Patient Navigation in Medically Underserved Areas study design

A trial with implications for efficacy, effect modification, and full continuum assessment

Yamile Molina, Anne E. Glassgow, Sage J. Kim, Karriem S. Watson, Julie S. Darnell, Elizabeth Calhoun

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background The Patient Navigation in Medically Underserved Areas study objectives are to assess if navigation improves: 1) care uptake and time to diagnosis; and 2) outcomes depending on patients' residential medically underserved area (MUA) status. Secondary objectives include the efficacy of navigation across 1) different points of the care continuum among patients diagnosed with breast cancer; and 2) multiple regular screening episodes among patients who did not obtain breast cancer diagnoses. Design/Methods Our randomized controlled trial was implemented in three community hospitals in South Chicago. Eligible participants were: 1) female, 2) 18 + years old, 3) not pregnant, 4) referred from a primary care provider for a screening or diagnostic mammogram based on an abnormal clinical breast exam. Participants were randomized to 1) control care or 2) receive longitudinal navigation, through treatment if diagnosed with cancer or across multiple years if asymptomatic, by a lay health worker. Participants' residential areas were identified as: 1) established MUA (before 1998), 2) new MUA (after 1998), 3) eligible/but not designated as MUA, and 4) affluent/ineligible for MUA. Primary outcomes include days to initially recommended care after randomization and days to diagnosis for women with abnormal results. Secondary outcomes concern days to treatment initiation following a diagnosis and receipt of subsequent screening following normal/benign results. Discussion This intervention aims to assess the efficacy of patient navigation on breast cancer care uptake across the continuum. If effective, the program may improve rates of early cancer detection and breast cancer morbidity.

Original languageEnglish (US)
Pages (from-to)29-35
Number of pages7
JournalContemporary Clinical Trials
Volume53
DOIs
StatePublished - Feb 1 2017

Fingerprint

Medically Underserved Area
Patient Navigation
Breast Neoplasms
Point-of-Care Systems
Community Hospital
Random Allocation
Primary Health Care
Breast
Randomized Controlled Trials
Morbidity
Health
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)
  • Pharmacology (medical)

Cite this

Patient Navigation in Medically Underserved Areas study design : A trial with implications for efficacy, effect modification, and full continuum assessment. / Molina, Yamile; Glassgow, Anne E.; Kim, Sage J.; Watson, Karriem S.; Darnell, Julie S.; Calhoun, Elizabeth.

In: Contemporary Clinical Trials, Vol. 53, 01.02.2017, p. 29-35.

Research output: Contribution to journalArticle

@article{527c55828a154d9c98f2c8353a5e2293,
title = "Patient Navigation in Medically Underserved Areas study design: A trial with implications for efficacy, effect modification, and full continuum assessment",
abstract = "Background The Patient Navigation in Medically Underserved Areas study objectives are to assess if navigation improves: 1) care uptake and time to diagnosis; and 2) outcomes depending on patients' residential medically underserved area (MUA) status. Secondary objectives include the efficacy of navigation across 1) different points of the care continuum among patients diagnosed with breast cancer; and 2) multiple regular screening episodes among patients who did not obtain breast cancer diagnoses. Design/Methods Our randomized controlled trial was implemented in three community hospitals in South Chicago. Eligible participants were: 1) female, 2) 18 + years old, 3) not pregnant, 4) referred from a primary care provider for a screening or diagnostic mammogram based on an abnormal clinical breast exam. Participants were randomized to 1) control care or 2) receive longitudinal navigation, through treatment if diagnosed with cancer or across multiple years if asymptomatic, by a lay health worker. Participants' residential areas were identified as: 1) established MUA (before 1998), 2) new MUA (after 1998), 3) eligible/but not designated as MUA, and 4) affluent/ineligible for MUA. Primary outcomes include days to initially recommended care after randomization and days to diagnosis for women with abnormal results. Secondary outcomes concern days to treatment initiation following a diagnosis and receipt of subsequent screening following normal/benign results. Discussion This intervention aims to assess the efficacy of patient navigation on breast cancer care uptake across the continuum. If effective, the program may improve rates of early cancer detection and breast cancer morbidity.",
author = "Yamile Molina and Glassgow, {Anne E.} and Kim, {Sage J.} and Watson, {Karriem S.} and Darnell, {Julie S.} and Elizabeth Calhoun",
year = "2017",
month = "2",
day = "1",
doi = "10.1016/j.cct.2016.12.001",
language = "English (US)",
volume = "53",
pages = "29--35",
journal = "Contemporary Clinical Trials",
issn = "1551-7144",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Patient Navigation in Medically Underserved Areas study design

