142nd APHA Annual Meeting and Exposition

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Effectiveness of patient navigators in improving follow-up of abnormal mammogram by mitigating medical distrust and dissatisfaction

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 3:10 PM - 3:30 PM

Nerida Berrios, BA , School of Public Health, Health Policy, University of Illinois at Chicago, Chicago, IL
Sage Kim, PhD , University of Illinois at Chicago, Chicago, IL
Elizabeth Calhoun, PhD , Division of Health Policy and Administration, University of Illinois at Chicago, School of Public Health, Chicago, IL
Audio (mp3) recording Recorded Presentation (mp4)
While timely follow-up of abnormal breast cancer diagnostic test results could lead to earlier diagnosis, many factors influence timely diagnostic resolution.  Individual and neighborhood characteristics affect access and quality of care.  In addition, medical distrust and satisfaction may affect how women seek healthcare.  Studies have documented that racial/ethnic minorities have a greater level of distrust and a lower level of satisfaction, which might contribute to delayed follow-up of abnormal mammogram. 

PNs can bridge underserved women and the healthcare system, which can improve patient satisfaction and mitigate medical distrust.  The purpose of this study is 1) to examine underlying individual and neighborhood characteristics associated with medical distrust and dissatisfaction among women who received breast cancer screening and diagnostic tests; and 2) to examine the effectiveness of PNs in improving follow-up of abnormal mammogram.

 

We geocoded addresses of 540 women Chicago residents who participated in the Patient Navigation in Medically Underserved Areas Program.  The mean % poverty was marginally higher for those who did not complete the follow up test within 60 days. Women with college and higher education had a greater level of medical distrust compared with women with less education; and women who had a greater distrust had a lower level of satisfaction.  In addition, women living in neighborhoods with a greater level of poverty had a lower level of satisfaction.  Neighborhood poverty was associated with delayed follow-up.  Overall, navigated women had more timely follow-up of abnormal results compared to usual care (p>.05).

Learning Areas:

Administer health education strategies, interventions and programs
Conduct evaluation related to programs, research, and other areas of practice
Program planning
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Social and behavioral sciences

Learning Objectives:
evaluate the effectiveness of patient navigator intervention identify geographic patterns of medical distrust and patient satisfaction examine the effects of neighborhood poverty on timely follow-up of abnormal test results

Keyword(s): Cancer, Health Care Access

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract Author on the content I am responsible for because I completed the analysis.
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: 4369.0: Community health workers/lay patient navigators: Defining the intersection of research and community