Abstract PO1-11-01: Effectiveness of Susan G. Komen’s national telehealth patient navigation model in reaching underserved populations and reducing cancer-related distress
Authors: McMahon Julie , Lautner Shelby , Spadine Mandy , Lee Toni , Okamoto Janet 
Published: May 2024

Abstract
Background: Despite its effectiveness in reducing breast cancer inequities, patient navigation (PN) is not accessible to all patients across the United States. To improve access, Susan G. Komen established a telehealth PN model, scaled to deliver PN services equitably across the country. Methods: Patients are referred to Komen patient navigators through Komen’s Helpline. Navigators conduct an initial distress screening and barrier assessment and create an individualized care plan. This information, recommended interventions, and other health data are documented, 62 days. Navigators communicate via the patient’s preferred method: phone, email, text, or video. A patient satisfaction survey is administered 30 days after the start of navigation. Results: From April 1, 2022, to March 31, 2023, 1,092 individuals were navigated. Navigation was provided throughout the continuum of care, including screening and diagnosis through treatment. Of the 3,064 barriers identified by patients, 63% were economic, 20% related to emotional health, 11% indicated lack of access to care and 6% related to care management. Eleven percent of individuals selected Spanish as their preferred language, 84% had a household income at or below 200% of the Federal Poverty Level and 24% were uninsured. Navigated individuals identified as: 46% Black or African American, 37% white or Caucasian, 20% Hispanic or Latino, 2% Asian, and 14% preferred not to answer. The average patient age was 54 years old, ranging from 20 to 101 years old. 588 patients identified as being diagnosed with breast cancer, with 69% diagnosed as early stage (Stage 0-III), 22% as metastatic (Stage IV), and 8% undesignated. Distress screening is administered, within the domains established by the National Comprehensive Cancer Network, at intake, major transitions in care and end of navigation. Average distress across all domains was 6.1 on an 11-point scale at first observation (a score of 10 indicating the highest level of distress). Financial distress was the highest average (7.5) followed by emotional distress (6.6). During navigation enrollment, financial distress decreased 14% and emotional distress decreased 14%. Survey respondents reported: the Komen navigation program helped them: follow their treatment plan (91%), will help them continue their care (92%), feel more prepared to talk with their care team (91%), to be able to get care faster (88%), and improve their quality of life (91%). Conclusion: Distress screening was developed for a clinical setting with in-network medical and mental health providers. This program’s demonstrates distress screening can be adapted for use in a non-clinical, virtual setting. Socioeconomic, survey, and distress data indicate Komen’s model succeeded in reaching people that research shows have numerous barriers to breast health services and cancer care, and overcome the most common barriers, thus improving access to timely, high-quality care. Opportunities for program improvement include: -To improve support for those experiencing high emotional distress, additional training in emotional support is being incorporated into onboarding and Komen’s Navigation Training Program. - Research shows that navigation is most effective when delivered by someone who shares a lived experience, so the diversity of navigators is important. More bilingual navigators have been added to the program to better serve the Spanish-speaking population. - To improve support of those living with metastatic breast cancer seeking navigation support, Komen has launched a research study to identify the unique needs of patients living with MBC, and use this information to enhance navigation services.
Citation Format: Julie McMahon, Shelby Lautner, Mandy Spadine, Toni Lee, Janet Okamoto. Effectiveness of Susan G. Komen’s national telehealth patient navigation model in reaching underserved populations and reducing cancer-related distress [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 PO1-11-01.