Abstract PO4-10-09: MBC Community Barriers and Patient Navigation Training Needs
Authors: McCoy Stephanie , Fox Kyandra , Volpe Kasey , Lee Toni , Okamoto Janet , McMahon Julie , Wojtanik Kari 
Published: May 2024

Background

Komen’s mission is to save lives by meeting the most critical needs in our communities and investing in breakthrough research to prevent and cure breast cancer. One method to achieve our mission is through patient navigation. Evidence supports the role of patient navigation in improving breast health outcomes. Patient navigators identify and address barriers to equitable cancer care delivery in a fragmented healthcare system and work to ease the burdens that patients diagnosed with breast cancer experience. As a valued member of a patient’s health care team, patient navigators contribute to improving the quality of cancer care and eliminating barriers throughout the continuum of care. However, not all breast cancer patients experience the same barriers.

Metastatic breast cancer (MBC) is the most advanced stage of breast cancer, and there is some evidence that suggests those diagnosed with MBC have unique experiences and needs that often determine and/or contribute to their disease trajectory. Despite this, little in-depth systematic work has been done to understand the unique challenges faced by those diagnosed with MBC or to explore strategies to address those challenges, and there have been no known efforts to equip patient navigators to specifically address the unique barriers of those diagnosed with MBC.

Methods

Susan G. Komen®’s Center for Applied Research (CfAR) designed the MBC Patient Navigation Training research study to improve the health outcomes of those diagnosed with MBC through patient navigation. The study design includes 4 phases of qualitative methodology with MBC and patient navigator communities to accomplish the following objectives:

Examine the needs and barriers of MBC patients (Phase 1)

Identify what needs and barriers MBC patients face that can be addressed through patient navigation (Phase 2)

Assess the gaps in Komen's Patient Navigation Training Programs' ability to prepare navigators across the United States to address the identified needs/barriers of MBC patients (Phase 3)

Design a new module to fill the gaps in Komen's Patient Navigation Training Program to support patient navigators serving MBC communities across the U.S. (Phase 4)

Participants were recruited through a grassroots approach to community engagement, with members of the study team, Komen staff, and other breast health advocates contacting individuals and organizations across the U.S. Individuals were invited to attend a virtual introductory call to meet study staff and each other before consenting to participate in the virtual focus groups.

Results

Participants diagnosed with MBC (n=17) attended one of four virtual focus groups held May 2023 to share their lived experiences. The focus groups were recorded, the recordings were transcribed and checked for accuracy, and study staff analyzed data using a constant comparison approach to qualitative data analysis with NVivo data management software. Those diagnosed with MBC identified challenges of their diagnosis, barriers within the healthcare system, financial toxicity, lack of support, and health inequities as factors limiting their access to care. These participants also identified the role patient navigators could serve to help address these challenges.

Next Steps

In Phase 2, the study team will examine to what extent patient navigators feel prepared to address the barriers of MBC communities. Based on the findings from this study, the team will identify areas where more training is needed (Phase 3) and design a training module for Komen’s Patient Navigation Training Program (Phase 4) to better prepare patient navigators across the U.S. to meet the needs of MBC communities and improve health outcomes and cancer care delivery.

Citation Format: Stephanie McCoy, Kyandra Fox, Kasey Volpe, Toni Lee, Janet Okamoto, Julie McMahon, Kari Wojtanik. MBC Community Barriers and Patient Navigation Training Needs [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-10-09.