Skip to main content
SpringerLink
Log in

Do Navigators’ Estimates of Navigation Intensity Predict Navigation Time for Cancer Care?

  • Published:
Journal of Cancer Education Aims and scope Submit manuscript

Abstract

Patient navigation requires that patient load be equitably distributed. We examined whether navigators could predict the relative amount of time needed by different patients for navigation. Analysis of 139 breast and colorectal cancer patients randomized to the navigation arm of a trial evaluating the effectiveness of navigation. Navigators completed a one-item scale estimating how much navigation time patients were likely to require. Participants were mostly females (89.2%) with breast cancer (83.4%); barriers to cancer care were insurance difficulties (26.6%), social support (18.0%), and transportation (14.4%). Navigator baseline estimates of navigation intensity predicted total navigation time, independent of patient characteristics. The total number of barriers, rather than any specific type of barrier, predicted increased navigator time, with a 16% increase for each barrier. Navigators’ estimate of intensity independently predicts navigation time for cancer patients. Findings have implications for assigning navigator case loads.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Gornick ME, Eggers PW, Riley GF (2004) Associations of race, education, and patterns of preventive service use with stage of cancer at time of diagnosis. Health Serv Res 39:1403–1427

    Article  PubMed  Google Scholar 

  2. Jean-Pierre P, Hendren S, Fiscella K, Loader S, Rousseau S, Schwartzbauer B et al (2011) Understanding the processes of patient navigation to reduce disparities in cancer care: perspectives of trained navigators from the Field. J Cancer Educ 26:111–120

    Article  PubMed  Google Scholar 

  3. Griggs JJ, Culakova E, Sorbero ME, Poniewierski MS, Wolff DA, Crawford J et al (2007) Social and racial differences in selection of breast cancer adjuvant chemotherapy regimens. J Clin Oncol 25:2522–2527

    Article  PubMed  Google Scholar 

  4. Shavers VL, Brown ML (2002) Racial and ethnic disparities in the receipt of cancer treatment. J Natl Cancer Inst 94(5):334–357

    Article  PubMed  Google Scholar 

  5. Freeman HP, Muth BJ, Kerner JF (1995) Expanding access to cancer screening and clinical follow-up among the medically underserved. Cancer Pract 3:19–30

    PubMed  CAS  Google Scholar 

  6. Dohan D, Schrag D (2005) Using navigators to improve care of underserved patients: current practices and approaches. Cancer 104:848–855

    Article  PubMed  Google Scholar 

  7. Battaglia TA, Roloff K, Posner MA, Freund KM (2007) Improving follow-up to abnormal breast cancer screening in an urban population. A patient navigation intervention. Cancer 109:359–367

    Article  PubMed  Google Scholar 

  8. Freeman HP (2006) Patient navigation: a community centered approach to reducing cancer mortality. J Cancer Educ 21:S11–S14

    Article  PubMed  Google Scholar 

  9. Robinson-White S, Conroy B, Slavish KH, Rosenzweig M (2010) Patient navigation in breast cancer: a systematic review. Cancer Nurs 33:127–140

    Article  PubMed  Google Scholar 

  10. Baquet CR, Mack KM, Mishra SI, Bramble J, DeShields M, Datcher D et al (2006) Maryland’s Special Populations Network. A model for cancer disparities research, education, and training. Cancer 107(8 Suppl):2061–2070

    Article  PubMed  Google Scholar 

  11. Gabram SG, Lund MB, Gardner J, Hatchett N, Bumpers HL, Okoli J et al (2008) Effects of an outreach and internal navigation program on breast cancer diagnosis in an urban cancer center with a large African-American population. Cancer 113:602–607

    Article  PubMed  Google Scholar 

  12. Fischer SM, Sauaia A, Kutner JS (2009) Patient navigation: a culturally competent strategy to address disparities in cancer care. J Palliat Med 10:1023–1028

    Article  Google Scholar 

  13. Parker VA, Clark JA, Leyson J, Calhoun E, Carroll JK, Freund KM et al (2010) Patient navigation: development of a protocol for describing what navigators do. Health Serv Res 45:514–531

