Abstract PR004: Pilot study examining a proactive, culturally-tailored model of patient navigation on satisfaction with care
Authors: McDougall Jean A. , Henderson Vida , Nyame Yaw A. , Carosso Elizabeth , Briant Katherine J. , Acosta Citlali Gomez , Devine Anne , Mendoza Jason A. , Lion Casey 
Published: December 2023

Patient navigation seeks to improve cancer outcomes by overcoming barriers to care among populations experiencing disparities. Since its introduction in 1990, numerous models of patient navigation have been introduced in different clinical locations, but without clear comparisons between them.  We conducted an observational pilot study of cancer patients receiving treatment at the Fred Hutchinson Cancer Center from April 2021-October 2022 to investigate the impact of a newly introduced model of patient navigation, characterized by proactive, longitudinal care with a focus on cultural or racial concordance and communication among Black, American Indian or Alaska Native, Asian or Pacific Islander, and Hispanic or Latino individuals, on patient-reported outcomes. We recruited patients age ≥18 years within 3 months of their first cancer-related clinic visit and invited them to complete online surveys at baseline and 3 months after enrollment. We sought to recruit n=160 for baseline assessments and of those, n=120 to also complete follow up assessments. Outcomes included patient satisfaction with cancer-related care, perceived stress, healthcare discrimination, trust in physicians, resilience, and whether clinical trials were discussed. Patients receiving the newer longitudinal navigation model were compared to those receiving the standard, acute model of navigation support and to patients receiving no navigation using descriptive statistics, including mean and standard deviations (SD) for scores on summary scales for each metric. We identified 1,122 cancer patients eligible for navigation services. Of those, 827 were invited to participate by email and 295 received targeted telephone and email recruitment. A total of 118 completed both the baseline and follow-up surveys (proactive navigation n=5; acute navigation n=17, and no navigation n=96). Median age was 51 years, 13% were Black, 8% were American Indian or Alaska Native, 3% were Asian or Pacific Islander, 12% were Hispanic or Latino, 57% were non-Hispanic White. Satisfaction with care improved by 4 points among patients receiving proactive navigation but did not change for patients in the acute or no navigation groups. The proportion of individuals reporting healthcare discrimination decreased among those who received proactive navigation, while no changes in perceived stress, resilience, or trust in physicians were seen across all groups. Four of 5 individuals receiving proactive navigation reported having discussed clinical trials options, compared to 1 and 0 of those receiving acute or no navigation, respectively. Our new proactive patient navigation model may improve satisfaction with cancer care, a key outcome proposed by the National Cancer Institute Patient Navigation Research Program. Additional fully powered studies using this new model of navigation are warranted to assess its potential to improve clinical and patient reported outcomes for diverse patients. 

Citation Format: Jean A. McDougall, Vida Henderson, Yaw A. Nyame, Elizabeth Carosso, Katherine J. Briant, Citlali Gomez Acosta, Anne Devine, Jason A. Mendoza, Casey Lion. Pilot study examining a proactive, culturally-tailored model of patient navigation on satisfaction with care [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr PR004.