Article

Addressing the unique psychosocial barriers to breast cancer treatment experienced by African-American women through integrative navigation.

Howard University Center for Urban Progress, 1840 7th Street, NW, 3rd Floor, Washington, DC 20001, USA.
Journal of National Black Nurses' Association: JNBNA 12/2011; 22(2):20-8.
Source: PubMed

ABSTRACT African-American women face a disproportionally high breast cancer mortality rate and a significantly low five-year survival rate after breast cancer treatment. This study investigated, through a series of focus groups, how 32 African-American women (N = 32) breast cancer patients and survivors managed their cancer-related health needs. Participants also reported important barriers to care including problematic interactions with medical professionals, challenges in intimate relations, difficulties in handling the stigma and myths about breast cancer, and the psychological challenges that they faced. A patient navigation model was implemented at an eastern urban hospital that emphasized integrative therapies such as meditation, nutritional instruction, and yoga. Follow-up telephone interviews with 37 additional African-American participants (N = 37) indicated the rating of effectiveness to be at 3.8 to 3.9 out of 4 for the integrative patient navigation program. Over half of the survivors reported using some complementary techniques after treatment was completed, thus suggesting a long-term improvement in their quality of life as a result of the integrative techniques.

4 Followers
 · 
180 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: Breast cancer is the leading cause of cancer deaths in Latinas. Time from cancer diagnosis to treatment initiation is critical in optimizing cancer care. Patient navigation is a potentially effective means of promoting timely treatment of breast cancer, yet efficacy is insufficiently documented. Redes en Accion here evaluates a culturally sensitive patient navigation program to reduce time from cancer to diagnosis to treatment and increase proportions of women treated within 30 days of diagnosis. METHODS: We analyzed 109 Latinas diagnosed with breast cancer from July 2008-January 2011 (42 navigated, 67 controls). Women were navigated by locally trained navigators or non-navigated (data abstracted from charts). Kaplan-Meier, Cox proportional hazards, and logistic regression were used to determine group differences. RESULTS: Time from cancer diagnosis to 1st treatment was lower in the navigated group (MED 21 days, control 32 days, HR 1.6, p=0.02). 64.3% began treatment within 30 days of cancer diagnosis, compared to 47.8% of non-navigated Latinas (p=0.015) controlling for stage of cancer at diagnosis and numerous characteristics of clinics and participants. Effects were due to navigator activities compared to those who did not need or utilize them, including appointment reminders, transportation arrangements, accompaniment to appointments, and translation services. CONCLUSIONS: Patient-centered navigation to assist Latina women with breast cancer diagnoses significantly reduces time from diagnosis to treatment, and increases the proportion of women who begin treatment within 30 days of diagnosis. Improvement appears to be associated with specific navigator activities.
    Cancer Research; 04/2013
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Breast cancer is the leading cause of cancer deaths in Latinas. Time from cancer diagnosis to treatment initiation is critical in optimizing care. Patient navigation (PN) is a potentially effective means of promoting timely breast cancer treatment, yet efficacy is insufficiently documented. Redes En Accin: The National Latino Cancer Research Network, tested the effects of a theory-driven, culturally-sensitive PN program for Latinas with breast cancer in six U.S. cities. We evaluated time from diagnosis to initial treatment and proportions of women treated within 30 days of diagnosis. We analyzed 109 Latinas diagnosed with breast cancer from July 2008-January 2011 (42 navigated, 67 controls). Women were navigated by locally trained navigators, or non-navigated. Kaplan-Meier, Cox proportional hazards, and logistic regression models were used to determine group differences. Time from cancer diagnosis to first treatment was lower in the navigated group (mean 24.98 days, control 38.12 days, HR 1.61, p=0.02). Additionally, 64.3% of navigated Latinas began treatment within 30 days of cancer diagnosis, vs. 47.8% of non-navigated Latinas (p=0.015). These results were independent of stage at diagnosis and cancer clinic and participant characteristics. Examination of navigator logbooks indicated that faster treatment times likely resulted from at least three activities: oncology appointment reminders, transportation and/or accompaniment to appointments, and translation services. Patient-centered navigation to assist Latina women with breast cancer diagnoses significantly reduces time from diagnosis to treatment, and increases the proportion of women beginning treatment within 30 days of diagnosis. Improvement appears to be associated with specific navigator activities.
    141st APHA Annual Meeting and Exposition 2013; 11/2013
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The interaction of clinical and patient-level challenges following a breast cancer diagnosis can be a significant source of health care disparities. Failure to address specific cultural features that create or exacerbate barriers can lead to less-than optimal navigation results, specifically in Hispanic/Latino women. To address these disparities, the study leaders in San Antonio, Texas, and 5 other regional partners of the federally-funded Redes En Acción: The National Latino Cancer Research Network developed a culturally-tailored patient navigation intervention model for Latinas with breast cancer. Compared with control patients, a higher percentage of navigated subjects initiated treatment within 30 days (69.0% versus 46.3%, P = .029) and 60 days (97.6% versus 73.1%, P = .001) following their cancer diagnosis. Time from cancer diagnosis to first treatment was lower in the navigated group (mean, 22.22 days; median, 23.00 days) than controls (mean, 48.30 days; median, 33.00 days). These results were independent of cancer stage at diagnosis and numerous characteristics of cancer clinics and individual participants. Successful application of patient navigation increased the percentage of Latinas initiating breast cancer treatment within 30 and 60 days of diagnosis. This was achieved through navigator provision of services such as accompaniment to appointments, transportation arrangements, patient telephone support, patient-family telephone support, Spanish-English language translation, and assistance with insurance paperwork. Cancer 2013. © 2013 American Cancer Society.
    Cancer 03/2014; 120(5). DOI:10.1002/cncr.28450 · 4.90 Impact Factor
Show more

Similar Publications