    Article  PubMed  Google Scholar 

  14. Campbell C, Craig J, Eggert J, Bailey-Dorton C (2010) Implementing and measuring the impact of patient navigation at a comprehensive community cancer center. Oncol Nurs Forum 37:61–68

    Article  PubMed  Google Scholar 

  15. Soothill K, Morris SM, Harman J, Francis B, Thomas C, McIllmurray MB (2001) The significant unmet needs of cancer patients: probing psychosocial concerns. Support Care Cancer 9:597–605

    Article  PubMed  CAS  Google Scholar 

  16. Sanson-Fisher R, Girgis A, Boyes A, Bonevski B, Burton L, Cook P (2000) The unmet supportive care needs of patients with cancer. Supportive care review group. Cancer 88:226–237

    Article  PubMed  CAS  Google Scholar 

  17. Byrne G, Brady AM, Griffith C, Macgregor C, Horan P, Begley C (2006) The community client need classification system—a dependency system for community nurses. J Nurs Manag 14:437–446

    Article  PubMed  Google Scholar 

  18. Lin CJ, Schwaderer KA, Morgenlander KH, Ricci EM, Hoffman L, Martz E et al (2008) Factors associated with patient navigators’ time spent on reducing barriers to cancer treatment. J Natl Med Assoc 100:1290–1297

    PubMed  Google Scholar 

  19. Carroll JK, Humiston SG, Meldrum SC, Salamone CM, Jean-Pierre P, Epstein RM et al (2010) Patients’ experiences with navigation for cancer care. Patient Educ Couns 80:241–247

    Article  PubMed  Google Scholar 

  20. Hendren S, Griggs JJ, Epstein RM, Humiston S, Rousseau S, Jean-Pierre P et al (2010) Study protocol: a randomized controlled trial of patient navigation-activation to reduce cancer health disparities. BMC Cancer 10:551

    Article  PubMed  Google Scholar 

  21. UCLA: Academic Technology Services, S. C. G. (2010). Statistical Computing - General FAQs. electronic [On-line]. Available: http://www.ats.ucla.edu/stat/mult_pkg/faq/general/log_transformed_regression.htm

  22. Wujcik D, Fair AM (2008) Barriers to diagnostic resolution after abnormal mammography: a review of the literature. Cancer Nurs 31:E16–E30

    Article  PubMed  Google Scholar 

  23. Brookfield KF, Cheung MC, Lucci J, Fleming LE, Koniaris LG (2009) Disparities in survival among women with invasive cervical cancer: a problem of access to care. Cancer 115:166–178

    Article  PubMed  Google Scholar 

  24. Byers TE, Wolf HJ, Bauer KR, Bolick-Aldrich S, Chen VW, Finch JL et al (2008) The impact of socioeconomic status on survival after cancer in the United States: findings from the National program of cancer registries patterns of care study. Cancer 113:582–591

    Article  PubMed  Google Scholar 

  25. Lannin DR, Mathews HF, Mitchell J, Swanson MS, Swanson FH, Edwards MS (1998) Influence of socioeconomic and cultural factors on racial differences in late-stage presentation of breast cancer. JAMA 279:1801–1807

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgment

This research was supported by the National Cancer Institute (identifying information has been removed per the journal’s submission instructions).

Author information

Authors and Affiliations

  1. University of Rochester Medical Center, Department of Family Medicine, 1381 South Ave, Rochester, NY, 14620, USA

    Jennifer Kate Carroll, Paul C. Winters & Kevin Fiscella

  2. University of Rochester Cancer Center, 601 Elmwood Ave, Rochester, NY, 14642, USA

    Jennifer Kate Carroll, Katie Devine & Kevin Fiscella

  3. Washington University, Brown School of Social Work, Washington, DC, USA

    Jason Q. Purnell

Authors
  1. Jennifer Kate Carroll
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paul C. Winters
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jason Q. Purnell
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Katie Devine
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kevin Fiscella
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jennifer Kate Carroll.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Carroll, J.K., Winters, P.C., Purnell, J.Q. et al. Do Navigators’ Estimates of Navigation Intensity Predict Navigation Time for Cancer Care?. J Canc Educ 26, 761–766 (2011). https://doi.org/10.1007/s13187-011-0234-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13187-011-0234-y

Keywords

Search

Navigation