Using Telenavigators to Support Rural Breast Cancer Patients
Creators: name: University Of California Office Of The President
Publisher: name: University of California Office of the President
publisherIdentifier: https://ror.org/00dmfq477
publisherIdentifierScheme: ROR
Year: 2024

description: Introduction: Our proposed research addresses breast cancer survivorship disparities in California’s rural communities, focusing on 3 designated rural/frontier northern California counties: frontier Modoc and Plumas Counties and rural Nevada County. Frontier is defined as “the most rural settled places along the rural-urban continuum, with residents far from health care, schools, grocery stores, and other necessities. Frontier areas face challenges in providing access to health and human services even greater than the challenges faced by less isolated rural communities.”1 Relative to the average California county, which has 239 people/sq mile, Modoc County has 2.5 persons/sq mile over 3,918 miles, Plumas has 7.8 people/sq miles over 2,553 miles, and rural Nevada County has 103 people/sq mile over 958 miles. Our research follows up on data from several previous CRC projects and input gathered by the Community-Research team over the past 2 years identifying a strong need for access to breast cancer information and support in rural/frontier communities, and mortality disparities among rural patients. Ultimately, we aim to test the feasibility and acceptability of using telehealth technology to empower rural breast cancer survivors as “telenavigators”, who would provide peer-delivered navigator services in response to the stated needs of the community. This Planning Grant will be used to support the further development and strengthening of our proposal to develop and test a telenavigator model that leverages telehealth technology and uses local breast cancer peer navigators to deliver access to informational and support resources and promote empowerment in problem-solving and coping in rural communities.
 
 
 
 
 
 
 
 General methodology: We propose a 6-month planning period focused on improving our CRC pilot grant application by revising the application according to the Review Committee’s critiques. During the 6-month period, we will plan to submit the application for the CBCRP pre-review, and target the March 2016 CRC application submission date. Specifically, we will focus our specific Planning Grant activities on: 
 
 
 
 1. Better organization of research plan to clarify overall flow and description of each phase and associated inclusion criteria and approaches, and demonstrate feasibility.
 
 
 
 2. Better integration with Precede-Proceed framework by more explicitly describing framework, where the currently proposed research fits in, and how the framework helps to guide future research informed by the current research.
 
 
 
 3. Describing how we will identify and address distress in patients.
 
 
 
 4. Discussing the applicability of the Neuvo Amanacer program for rural white non-Latino patients.
 
 
 
 5. Discuss the engagement of nursing students in the pilot project.
 
 
 
 6. Expand upon the “Potential limitations and strengths” section by addressing issues raised by Reviewers that would be infeasible to include in the pilot project, such as: matching on disease spectrum, including more patients, etc.
 
 
 
 
 
 
 
 Community involvement: This project is in response to the community partners’ ongoing collaboration with the designated communities to increase access to specialty care through telehealth. The services identified in this pilot were identified by the communities. Community partners from rural community-based organizations, breast cancer patients, and key stakeholders in rural communities will be involved in the Planning Grant, including informing the applicability of the Neuvo Amanacer program that we aim to adapt to rural patients, and to address concerns regarding the identification and management of distress among navigated patients. 
 
 
 
 
 
 
 
 Future plans: This Planning Grant will provide the necessary preliminary data and protected time to strength our CRC Pilot Grant. Our ultimate goal is to pursue a larger study through the CRC Full Research Award to test the dissemination and effectiveness of this intervention. As we envision that the innovative delivery of support services by telenavigators has tremendous potential for impact beyond the rural community, we will also pursue applications to test its effectiveness in other isolated communities.
 
 
 
 
 
 1 Rural Assistance Center, Definition of Rural, http://www.raconline.org/topics/frontier.