142nd APHA Annual Meeting and Exposition

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Patient navigator and physician champion as partners in addressing racial equity issues in cancer care

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 10:50 AM - 11:10 AM

Linda Robertson, DrPH, RN, MSN , Department of Medicine, University of Pittsburgh, Pittsburgh, PA
Karen Foley, RN, BSN, CCRC , Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA
Kristin Z. Black, MPH , Gillings School of Global Public Health / Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
Brian Cass , Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC
Samuel Cykert, MD , Division of General Medicine and Clinical Epidemiology and NC Area Health Education Centers Program, University of North Carolina Chapel Hill, Chapel Hill, NC
Michael Davis , UPMC CancerCenter
Steven Evans, MD , Pittsburgh Surgical Specialists, Inc, University of Pittsburgh
Ziya Gizlice, PhD , Center for Health Promotion and Disease Prevention, University of North Carolina Chapel Hill, Chapel Hill, NC
Christina Hardy, MPH , Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC
Dwight Heron, MD, FACRO, FACR , University of Pittsburgh/ UPMC CancerCenter
Skip Hislop , Cone Health, NC
Nora Jones, MEd , 501(C)3 agency which sponsors anti-racism workshops, The Partnership Project, Greensboro, NC
Alexandra Lightfoot, EdD , Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, Chapel Hill, NC
Mary S. Mouw, MD , Gillings School of Global Public Health, Department of Health Behavior, Chapel Hill, NC
Jennifer Schaal, MD , The Partnership Project, Greensboro, NC
Amondre Smith
Youland Williams, RN, MSN, NEA-BC , Cone Health Cancer Center, Greensboro, NC
Janet Yewon
Background: Inequity in cancer care continues to be a problem for African Americans who are often diagnosed at later stages and are less likely to complete recommended treatments. Accountability for Cancer Care through Undoing Racism and Equity is an NCI-funded systems change intervention trial to increase racial equity in quality and completion of treatment for early stage breast and lung cancer patients at two cancer centers. 

Methods: Embedded within this study is a randomized control trial of newly diagnosed Caucasians and African Americans with stage 1 and 2 breast and lung cancers. Individuals are randomly assigned to a specially trained patient navigator or to usual care.  Since most health systems do not have methods of tracking “real time” clinical performance, a real time registry has been developed.  This registry provides “Monthly Clinical Performance Reports” that are delivered by a physician champion to the cancer center care providers.

Results: The registry provides the navigator with daily information regarding treatment and appointment adherence for all trial participants.  This information allows the navigator, physician champion, and healthcare team to intervene with patients to identify and remove barriers to care, and minimize or eliminate interruptions to the cancer treatments.  The monthly reports provide each provider with status reports on their patients regarding adherence to treatment.  Interim analysis has shown an increase in treatment completion at both cancer centers.

Conclusions: The combination of the patient navigator and physician champion with real time information appears to have a positive effect on patient treatment completion.

Learning Areas:

Communication and informatics
Diversity and culture
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe the role of the patient navigator and physician champion in relation to racial equity issues. Discuss the process in which the physician champion addresses issues of concern with the treating physician/healthcare team. Identify at least 2 barriers that may interfere with cancer care and patient compliance.

Keyword(s): Cancer

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the prinicipal investigator at the University of Pittsburgh/UPMC CancerCenter for an R0-1 funded by the NCI, Accountability for Cancer Care through Undoing Racism and Equity. I am also involved in health equity related issues in underserved communities. My other areas of interest include decision making and community based participatory research.
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.

Back to: 4115.0: Mapping the landscape of equity and system change in cancer care: The ACCURE project