National Cancer Institute Patient Navigation Research Program: Methods, protocol, and measures

Karen M. Freund, Tracy A. Battaglia, Elizabeth Calhoun, Donald J. Dudley, Kevin Fiscella, Electra Paskett, Peter C. Raich, Richard G. Roetzheim, Charles L. Bennett, Jack A. Clark, Roland Garcia, Amanda Greene, Steven R. Patierno, Victoria Warren-Mears

Research output: Contribution to journalArticlepeer-review

215 Scopus citations

Abstract

BACKGROUND. Patient, provider, and systems barriers contribute to delays in cancer care, a lower quality of care, and poorer outcomes in vulnerable populations, including low-income, underinsured, and racial/ethnic minority populations. Patient navigation is emerging as an intervention to address this problem, but navigation requires a clear definition and a rigorous testing of its effectiveness. Pilot programs have provided some evidence of benefit, but have been limited by evaluation of single-site interventions and varying definitions of navigation. To overcome these limitations, a 9-site National Cancer Institute Patient Navigation Research Program (PNRP) was initiated. METHODS. The PNRP is charged with designing, implementing, and evaluating a generalizable patient navigation program targeting vulnerable populations. Through a formal committee structure, the PNRP has developed a definition of patient navigation and metrics to assess the process and outcomes of patient navigation in diverse settings, compared with concurrent continuous control groups. RESULTS. The PNRP defines patient navigation as support and guidance offered to vulnerable persons with abnormal cancer screening or a cancer diagnosis, with the goal of overcoming barriers to timely, quality care. Primary outcomes of the PNRP are 1) time to diagnostic resolution; 2) time to initiation of cancer treatment; 3) patient satisfaction with care; and 4) cost effectiveness, for breast, cervical, colon/rectum, and/or prostate cancer. CONCLUSIONS. The metrics to assess the processes and outcomes of patient navigation have been developed for the NCI-sponsored PNRP. If the metrics are found to be valid and reliable, they may prove useful to other investigators.

Original languageEnglish (US)
Pages (from-to)3391-3399
Number of pages9
JournalCancer
Volume113
Issue number12
DOIs
StatePublished - Dec 15 2008
Externally publishedYes

Keywords

  • Breast cancer
  • Case management
  • Cervical cancer
  • Colorectal cancer
  • Medically underserved areas
  • Minority groups
  • Navigation
  • Prostate cancer
  • Vulnerable populations

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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