Patient navigation educational curriculum for cancer care in Mexico.
Authors: Chavarri Guerra Yanin , Ramos-Lopez Wendy Alicia , Olaya-Vargas Alberto , Platas Alejandra , Navarrete Reyes Ana Patricia , Villarreal-Garza Cynthia , Touya Diego , Bautista Elysse , Soto Pérez de Celis Enrique , Aldaco Fernando , Arenas Arrocena Juan , Unger-Saldana Karla , San Miguel Sandra 
Published: June 2023

e18592

Background: In Latin America (LatAm), cancer is a major public health issue with high mortality rates. Patient navigation (PN) programs have emerged as a strategy to improve access to cancer care for underserved populations. Unfortunately, there is a lack of educational opportunities for those willing to become patient navigators in LatAm. The aim of this study was to develop and implement an educational PN curriculum for healthcare workers interested in improving cancer care in Mexico. Methods: A multidisciplinary team of national top-level cancer experts designed an online comprehensive PN curriculum, which was implemented online following the ECHO model. It consisted of a four-day virtual conference including virtual lectures and workshops. Participants were ask to develop or improve PN programs tailored for their specific institutional needs. After the conference, attendees were tasked with implementing their planned programs. They participated in eight monthly conference video calls designed to reinforce PN project implementation, assist in overcoming barriers and continue conversations with expert faculty. Participants completed pre- and post- course knowledge and satisfaction questionnaires. Progress of participants’ individual goals implementation was assessed at 4 and 8 months after the conference. Results: 28 participants attended the online conference, 56% of them were physicians, 16% psychologists, 4% nurses, and 4% social workers. 89% worked in a public hospital, 72% took care of adults with solid cancer, and 28% of children with hematologic/solid cancers. 93% considered the program was excellent and 100% that the information improved their knowledge. Participants’ baseline knowledge score was 66% (range 27-76%) with a significant increase in the proportion of correct answers of 12% (p < 0.01) at the end of the program (final score 74%; range 58-84%). At 4- and 8-month follow-up, participants reported 54% and 60% of progress regarding their goals on implementing a PN program at their institutions. Most common barriers to PN program implementation were communication issues with other healthcare providers in 44% of participants, and lack of financial support in 11%. At 8 months, most participants felt that they were well prepared for providing PN for patients with cancer (mean = 4.2/5; SD 0.42); and well prepared for managing patient and institutional barriers for cancer care (mean = 4/5; SD 0.67). Conclusions: Our results showed that implementing a virtual educational PN curriculum was feasible, that healthcare providers' knowledge on PN topics significantly increased and that it helped with their PN implementation plans. Educational PN programs like the one we propose could help and guide healthcare providers to implement PN programs for cancer care at institutions across countries in LatAm, where patients face similar barriers for accessing cancer care.