Catalyzing Navigation for Breast Cancer Survivorship (CaNBCS) in Safety-Net Settings: A Mixed Methods Study

Autor: Barbara Ciccarelli, Urmimala Sarkar, Paul Couey, Nancy J. Burke, Natalie A. Rivadeneira, Evelin Trejo, Niharika Dixit
Rok vydání: 2021
Předmět:
Sociodemographic Factors
Safety net
Health Status
Cancer survivors
Clinical Trials and Supportive Activities
Oncology and Carcinogenesis
Breast Neoplasms
Survivorship
Breast cancer
7.1 Individual care needs
Clinical Research
Survivorship curve
Patient-Centered Care
Breast Cancer
care delivery
Medicine
Humans
Patient Navigation
Original Research Article
Oncology & Carcinogenesis
implementation
Poverty
RC254-282
Cancer
business.industry
Rehabilitation
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Hematology
General Medicine
Physical Functional Performance
Health Services
medicine.disease
Social Participation
humanities
United States
patient navigation
Mental Health
Good Health and Well Being
Oncology
Ethnic and Racial Minorities
Quality of Life
safety net
Female
Management of diseases and conditions
business
survivorship care plans
Safety-net Providers
Demography
Zdroj: Cancer Control, Vol 28 (2021)
Cancer Control : Journal of the Moffitt Cancer Center
Popis: Purpose The current number of breast cancer survivors (BCS) in the United States is approximately 3.8 million, and this number is further expected to increase with improvement in treatments. Survivorship care plans (SCPs) are patient-centered tools that are designed to meet cancer survivors' informational needs about their treatment history, recommended health care, and health maintenance. However, the data on SCP benefits remain uncertain, especially in low-income and racial and ethnic minority cancer survivors. Patient navigation is an effective intervention to improve patient adherence and experience of interdisciplinary breast cancer treatment. Objectives This study sought to understand the role of lay patient navigators (LPN) in survivorship care planning for BCS in safety-net settings. Methods This study is a mixed methods pilot randomized clinical trial to understand the role of patient navigation in cancer survivorship care planning in a public hospital. We invited BCS who had completed active breast cancer treatment within 5 years. LPNs discussed survivorship care planning and survivorship care-related issues with BCS in the intervention arm over a 6-month intervention period and accompanied patients to their primary care appointment. LPNs also encouraged survivors to discuss health care issues with oncology and primary care providers. The primary objective was to assess BCS’ health-related quality of life (HRQOL). The secondary objectives were self-efficacy and implementation. We assessed implementation with 45–60-min semi-structured interviews with 15 BCS recruited from the intervention arm and 60-min focus groups with the oncologists and separately with LPNs. Results We enrolled 40 patients, 20 randomized to usual care and 20 randomized to LPN navigation. We did not find a statistically significant difference between the two arms in HRQOL. There was also no difference in self-efficacy between the two arms. Qualitative analysis identified implementation barriers to intervention that may have contributed to less effective intervention. Implications for Cancer Survivors Future survivorship care planning interventions need to consider: Cancer survivors’ needs and preferences, the need for dedicated resources, and the role of electronic health records in survivorship care plan delivery.
Databáze: OpenAIRE
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