Design of a prostate cancer patient navigation intervention for a Veterans Affairs hospital

Narissa J. Nonzee, June M. McKoy, Alfred W. Rademaker, Peter Byer, Thanh Ha Luu, Dachao Liu, Elizabeth A. Richey, Athena T. Samaras, Genna Panucci, Xinqi Dong, Melissa A. Simon

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Patient navigation programs have been launched nationwide in an attempt to reduce racial/ethnic and socio-demographic disparities in cancer care, but few have evaluated outcomes in the prostate cancer setting. The National Cancer Institute-funded Chicago Patient Navigation Research Program (C-PNRP) aims to implement and evaluate the efficacy of a patient navigation intervention for predominantly low-income minority patients with an abnormal prostate cancer screening test at a Veterans Affairs (VA) hospital in Chicago. Methods/Design. From 2006 through 2010, C-PNRP implemented a quasi-experimental intervention whereby trained social worker and lay health navigators worked with veterans with an abnormal prostate screen to proactively identify and resolve personal and systems barriers to care. Men were enrolled at a VA urology clinic and were selected to receive navigated versus usual care based on clinic day. Patient navigators performed activities to facilitate timely follow-up such as appointment reminders, transportation coordination, cancer education, scheduling assistance, and social support as needed. Primary outcome measures included time (days) from abnormal screening to diagnosis and time from diagnosis to treatment initiation. Secondary outcomes included psychosocial and demographic predictors of non-compliance and patient satisfaction. Dates of screening, follow-up visits, and treatment were obtained through chart audit, and questionnaires were administered at baseline, after diagnosis, and after treatment initiation. At the VA, 546 patients were enrolled in the study (245 in the navigated arm, 245 in the records-based control arm, and 56 in a subsample of surveyed control subjects). Discussion. Given increasing concerns about balancing better health outcomes with lower costs, careful examination of interventions aimed at reducing healthcare disparities attain critical importance. While analysis of the C-PNRP data is underway, the design of this patient navigation intervention will inform other patient navigation programs addressing strategies to improve prostate cancer outcomes among vulnerable populations.

Original languageEnglish (US)
Article number340
JournalBMC health services research
Volume12
Issue number1
DOIs
StatePublished - Sep 27 2012
Externally publishedYes

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Patient Navigation
Veterans Hospitals
Prostatic Neoplasms
Veterans
Research
Healthcare Disparities
Demography
National Cancer Institute (U.S.)
Health
Urology
Vulnerable Populations
Patient Satisfaction
Early Detection of Cancer
Social Support
Prostate
Neoplasms
Appointments and Schedules
Therapeutics
Outcome Assessment (Health Care)
Education

All Science Journal Classification (ASJC) codes

  • Health Policy

Cite this

Nonzee, N. J., McKoy, J. M., Rademaker, A. W., Byer, P., Luu, T. H., Liu, D., ... Simon, M. A. (2012). Design of a prostate cancer patient navigation intervention for a Veterans Affairs hospital. BMC health services research, 12(1), [340]. https://doi.org/10.1186/1472-6963-12-340
Nonzee, Narissa J. ; McKoy, June M. ; Rademaker, Alfred W. ; Byer, Peter ; Luu, Thanh Ha ; Liu, Dachao ; Richey, Elizabeth A. ; Samaras, Athena T. ; Panucci, Genna ; Dong, Xinqi ; Simon, Melissa A. / Design of a prostate cancer patient navigation intervention for a Veterans Affairs hospital. In: BMC health services research. 2012 ; Vol. 12, No. 1.
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Nonzee, NJ, McKoy, JM, Rademaker, AW, Byer, P, Luu, TH, Liu, D, Richey, EA, Samaras, AT, Panucci, G, Dong, X & Simon, MA 2012, 'Design of a prostate cancer patient navigation intervention for a Veterans Affairs hospital', BMC health services research, vol. 12, no. 1, 340. https://doi.org/10.1186/1472-6963-12-340

Design of a prostate cancer patient navigation intervention for a Veterans Affairs hospital. / Nonzee, Narissa J.; McKoy, June M.; Rademaker, Alfred W.; Byer, Peter; Luu, Thanh Ha; Liu, Dachao; Richey, Elizabeth A.; Samaras, Athena T.; Panucci, Genna; Dong, Xinqi; Simon, Melissa A.

