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

  • Pascal Jean-Pierre
  • Samantha Hendren
  • Kevin Fiscella
  • Starlene Loader
  • Sally Rousseau
  • Bonnie Schwartzbauer
  • Mechelle Sanders
  • Jennifer Carroll
  • Ronald Epstein
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

Authors and Affiliations

  • Pascal Jean-Pierre
    • 1
    • 2
    • 4
  • Samantha Hendren
    • 3
  • Kevin Fiscella
    • 1
    • 2
  • Starlene Loader
    • 2
  • Sally Rousseau
    • 2
  • Bonnie Schwartzbauer
    • 2
  • Mechelle Sanders
    • 2
  • Jennifer Carroll
    • 1
    • 2
  • Ronald Epstein
    • 2
  1. 1.Radiation Oncology DepartmentUniversity of Rochester Medical CenterRochesterUSA
  2. 2.Family Medicine ResearchUniversity of Rochester Medical CenterRochesterUSA
  3. 3.University of Michigan Medical CenterAnn ArborUSA
  4. 4.Pediatrics Department and Sylvester Comprehensive Cancer CenterUniversity of Miami School of MedicineMiamiUSA