hawaiian Cancer Network, Honolulu, HI
Jermy Domingo, MPH, Papa Ola Lokahi, Imi Hale Native Hawaiian Cancer Network, Honolulu, HI
JoAnn Tsark, MPH, `Imi Hale Native Hawaiian Cancer Network, Papa Ola Lokahi, Honolulu, HI
Cancer patient navigation (CPN) is designed to help people access and complete recommended cancer screening and treatment, but there is limited agreement on how to best target CPN services. Evaluation to definitively quantify outcomes has proven elusive. This paper describes patient navigation in four healthcare facilities in Hawai‘i and presents findings from evaluation. Descriptive data were gathered through interviews with CPN personnel. De-identified program and evaluation data were provided by each of the facilities. Study waivers were obtained from the IRBs affiliated with each program. All four facilities navigated clients through cancer diagnosis and treatment, and one also navigated patients to cancer screening. Cancer screening navigation was offered to rural-dwelling people and evaluated by randomized control trial, which demonstrated that navigation significantly increased compliance with recommended cancer screening tests. The programs providing navigation to treatment were more difficult to evaluate because navigators assisted a large variety of patients with a variety of cancers at a variety of stages, each with individualized treatment plans. However, data suggest that navigation services were provided to patients with the greatest needs for information, reassurance, transportation, financing, appointment scheduling, and service coordination. Case study methods and client satisfaction surveys also helped to document program impact. CPN services can reduce disparities in cancer screening, are appreciated by clients, and can be successfully targeted to individuals at greatest need for assistance. More work is needed to develop evaluation methods to test navigation's ability to help cancer patients efficiently complete individualized treatment.

Learning Areas:

Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Public health administration or related administration

Learning Objectives:
Describe cancer patient navigation programs. Evaluate cancer patient navigation programs.

Keyword(s): Cancer, Case Management

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: 30 years in public health education and evaluation; 20 years of university teaching
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.