Abstract
This study synthesized lessons learned from US-based community and clinic health navigator (CHN) interventions on cancer screening promotion to identify characteristics of models and approaches for addressing cancer disparities. The combination terms “cancer screening” and “community health workers or navigators” or “patient navigators” were used in searching Medline, CINAHL, and PsycInfo. A total of 27 articles published during January 2005∼April 2014 were included. Two CHN models were identified: community-based (15 studies) and clinic/hospital-based (12 studies). While both models used the term “navigators,” most community-based programs referred them as community health workers/navigators/advisors, whereas clinic-based programs often called them patient navigators. Most community-based CHN interventions targeted specific racial/ethnic minority or rural groups, while clinic-based programs mostly targeted urban low income or mixed ethnic groups. Most community-based CHN programs outreached members from community networks, while clinic-based programs commonly worked with pre-identified in-service clients. Overall, regardless model type, CHNs had similar roles and responsibilities, and interventions demonstrated effective outcomes. Our review identified characteristics of CHN interventions with attention to different settings. Lessons learned have implication on the dissemination and implementation of CHN interventions for cancer screening promotion across setting and target groups.
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References
Centers for Disease Control and Prevention (2012) Cancer screening—United States, 2010. Morb Mortal Wkly Rep 61(3):41–45
Centers for Disease Control and Prevention (2011) Colorectal cancer screening—United States, 2002, 2004, 2006, and 2008. Morb Mortal Wkly Rep 60(1):42–46
Henley SJ, King JB, German RR, Richardson LC, Plescia M (2010) Surveillance of screening-detected cancers (colon and rectum, breast, and cervix)—United States, 2004–2006. Morb Mortal Wkly Rep 59(9):1–25
Hou S, Sealy D, Kabiru C (2011) Closing the disparity gap: cancer screening interventions among Asians—a systematic literature review. Asian Pac J Cancer Prev 12(11):3133–3139
Nguyen TN, Tanjasiri SP, Kagawa-Singer M, Tran JH, Foo MA (2008) Community health navigators for breast- and cervical-cancer screening among Cambodian and Laotian women: intervention strategies and relationship-building processes. Health Promot Pract 9(4):356–367
Taylor VM, Jackson JC, Yasui Y, Nguyen TT, Woodall E, Acorda E et al (2010) Evaluation of a cervical cancer control intervention using lay health workers for Vietnamese American women. Am J Public Health 100(10):1924–1929
Kagwa-Singer M, Tanjasiri SR, Foo MA, Tran JH (2006) Breast and cervical cancer control among Pacific Islander and Southeast Asian women: participatory action research strategies for baseline data collection in California. J Cancer Educ 21(Suppl):S53–S60
Braun KL, Kagawa-Singer M, Holden A, Burhansstipanov L, Tran JH, Seals BF, Corbie-Smith G, Tsark JU, Harjo L, Foo MA, Ramirez AG (2012) Cancer patienti navigator tasks across the cancer care continuum. J Health Care Poor Underserved 23:398–413
Braun KL, Allison A, Tsark JU (2008) Using community-based research methods to design cancer patient navigation training. Prog Commun Health Partnerships:Res Educ Action 2(4):329–340
Luque JS, Mason M, Reyes-Garcia C, Hinojosa A, Meade CD (2011) Salud es vida: development of a cervical cancer education curriculum for promotora outreach with Latina farmworkers in rural southern Georgia. Am J Public Health 101(12):2233–2235
