141st APHA Annual Meeting

In This section

284337
Navigating Latinas with breast cancer to treatment: The six cities study

Wednesday, November 6, 2013 : 11:00 AM - 11:15 AM

Amelie Ramirez, DrPH , Dept of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, San Antonio, TX
Eliseo J. Perez-Stable, MD , Department Medicine, University of California, San Francisco, San Francisco, CA
Frank Penedo, PhD , Department of Medical Social Sciences / Northwestern University, Northwestern University, Chicago, IL
Gregory Talavera, MD, MPH , Graduate School of Public Health, San Diego State University, San Diego, CA
J. Emilio Carrillo, MD, MPH , Weill Cornell Medical College, Cornell University, New York, NY
Maria E. Fernandez, PhD , Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX
Alan Holden, PhD , The Institute for Health Promotion Research, Department of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, San Antonio, TX
Edgar Munoz, MS , The Institute of Health Promotion Research, Dept of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, San Antonio, TX
Dorothy Long Parma, MD, MPH , Institute for Health Promotion Research, University of Texas Health Science Center at San Antonio, San Antonio, TX
Kipling Gallion, MA , Dept of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, San Antonio, TX
Breast cancer is the leading cause of cancer deaths in Latinas. Time from cancer diagnosis to treatment initiation is critical in optimizing care. Patient navigation (PN) is a potentially effective means of promoting timely breast cancer treatment, yet efficacy is insufficiently documented.

Redes En Acción: The National Latino Cancer Research Network, tested the effects of a theory-driven, culturally-sensitive PN program for Latinas with breast cancer in six U.S. cities. We evaluated time from diagnosis to initial treatment and proportions of women treated within 30 days of diagnosis.

We analyzed 109 Latinas diagnosed with breast cancer from July 2008-January 2011 (42 navigated, 67 controls). Women were navigated by locally trained navigators, or non-navigated. Kaplan-Meier, Cox proportional hazards, and logistic regression models were used to determine group differences.

Time from cancer diagnosis to first treatment was lower in the navigated group (mean 24.98 days, control 38.12 days, HR 1.61, p=0.02). Additionally, 64.3% of navigated Latinas began treatment within 30 days of cancer diagnosis, vs. 47.8% of non-navigated Latinas (p=0.015). These results were independent of stage at diagnosis and cancer clinic and participant characteristics. Examination of navigator logbooks indicated that faster treatment times likely resulted from at least three activities: oncology appointment reminders, transportation and/or accompaniment to appointments, and translation services.

Patient-centered navigation to assist Latina women with breast cancer diagnoses significantly reduces time from diagnosis to treatment, and increases the proportion of women beginning treatment within 30 days of diagnosis. Improvement appears to be associated with specific navigator activities.

Learning Areas:
Chronic disease management and prevention
Clinical medicine applied in public health
Conduct evaluation related to programs, research, and other areas of practice
Other professions or practice related to public health
Public health or related research

Learning Objectives:
Evaluate efficacy of a theory-driven, culturally sensitive patient navigation program for Latinas with breast cancer

Keywords: Health Care Delivery, Health Care Quality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: My primary goal is to research the causes and solutions for health disparities affecting residents locally, regionally and nationally. My Institute's research and community outreach include all chronic diseases, with special emphasis on cancer prevention and control. With over 30 years' experience in program planning, implementation and evaluation, much of my work has focused on underserved Latino audiences. I have led multiple NCI-funded programs and am PI of Redes en Accion (Networks in Action).
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.