1 / 48

Patient Navigation Research Program (PNRP)

March 8, 2010. Patient Navigation Research Program (PNRP). 45th Regular Meeting of the Board of Scientific Advisors Center to Reduce Cancer Health Disparities. U.S. Healthcare System Maze Needs a GPS for Vulnerable Populations. Language/interpreter. Employment/ Loss Wages. Fear.

neci
Download Presentation

Patient Navigation Research Program (PNRP)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. March 8, 2010 Patient Navigation Research Program (PNRP) 45th Regular Meeting of the Board of Scientific Advisors Center to Reduce Cancer Health Disparities

  2. U.S. Healthcare System Maze Needs a GPS for Vulnerable Populations Language/interpreter Employment/ Loss Wages Fear Transportation Location of Facility Problems with Scheduling Perceptions and Beliefs Comorbidities Communication with Medical Personnel Uninsured, Underinsured Disability Healthcare Barriers Child/Adult Care Literacy

  3. Patient Navigation as a Personalized GPS

  4. AGENDA

  5. Patient Navigation Research Program (PNRP)

  6. National Navigation Programs Across Cancer Care Diagnostic Navigation Early Detection/ Screening testing Treatment Survivorship Abnormal Findings Diagnosis PNRP NCCCP* NCI Supported Programs MB-CCOP CDRP HRSA* CMS* ACS *Comorbidities

  7. Patient Navigation Research Program Navigators work with cancer patients to “navigate” the health care system and access appropriate social and financial services. The most important role of patient navigators is to ensure that individuals with suspicious cancer findings receive timely diagnosis and treatment.

  8. PNRP Grantee Map

  9. Cancer Types by Site

  10. PNRP Hypotheses T1

  11. PNRP Evolution

  12. PNRP Triad Enhancing Patient Access

  13. PNRP Target Populations

  14. Participant Characteristics

  15. Navigation Delivery

  16. Navigator Profile Reflects Community

  17. Healthcare System Settings (n=95) 58% Public Clinics

  18. PNRP Recruitment and Training

  19. Enrolled Participants over Time

  20. Best PracticeRecruitment Strategies

  21. Local Training Expanded through National Workshops and Web-based Trainings 2nd National PN Workshop n=234 1st National PN Workshop n=196 3rd National PN Workshop n=350 2005 2006 2007 2008 2009 2010 Barriers and Resources Webinars Proactive Navigation Webinars n=40 PNRP PN Toolkit

  22. PN Training- Core Competencies and Local Context - • Local PN Training • Orientation training for new PNs/continued education training tailored to local context/patient culture • Training on research surveys, tracking logs, ethics/IRB, and informed consent • Small group and one-on-one onsite training to check on current cases, provide cancer specifics, receive feedback, and assess progress • National PN Training • Standardized training across PNRP sites • Build core competency • Address training needs • Control for training effects Strength of PNRP Training Shared set of competencies tailored to specific local context and culture

  23. Accomplishments in Support of Science

  24. Tools and Resources: Researcher Screening test/finding or diagnosis Diagnostic work-up Diagnosis Stage of disease Clinical trials Treatment Data Dictionary Geographic location Setting Onsite services Pts served/yr Pt Ethnicity/race Impact of Events Scale (IES) Comm. & Attitudinal Self-Efficacy (CASE) Barriers Actions PN encounters Client interaction Care management Document Other intervention aspects Satisfaction with care Satisfaction with navigator

  25. Tools and Resources: Patient and Provider

  26. Partners

  27. Site-Specific Partnerships/Collaborations

  28. Interim Analysis Findings

  29. PNRP Hypothesis – Interim Analysis T1

  30. Breast

  31. Selected Demographic Characteristics of Study Participants (Breast) Age Race/Ethnicity Insurance # with Abnormal Finding (n=2,047) (n=1,701)

  32. Median T1 by Racial/Ethnic Group(Breast) Median # Days **p=<0.05

  33. Median T1 by Insurance Coverage(Breast) Median # Days

  34. Percentage of Diagnosed Cancers(Breast) % % Cancers in Abnormals % (n=1701) (n=2047)

  35. Demographic Characteristics of Navigated Participants Diagnosed with Breast Cancer (n=154) African American Uninsured Private Hispanic Age Insurance Race/Ethnicity

  36. Cervix

  37. Selected Demographic Characteristics of Participants (Cervix) # with Abnormal Finding (n=566) (n=909)

  38. Median T1 by Racial/Ethnic Group(Cervix)

  39. Percentage of Diagnosed Cancers(Cervix) % Cancers in Abnormals (n=909) (n=566)

  40. Demographic Characteristics of Navigated Participants Diagnosed with Cervix Cancer (n=66) African American Uninsured Hispanic Private Age Insurance Race/Ethnicity

  41. Barriers Analysis

  42. Significant Barriers and Time to Diagnostic Resolution (Breast) **Fitted Model significance, p<0.05 # Days to Diagnostic Resolution

  43. Impact of Navigation Delivery on Time to Diagnostic Resolution(Breast) # Barriers (n=731) (n=703) # Days to Diagnostic Resolution

  44. Impact on Diagnostic Resolution

  45. Select Research Projects Overviews

  46. Highlights

  47. Next Steps

  48. PNRP Program Staff Dr. Martha Hare Dr. Mary Ann Van Duyn Dr. Mollie Howerton Dr. Kenneth Chu Donald Corle, M.S. (DCP) http://crchd.cancer.gov

More Related