Patient Navigation in the Safety Net:CONNECTeDD



Status:Completed
Conditions:Breast Cancer, Cervical Cancer, Cervical Cancer, Cancer, Cancer, Women's Studies
Therapuetic Areas:Oncology, Reproductive
Healthy:No
Age Range:18 - Any
Updated:6/16/2016
Start Date:July 2005
End Date:September 2011

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The Boston University Medical Center, funded by the National Cancer Institutes will train
health workers at six of its affiliated Community Health Centers to guide patients through
the cancer care system. The project will help to teach patients how to communicate more
effectively with their health care team in order to understand the treatment options
available to them. Although not widely available, it is believed patient navigation programs
are beneficial.

This research study will evaluate how well this tool works, especially among those who
experience disparities in health care. The goal is to determine if having a trained
navigator shortens the time between an abnormal test result and a definitive diagnosis and
between a definitive diagnosis and completion of treatment for breast and Cervical cancer
patients. The project also will evaluate whether navigation improves the ability to
communicate with the doctor, satisfaction with patient's care and quality of life.

Racial and ethnic minority groups and low-income persons experience significantly higher
cancer mortality rates than other Americans. These disparities are due to at least two
factors: (1) delays in follow-up of abnormal cancer screening results and (2) suboptimal
management of diagnosed cancer. Patient navigation represents a promising means for
addressing disparities by improving cancer related management for minority and other
underserved populations. However, patient navigation for cancer has yet to be evaluated
through a well-designed randomized controlled trial. Furthermore, patient navigation is
likely to prove most effective and sustainable when it is integrated into primary care and
helps patients be more active in their care. This combination of patient empowerment and
engagement is referred to as "activation." The aim of this project is to evaluate the
effectiveness and costs of such a program in a rigorous manner so that the results can be
generalized and the program can be widely disseminated and implemented. We will develop,
implement, and evaluate a primary care-based, patient navigation-activation program using
specially-trained patient Navigators who work within one of the six affiliated Community
Health Centers. We propose to investigate the effect of this intervention on timing and
quality of cancer-related care. Secondary aims examine the impact of navigation on
disparities in care, improvement in patient activation, and total costs. Project findings
will inform national policy regarding patient navigation for cancer.

Inclusion Criteria:

- Receive care at one of the 6 participating community Health centers

- Have received a positive breast or colorectal cancer screening test requiring
follow-up on a different day

- Have been newly diagnosed with breast or colorectal cancer

- Have received notification by the provider of an abnormal breast or colorectal
screening result

Exclusion Criteria:

- Cognitively impaired

- Institutionalized (nursing home, incarcerated)

- Children <18

- Actively involved in cancer treatment at time of presentation

- Currently or previously navigated with (a) navigation documented in the medical
record or (b) patient can articulate that they are in a navigation program or case
management program for cancer
We found this trial at
1
site
Boston, Massachusetts 02118
?
mi
from
Boston, MA
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