T2 - A trial with implications for efficacy, effect modification, and full continuum assessment

AU - Molina, Yamile

AU - Glassgow, Anne E.

AU - Kim, Sage J.

AU - Watson, Karriem S.

AU - Darnell, Julie S.

AU - Calhoun, Elizabeth

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Background The Patient Navigation in Medically Underserved Areas study objectives are to assess if navigation improves: 1) care uptake and time to diagnosis; and 2) outcomes depending on patients' residential medically underserved area (MUA) status. Secondary objectives include the efficacy of navigation across 1) different points of the care continuum among patients diagnosed with breast cancer; and 2) multiple regular screening episodes among patients who did not obtain breast cancer diagnoses. Design/Methods Our randomized controlled trial was implemented in three community hospitals in South Chicago. Eligible participants were: 1) female, 2) 18 + years old, 3) not pregnant, 4) referred from a primary care provider for a screening or diagnostic mammogram based on an abnormal clinical breast exam. Participants were randomized to 1) control care or 2) receive longitudinal navigation, through treatment if diagnosed with cancer or across multiple years if asymptomatic, by a lay health worker. Participants' residential areas were identified as: 1) established MUA (before 1998), 2) new MUA (after 1998), 3) eligible/but not designated as MUA, and 4) affluent/ineligible for MUA. Primary outcomes include days to initially recommended care after randomization and days to diagnosis for women with abnormal results. Secondary outcomes concern days to treatment initiation following a diagnosis and receipt of subsequent screening following normal/benign results. Discussion This intervention aims to assess the efficacy of patient navigation on breast cancer care uptake across the continuum. If effective, the program may improve rates of early cancer detection and breast cancer morbidity.

AB - Background The Patient Navigation in Medically Underserved Areas study objectives are to assess if navigation improves: 1) care uptake and time to diagnosis; and 2) outcomes depending on patients' residential medically underserved area (MUA) status. Secondary objectives include the efficacy of navigation across 1) different points of the care continuum among patients diagnosed with breast cancer; and 2) multiple regular screening episodes among patients who did not obtain breast cancer diagnoses. Design/Methods Our randomized controlled trial was implemented in three community hospitals in South Chicago. Eligible participants were: 1) female, 2) 18 + years old, 3) not pregnant, 4) referred from a primary care provider for a screening or diagnostic mammogram based on an abnormal clinical breast exam. Participants were randomized to 1) control care or 2) receive longitudinal navigation, through treatment if diagnosed with cancer or across multiple years if asymptomatic, by a lay health worker. Participants' residential areas were identified as: 1) established MUA (before 1998), 2) new MUA (after 1998), 3) eligible/but not designated as MUA, and 4) affluent/ineligible for MUA. Primary outcomes include days to initially recommended care after randomization and days to diagnosis for women with abnormal results. Secondary outcomes concern days to treatment initiation following a diagnosis and receipt of subsequent screening following normal/benign results. Discussion This intervention aims to assess the efficacy of patient navigation on breast cancer care uptake across the continuum. If effective, the program may improve rates of early cancer detection and breast cancer morbidity.

UR - http://www.scopus.com/inward/record.url?scp=85003946055&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85003946055&partnerID=8YFLogxK

U2 - 10.1016/j.cct.2016.12.001

DO - 10.1016/j.cct.2016.12.001

M3 - Article

VL - 53

SP - 29

EP - 35

JO - Contemporary Clinical Trials

JF - Contemporary Clinical Trials

SN - 1551-7144

ER -