Abstract B92: Satisfaction with a breast cancer patient navigation program: Perspectives of patients, navigators, and clinical staff
Authors: Ford Marvella E. , Cartmell Kathleen , Bryant Debbie C. , Jefferson Melanie S. , Alberg Anthony J. 
Published: December 2010

Introduction: Patient navigation interventions are an emerging approach to reducing cancer disparities but few formal evaluations have been published. The purpose of this study was to evaluate perceptions of a breast cancer patient navigation program among patients, patient navigators (PNs), and breast cancer clinic staff members.

Methods: Post-program interviews were conducted with 218 navigated patients. Individual semi-structured interviews were conducted with 5 PNs. Surveys were administered to 19 clinic staff.

Results: Perceptions among Navigated Patients (n=218). Fifty-three percent of the surveyed patients were African American (n=116), 15.1% were Hispanic (n=33), 33.9% were married (n=74), 65.1% had ≤ a high school degree (n=142), and 75.2% had an annual income &lt;$20,000 (n=164). The mean age was 44 years. Eighty-nine percent of the surveyed patients rated their overall satisfaction with the navigation services they received as excellent (n=194), 98.2% stated that they received the types of services that they needed (n=214), and all reported that they would recommend the program to others.

Perceptions among Navigators (n=5). Strengths of the program cited by the five navigators included: (a) the satisfaction that stems from helping patients receive needed health services; (b) recognition of the role of religious beliefs in the treatment decision-making of patients; (c) the need for navigators to be organized so they can effectively coordinate treatment among different clinicians for the patient; (d) using creative solutions to maintaining contact with navigated patients, such as pre-paid cell phones; and (e) meeting the challenges involved in working with patients with a wide variety of needs.

Weaknesses of the program cited by the five navigators included: (a) difficulty in clarifying/distinguishing the roles of navigators and social workers; (b) language barriers with non-English speaking patients and the need to rely on hospital translation services, which often resulted in delayed provision of navigation services and slowed the clinic visit; and (c) the difficulty of presenting complex medical information in lay language to patients.

Perceptions among Breast Cancer Clinic Staff Members (n=19). All respondents agreed/strongly agreed that navigators were knowledgeable, available when needed, and related well with navigated patients, breast clinicians and staff. Respondents agreed/strongly agreed that compared to patients who did not have a patient navigator, navigated patients were more prepared with requested documents needed for the clinic appointment (73.7%), missed fewer clinic appointments (76.5%), were more informed about their breast cancer treatment (89.5%), and received more timely breast cancer treatment (68.4%).

Conclusions: We adopted a “triangulation” strategy to integrate perceptions of a patient navigation program through the eyes of patients, navigators, and breast cancer clinic staff members. The results show that the patient navigation program was favorably reviewed by these constituencies.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B92.