National Cancer Institute Patient Navigation Research Program

Methods, protocol, and measures

Authors

  • Karen M. Freund MD, MPH,

    Corresponding author
    1. Women's Health Unit, Department of Medicine, and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, Massachusetts
    • Boston University School of Medicine, 715 Albany Street, Crosstown 470, Boston, MA 02118
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    • Fax: (617) 638-8096

  • Tracy A. Battaglia MD, MPH,

    1. Women's Health Unit, Department of Medicine, and Women's Health Interdisciplinary Research Center, Boston University School of Medicine, Boston, Massachusetts
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  • Elizabeth Calhoun PhD,

    1. Division of Health Policy Administration, School of Public Health, University of Illinois at Chicago, Chicago, Illinois
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  • Donald J. Dudley MD,

    1. Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, Texas
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  • Kevin Fiscella MD MPH,

    1. Department of Family Medicine and Community and Preventive Medicine and Division of Oncology, James P. Wilmont Cancer Center, University of Rochester, School of Medicine, Rochester, New York
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  • Electra Paskett PhD,

    1. Division of Epidemiology, Comprehensive Cancer Center, Ohio State University, Columbus, Ohio
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  • Peter C. Raich MD,

    1. Division of Hematology/Oncology, Department of Medicine, Denver Health and Hospital Authority, Denver, Colorado
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  • Richard G. Roetzheim MD,

    1. Department of Family Medicine, University of South Florida, Division of Health Outcomes and Behaviors, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
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  • The Patient Navigation Research Program Group


  • The following are members of the Patient Navigation Research Group: Charles L. Bennett, MD (Northwestern University); Jack A. Clark, PhD (Boston University School of Public Health); Roland Garcia, PhD (Center to Reduce Cancer Health Disparities, National Cancer Institute); Amanda Greene, PhD (NOVA Research); Steven R. Patierno, PhD (George Washington University Cancer Institute); and Victoria Warren-Mears, PhD, RD, LD (Northwest Tribal Epidemiology Center).

  • The contents are solely the responsibility of the authors and do not necessarily represent the official views of the Center to Reduce Cancer Health Disparities, National Cancer Institute.

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. Cancer 2008. © 2008 American Cancer Society.

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