Nguyen TN, Tran JH, Kagawa-Singer M, Foo MA (2011) A qualitative assessment of community-based breast health navigation services for Southeast Asian women in southern California: recommendations for developing a navigator training curriculum. Am J Public Health 101(1):87–93
Watson-Johnson LC, Bhagatwala J, Reyes-Garcia C, Hinojosa A, Mason M, Meade CD, Luque JS (2012) Refinement of an educational toolkit to promote cervical cancer screening among Hispanic immigrant women in rural southern Georgia. J Health Care Poor Underserved 23(2012):1704–1711
Sly J, Jandorf L, Hall D, Edwards T, Goodman A, Maysonet E et al (2012) Challenges to relicating evidence-based research in real-world settings: training African-American peers as patient navigators for colon cancer screening. J Cancer Educ 27(4):680–686
Jandorf L, Gutierrez Y, Lopez J, Christie J, Itzkowitz SH (2005) Use of a patient navigator to increase colorectal cancer screening in an urban neighborhood health clinic. J Urban Health 82(2):216–224
Percac-Lima S, Grant RW, Green AR, Ashburner JM, Gamba G, Oo S et al (2009) A culturally tailored navigator program for colorectal cancer screening in a community health center: a randomized, controlled trial. J Gen Intern Med 24(2):211–217
Shelton RC, Thompson HS, Jandorf L, Varela A, Oliveri B, Villagra C et al (2011) Training experiences of lay and professional patient navigators for colorectal cancer screening. J Cancer Educ 26(2):277–284
Christie J, Itzkowitz SH, Lihau-Nkanza I, Castillo A, Redd WH, Jandorf L (2008) A Randomized controlled trial using patient navigation to increase colonoscopy screening among low-income minorities. J Natl Med Assoc 100(3):278–284
Lasser KE, Murillo J, Lisboa S, Casimir AN, Valley-Shah L, Emmons KM et al (2011) Colorectal cancer screening among ethnically diverse, low-income patients a randomized controlled trial. Arch Intern Med 171(10):906–912
Myers RE, Hyslop T, Sifri R, Bittner-Fagan H, Katurakes NC, Cocroft J et al (2008) Tailored navigation in colorectal cancer screening. Med Care 46(9,Suppl1):S123–S131
Percac-Lima S, Ashburner JM, Bond B, Oo S, Atlas SJ (2013) Decreasing disparities in breast cancer screening in refugee women using culturally tailored patient navigation. J Gen Intern Med 28(11):1463–8
Lasser KE, Murillo J, Medlin E, Lisboa S, Valley-Shah L, Fletcher RH et al (2009) A multilevel intervention to promote colorectal cancer screening among community health center patients: results of a pilot study. BMC Fam Pract 10:37
Nuss HJ, Williams DL, Hayden J, Huard CR (2013) Applying the social ecological model to evaluate a demonstration colorectal cancer screening program in Louisiana. J Health Care Poor Underserved 23:1026–1035
Jandorf L, Cooperman JL, Stossel LM, Itzkowitz S, Thompson HS, Villagra C, Thelemaque LD, McGinn T, Winkel G, Valdimarsdottir H, Chelton RC, Redd W (2013) Implementation of culturally targeted patient navigation system for screening colonoscopy in a direct referral system. Health Educ Res 28(5):803–815
(OBSSR) OoBaSSR. National Institutes of Health (2013) Dissemination and implementation. http://obssr.od.nih.gov/scientific_areas/translation/dissemination_and_implementation/index.aspx. Accessed 27 Sep 2013.
(FIC) FIC. Frequently asked questions about implementation science (2013) National Institutes of Health. http://www.fic.nih.gov/News/Events/implementation-science/Pages/faqs.aspx Accessed 27 Sep 2013.
