Building a Navigation System to Reduce Cancer Disparities Among Urban Black Older Adults
Building a Navigation System to Reduce Cancer Disparities Among Urban Black Older Adults
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DOI：
10.1353/cpr.2013.0018
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发表时间：
2013-06-01
影响因子：
1.1
通讯作者：
Ford, Jean G.
中科院分区：
文献类型：
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作者：
Bone, Lee R.;Edington, Kristen;Ford, Jean G.
背景：尽管近几十年来癌症治疗结果有所改善，但种族、民族、收入和教育程度方面的巨大差异仍然存在。患者导航服务在改善癌症检测、治疗和护理以及减少癌症健康差异方面日益取得成功。为了推动制定患者导航计划的进展，必须向研究人员和健康服务提供者提供对该计划每个组成部分的广泛描述。目标：我们试图描述旨在改善癌症筛查的患者导航计划的组成部分，该计划基于巴尔的摩市以黑人为主的老年人对癌症筛查和癌症治疗服务的知情决策。方法：采用社区学术参与方法在马里兰州巴尔的摩制定了患者导航计划。患者导航系统的组成部分包括建立社区学术（咨询）委员会（CAC）；社区卫生工作者（CHW）/导航员和监管人员的招聘和选拔，社区卫生工作者/导航员的初始培训和继续教育，以及社区卫生工作者/导航员的评估。该研究得到了约翰·霍普金斯大学彭博公共卫生学院机构审查委员会的批准。结论：将基于社区的参与性研究原则纳入该患者导航计划的各个方面有助于实现干预目标。该患者导航计划成功为 1,302 名城市黑人老年人提供癌症导航服务。在经验丰富的主管和调查员的监督下，适当招募、选择和培训社区卫生工作者是患者导航计划的关键要素。该模型有可能被研究和卫生服务提供者采用。
Background: Although cancer outcomes have improved in recent decades, substantial disparities by race, ethnicity, income, and education persist. Increasingly, patient navigation services are demonstrating success in improving cancer detection, treatment, and care and in reducing cancer health disparities. To advance progress in developing patient navigation programs, extensive descriptions of each component of the program must be made available to researchers and health service providers.Objective: We sought to describe the components of a patient navigation program designed to improve cancer screening based on informed decision making on cancer screening and cancer treatment services among predominantly Black older adults in Baltimore City.Methods: A community academic participatory approach was used to develop a patient navigation program in Baltimore, Maryland. The components of the patient navigation system included the development of a community academic (advisory) committee (CAC); recruitment and selection of community health workers (CHWs)/navigators and supervisory staff, initial training and continuing education of the CHWs/navigators, and evaluation of CHWs/navigators. The study was approved by the Johns Hopkins Bloomberg School of Public Health Institutional Review Board.Conclusions: The incorporation of community-based participatory research principles into each facet of this patient navigation program facilitated the attainment of the intervention's objectives. This patient navigation program successfully delivered cancer navigation services to 1,302 urban Black older adults. Appropriately recruited, selected and trained CHWs monitored by an experienced supervisor and investigators are the key elements in a patient navigation program. This model has the potential to be adapted by research and health service providers.