Satisfaction with cancer care among underserved racial-ethnic minorities and lower-income patients receiving patient navigation


  • Study data resulted from the collaborative efforts of the National Cancer Institute Center to Reduce Cancer Health Disparities and the National Cancer Institute Program Evaluation Contractor (NOVA Research Company). The Patient Navigation Research Program Investigators include: Center to Reduce Cancer Health Disparities, National Cancer Institute: Martha Hare, Mollie Howerton, Ken Chu, Emmanuel Taylor, and Mary Ann Van Duyn; NOVA Research Company: Paul Young, Frederick R. Snyder, and Kathy Parillo; Boston Medical Center and Boston University: Karen M. Freund (Principal Investigator), Tracy Battaglia (co-Principal Investigator), Sharon Bak, Bonnie Sherman, Sarah Karon, Richard Kalish, Nisha Thrakar, James Taylor, Stephen Tringale, Patrick Egan, Barbara Lottero, and Walter Phinney; Denver Health and Hospital Authority: Peter Raich (Principal Investigator), Elizabeth Whitley (co-Principal Investigator), Patricia A. Valverde, Diane Fairclough, William Thorland, Lina Escobar, Kristin Kilbourn, Besty Risendahl, Rachel Everhart, Evelinn Borrayo, Tim Byers, Hermenia Arambula, Inna Pines, Carol Spitz, and Jesus Tovar; George Washington University Cancer Institute: Steven Patierno (Principal Investigator), Lisa Alexander, Paul Levine, Heather Young, Heather Hoffman, Nancy LaVerda, Larisa Caicedo, William Funderburk, Elmer Huerta, Jeanne Mandelblatt, Jennifer Eng-Wong, Sandra Swain, Wayne Frederick, and Felicia Buadoo-Adade; H. Lee Moffitt Cancer Center and Research Institute: Richard Roetzheim (Principal Investigator), Cathy Meade, Kristen J. Wells, Ercilia Calcano, Ji-Hyun Lee, William Fulp, and Marlene Rivera; Northwest Portland Area Indian Health Board: Victoria Warren-Mears (Principal Investigator), Matthew Town, Jenine Dankovchik, and Meagan Cahn; Northwestern University Robert H. Lurie Comprehensive Cancer Center: Steven Rosen (Principal Investigator), Melissa A. Simon, Narissa Nonzee, and June McKoy; Ohio State University Comprehensive Cancer Center: Electra D. Paskett (Principal Investigator), Douglas Post, Mira Katz, David Murray, Cathy Tatum, Cecilia DeGraffinreid, Gregory Young, and Melissa Gorsline; University of Illinois at Chicago and Access Community Health Center: Elizabeth Calhoun (Principal Investigator), Julie Darnell, Julia Shklovskaya, Mickey Eder, Young Cho, and Talar Markossian; University of Rochester: Kevin Fiscella (Principal Investigator), Samantha Hendren, Jennifer Carroll, Ronald Epstein, Jennifer Griggs, Sharon Humiston, Pascal Jean-Pierre, Starlene Loader, Vi Luong, Sally Rousseau, Charcy Salamone, Michele Sanders, Bonnie Schwartzbauer, and Amanat Yosha; and University of Texas Health Science Center at San Antonio Cancer Therapy and Research Center: Donald J. Dudley (Principal Investigator), Joan Drake, Kevin Hall, Alan Holden, Anand Karnard, Amelie Ramirez, Jennifer Quinlan, and Pamela Saegert.



Patient navigation is a barrier-focused program of care coordination designed to achieve timely and high-quality cancer-related care for medically underserved racial-ethnic minorities and the poor. However, to the authors' knowledge, few studies to date have examined the relationship between satisfaction with navigators and cancer-related care.


The authors included data from 1345 patients with abnormal cancer screening tests or a definitive cancer diagnosis who participated in the Patient Navigation Research Program to test the efficacy of patient navigation. Participants completed demographic questionnaires and measures of patient satisfaction with cancer-related care (PSCC) and patient satisfaction with interpersonal relationship with navigator (PSN-I). The authors obtained descriptive statistics to characterize the sample and conducted regression analyses to assess the degree of association between PSN-I and PSCC, controlling for demographic and clinical factors. Analyses of variance were conducted to examine group differences controlling for statistically significant covariates.


Statistically significant relationships were found between the PSCC and PSN-I for patients with abnormal cancer screening tests (1040 patients; correlation coefficient (r), 0.4 [P<.001]) and those with a definitive cancer diagnosis (305 patients; correlation coefficient, 0.4 [P<.001]). The regression analysis indicated that having an abnormal colorectal cancer screening test in the abnormal screening test group and increased age and minority race-ethnicity status in the cancer diagnosis group were associated with a higher satisfaction with cancer care (P<.01).


Satisfaction with navigators appears to be significantly associated with satisfaction with cancer-related care. Information regarding the patient-navigator relationship should be integrated into patient navigation programs to maximize the likelihood of reducing caner disparities and mortality for medically underserved racial-ethnic minorities and the poor. Cancer 2016;122:1060–1067. © 2016 American Cancer Society