Garrad J (2003) Health sciences literature review made easy: the matrix method, 4th edn. Jones and Bartlett, Burlington
Ma GX, Shive S, Tan Y, Gao W, Rhee J, Park M et al (2009)Community-based colorectal cancer intervention in underserved Korean Americans. Cancer Epidemiol 33(5):381–386
Maxwell A, Danao L, Cayetano R, Crespi C, Bastani R (2012) Evaluating the training of Filipino American community health advisors to disseminate colorectal cancer screening. J Community Health 37(6):1218–1225
Fernández MEP, Gonzales AMSW, Tortolero-Luna GMDP, Williams JMPH, Saavedra-Embesi MMPH, Chan WP et al (2009) Effectiveness of Cultivando la Salud: a breast and cervical cancer screening promotion program for low-income Hispanic women. Am J Public Health 99(5):936–943
O’Brien MJ, Halbert CH, Bixby R, Pimentel S, Shea JA (2010) Community health worker intervention to decrease cervical cancer disparities in Hispanic women. J Gen Intern Med 25(11):1186–1192
Mason TA, Thompson WW, Allen D, Rogers D, Gabram-Mendola S, Arriola KRJ (2013) Evaluation of the Avon foundation community education and outreach initiative community patient navigation program. Health Promot Pract 14(1):105–112
Dignan MB, Burhansstipanov L, Hariton J, Harjo L, Rattler T, Lee R et al (2005) A comparison of two native American navigator formats: face-to-face and telephone. Cancer Control 12(Suppl 2):28–33
Saad-Harfouche FG, Jandorf L, Gage E, Thelemaque LD, Colon J, Castillo AG et al (2011) Esperanza y Vida: training lay health advisors and cancer survivors to promote breast and cervical cancer screening in Latinas. J Community Health 36(2):219–227
Feltner FJ, Ely GE, Whitler ET, Gross D, Dignan M (2012) Effectiveness of community health workers in providing outreach and education for colorectal cancer screening in Appalachian Kentucky. Soc Work Health Care 51(5):430–440
Williams KP, Roman L, Meghea CI, Penner L, Hammad A, Gardiner J (2013) Kin KeeperSM: design and baseline characteristics of a community-based randomized controlled trial promoting cancer screening in Black, Latina, and Arab women. Contemparary Clin Trials 34(2):312–319
Philips CE, Rothstein JD, Beaver K, Sherman BJ, Freund KM, Battaglia TA (2010) Patient navigation to increase mammography screening among inner city women. J Gen Intern Med 26(2):123–129
Andrews JO, Felton G, Wewers ME, Heath J (2004) Use of community health workers in research with ethnic minority women. J Nurs Scholarsh 36(4):358–365
Gibbons MC, Tyus NC (2007) Systematic review of U.S.-based randomized controlled trials using community health workers. Prog Commun Health Partnerships Res Educ Action 1(4):371–381
Wells KJ, Luque JS, Miladinovic B, Vargas N, Asvat Y, Roetzheim RG et al (2011) Do community health worker interventions improve rates of screening mammography in the United States? A systematic review. Cancer Epidemiol Biomark Prev 20(8):1580–1598
Bone LR, Edington K, Rosenberg J, Wenzel J, Garza MA, Klein C et al (2013) Building a navigation system to reduce cancer disparities among urban Black older adults. Prog Commu Health Partnerships Res Educ Action 7(2):209–218
Nguyen T-UN, Tran JH, Kagawa-Singer M, Foo MA (2011) A qualitative assessment of community-based breast health navigation services for Southeast Asian women in Southern California: recommendations for developing a navigator training curriculum. Am J Public Health 101(1):87–93
Swider S, Martin M, Lynas C, Rothschild S (2010) Project match: training for a promotora intervention. Diabetes Educ 361:98–108
Dwan KGC, Williamson PR, Kirkham JJ, for the Reporting Bias Group (2013) Systematic review of the empirical evidence of study publication bias and outcome reporting bias—an updated review. PLoS One 8(7):e66844
Hiatt RA, Pasick RJ, Stewart S, Bloom J, Davis P, Gardiner P et al (2008) Cancer screening for underserved women: the breast and cervical cancer intervention study. Cancer Epidemiol Biomark Prev 17(8):1945–1949
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Hou, SI., Roberson, K. A Systematic Review on US-Based Community Health Navigator (CHN) Interventions for Cancer Screening Promotion—Comparing Community- Versus Clinic-Based Navigator Models. J Canc Educ 30, 173–186 (2015). https://doi.org/10.1007/s13187-014-0723-x
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DOI: https://doi.org/10.1007/s13187-014-0723-x