Abstract B033: Patient navigation at NCI-designated, safety-net, and rural cancer centers: Why is tailoring necessary?
Authors: Cooper Dexter L , Carter Vivian , Hernandez Natalie D , Le Mindy , Robinson Kimberly , Ennis Shawn J , Fouad Mona , Rivers Brian M 
Published: September 2020

Abstract
Introduction: Recent studies suggest where patients receive cancer care is a determinant of survivorship outcomes. As a culturally and individually tailored approach to addressing barriers to cancer care and other contributors to cancer disparities, patient navigation (PN) is an effective strategy to enhance the efficiency of healthcare systems and continuity of care. Patient navigation programs have emerged as a strategy to reduce morbidity and mortality for cancer and associated late and long-term effects of treatment. This study utilized the Community-Based Participatory Research (CBPR) framework to evaluate an enhanced ‘care coordination model’, linking navigators with cancer patients at an NCI-designated cancer center, a safety-net hospital cancer center, and a rural hospital cancer center. The purpose of this study is to characterize the implementation of the patient navigation model in three unique clinical settings for cancer care delivery. Methods: Eligible participants were identified from the partnership between Morehouse School of Medicine (MSM), Tuskegee University (TU) and the O’ Neal Comprehensive Cancer Center at UAB sites by the health-systems patient navigator (HSPN). The HSPN screened patients to assess their need for navigation services. Those in need of navigation were introduced to the study at their prospective treatment facilities. Patients were linked with community-based patient navigators (CBPNs) to ensure continuity of addressing the clinical and non-clinical effects of treatment. Findings: Navigators aided with service requests; however, there were differences in the types of services requested based on cancer center and treatment status. Participants who were in treatment the NCI-designated cancer center (n=35) were mostly Black (62.9%), female (91.4%), single (45.7%), employed (34.3%), had Medicare (28.6%) and a yearly household income $5,001 to $10,000. They mostly requested assistance with gas (88.6%), social support (74.3%) financial assistance (48.6%), and lodging (20%). Participants who completed treatment at the safety-net hospital cancer center (n=20) were mostly Black (85%), female (80%), single (50%), disabled (45%), had Medicaid (55%), and a yearly household income of less than $5,000 a year (23.5%) and $15,001 -$25,000 (23.5%) a year. These survivors requested assistance with food procurement (75%), financial assistance (50%), education (35%), transportation (25%), and clothing (25%). Participants who were in treatment at the rural hospital cancer center (n=4) were all Black (85%), mostly male (75%), and half were married (50%). These survivors requested assistance with transportation (50%) and financial assistance (50%). Conclusion: The work of navigators, whether they are health-systems or community patient navigators, is dynamic and valuable to the care of cancer survivors, especially for disparate populations. The adaptability of this model based on the dynamics of the clinical setting emphasizes the utility of this model.
Citation Format: Dexter L Cooper, Vivian Carter, Natalie D Hernandez, Mindy Le, Kimberly Robinson, Shawn J Ennis, Mona Fouad, Brian M Rivers. Patient navigation at NCI-designated, safety-net, and rural cancer centers: Why is tailoring necessary? [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B033.