Journal of Cancer Education

, Volume 26, Issue 1, pp 111–120

Understanding the Processes of Patient Navigation to Reduce Disparities in Cancer Care: Perspectives of Trained Navigators from the Field

Authors

    • Radiation Oncology DepartmentUniversity of Rochester Medical Center
    • Family Medicine ResearchUniversity of Rochester Medical Center
    • Pediatrics Department and Sylvester Comprehensive Cancer CenterUniversity of Miami School of Medicine
  • Samantha Hendren
    • University of Michigan Medical Center
  • Kevin Fiscella
    • Radiation Oncology DepartmentUniversity of Rochester Medical Center
    • Family Medicine ResearchUniversity of Rochester Medical Center
  • Starlene Loader
    • Family Medicine ResearchUniversity of Rochester Medical Center
  • Sally Rousseau
    • Family Medicine ResearchUniversity of Rochester Medical Center
  • Bonnie Schwartzbauer
    • Family Medicine ResearchUniversity of Rochester Medical Center
  • Mechelle Sanders
    • Family Medicine ResearchUniversity of Rochester Medical Center
  • Jennifer Carroll
    • Radiation Oncology DepartmentUniversity of Rochester Medical Center
    • Family Medicine ResearchUniversity of Rochester Medical Center
  • Ronald Epstein
    • Family Medicine ResearchUniversity of Rochester Medical Center
Article

DOI: 10.1007/s13187-010-0122-x

Cite this article as:
Jean-Pierre, P., Hendren, S., Fiscella, K. et al. J Canc Educ (2011) 26: 111. doi:10.1007/s13187-010-0122-x

Abstract

Patient navigation (PN) programs are being widely implemented to reduce disparities in cancer care for racial/ethnic minorities and the poor. However, few systematic studies cogently describe the processes of PN. We qualitatively analyzed 21 transcripts of semistructured exit interviews with three navigators about their experiences with patients who completed a randomized trial of PN. We iteratively discussed codes/categories, reflective remarks, and ways to focus/organize data and developed rules for summarizing data. We followed a three-stage analysis model: reduction, display, and conclusion drawing/verification. We used ATLAS.ti_5.2 for text segmentation, coding, and retrieval. Four categories of factors affecting cancer care outcomes emerged: patients, navigators, navigation processes, and external factors. These categories formed a preliminary conceptual framework describing ways in which PN processes influenced outcomes. Relationships between processes and outcomes were influenced by patient, navigator, and external factors. The process of PN has at its core relationship-building and instrumental assistance. An enhanced understanding of the process of PN derived from our analyses will facilitate improvement in navigators’ training and rational design of new PN programs to reduce disparities in cancer-related care.

Keywords

Patient navigationCancer careHealthcare disparitiesRacial-ethnic minoritiesCancer screening

Copyright information

© Springer 2010