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Overview

Navigation Intervention and Cancer Screening Behavior in Navajo Communities Randall W. Rupper Yuan-Chin Amy Lee Randall Burt Sandra Marsh Stephen C. Alder. Overview. Context. Medicare became concerned with obvious disparities in cancer prevention and treatment

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Overview

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Presentation Transcript

  1. Navigation Intervention and Cancer Screening Behavior in Navajo CommunitiesRandall W. RupperYuan-Chin Amy LeeRandall Burt Sandra MarshStephen C. Alder

  2. Overview

  3. Context • Medicare became concerned with obvious disparities in cancer prevention and treatment • Study suggested “Patient Navigators” as the most likely mechanism for success • CMS demonstration project • Legally defined hybrid grant/contract • Required to fund specific populations including AI/AN • Required to have at least one rural location

  4. Overview • Purpose: To determine whether navigation services increase cancer screening and early treatment among targeted ethnic/minority populations. • Huntsman Cancer Institute - one of 6 sites funded • Utah: 10 communities from the Navajo Nation • Montana: 8 participating communities

  5. Demonstration Strategy • Patient navigation • barrier-focused intervention focusing on underserved populations • related to cancer care1. • PNs act as a bridge between patients, providers, and community resources • Navigation vs. education • Randomization by community • Wells KJ et al. Patient Navigation: State of the art, or is it a science?. Cancer. 2008; 113(8): 1999-2010.

  6. Data collection • Data collection involved a self-reported baseline survey, an annual follow-up survey, and exit survey for the navigation group • Participants were enrolled and active between 2007 and 2010.

  7. Selected Results

  8. Total Triage 587 Ineligible 2 Screening 580 Treatment 5 Intervention 213 (35 with Annual) Control 367 (96 with Annual) Exit 157 Exit 228

  9. Demographic characteristics

  10. Summary • Compared to the education group, navigation group was observed to improve the proportion of screening by blood stool test and PSA test. • The navigation intervention was implied to improve the belief in chance of survival if cancer is detected early.

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