In: BMC health services research, Vol. 12, No. 1, 340, 27.09.2012.

Research output: Contribution to journalArticle

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T1 - Design of a prostate cancer patient navigation intervention for a Veterans Affairs hospital

AU - Nonzee, Narissa J.

AU - McKoy, June M.

AU - Rademaker, Alfred W.

AU - Byer, Peter

AU - Luu, Thanh Ha

AU - Liu, Dachao

AU - Richey, Elizabeth A.

AU - Samaras, Athena T.

AU - Panucci, Genna

AU - Dong, Xinqi

AU - Simon, Melissa A.

PY - 2012/9/27

Y1 - 2012/9/27

N2 - Background: Patient navigation programs have been launched nationwide in an attempt to reduce racial/ethnic and socio-demographic disparities in cancer care, but few have evaluated outcomes in the prostate cancer setting. The National Cancer Institute-funded Chicago Patient Navigation Research Program (C-PNRP) aims to implement and evaluate the efficacy of a patient navigation intervention for predominantly low-income minority patients with an abnormal prostate cancer screening test at a Veterans Affairs (VA) hospital in Chicago. Methods/Design. From 2006 through 2010, C-PNRP implemented a quasi-experimental intervention whereby trained social worker and lay health navigators worked with veterans with an abnormal prostate screen to proactively identify and resolve personal and systems barriers to care. Men were enrolled at a VA urology clinic and were selected to receive navigated versus usual care based on clinic day. Patient navigators performed activities to facilitate timely follow-up such as appointment reminders, transportation coordination, cancer education, scheduling assistance, and social support as needed. Primary outcome measures included time (days) from abnormal screening to diagnosis and time from diagnosis to treatment initiation. Secondary outcomes included psychosocial and demographic predictors of non-compliance and patient satisfaction. Dates of screening, follow-up visits, and treatment were obtained through chart audit, and questionnaires were administered at baseline, after diagnosis, and after treatment initiation. At the VA, 546 patients were enrolled in the study (245 in the navigated arm, 245 in the records-based control arm, and 56 in a subsample of surveyed control subjects). Discussion. Given increasing concerns about balancing better health outcomes with lower costs, careful examination of interventions aimed at reducing healthcare disparities attain critical importance. While analysis of the C-PNRP data is underway, the design of this patient navigation intervention will inform other patient navigation programs addressing strategies to improve prostate cancer outcomes among vulnerable populations.

AB - Background: Patient navigation programs have been launched nationwide in an attempt to reduce racial/ethnic and socio-demographic disparities in cancer care, but few have evaluated outcomes in the prostate cancer setting. The National Cancer Institute-funded Chicago Patient Navigation Research Program (C-PNRP) aims to implement and evaluate the efficacy of a patient navigation intervention for predominantly low-income minority patients with an abnormal prostate cancer screening test at a Veterans Affairs (VA) hospital in Chicago. Methods/Design. From 2006 through 2010, C-PNRP implemented a quasi-experimental intervention whereby trained social worker and lay health navigators worked with veterans with an abnormal prostate screen to proactively identify and resolve personal and systems barriers to care. Men were enrolled at a VA urology clinic and were selected to receive navigated versus usual care based on clinic day. Patient navigators performed activities to facilitate timely follow-up such as appointment reminders, transportation coordination, cancer education, scheduling assistance, and social support as needed. Primary outcome measures included time (days) from abnormal screening to diagnosis and time from diagnosis to treatment initiation. Secondary outcomes included psychosocial and demographic predictors of non-compliance and patient satisfaction. Dates of screening, follow-up visits, and treatment were obtained through chart audit, and questionnaires were administered at baseline, after diagnosis, and after treatment initiation. At the VA, 546 patients were enrolled in the study (245 in the navigated arm, 245 in the records-based control arm, and 56 in a subsample of surveyed control subjects). Discussion. Given increasing concerns about balancing better health outcomes with lower costs, careful examination of interventions aimed at reducing healthcare disparities attain critical importance. While analysis of the C-PNRP data is underway, the design of this patient navigation intervention will inform other patient navigation programs addressing strategies to improve prostate cancer outcomes among vulnerable populations.

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