Skip to main content

Advertisement

Log in

Keys to the Successful Implementation of Community-Based Outreach and Navigation: Lessons from a Breast Health Navigation Program

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

Abstract

The well-documented racial disparities in breast cancer mortality have prompted an aggressive response from the public health community, including the development and implementation of breast health education and breast cancer navigation programs. Many programs are successfully reaching women and providing education and motivation to get screened, and separately, many programs are successfully navigating women who have received abnormal results from a screening mammogram and need follow-up. However, a crucial gap in services remains, where women in the community are not receiving systematic navigation to their initial screening mammogram. This paper describes a community-based, community health worker-led breast health education and screening navigation program, details the metrics used to measure navigation outcomes, and discusses unique features of this project which could be adapted within other settings to initiate similar programming.

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

Access this article

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

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ansell D, Grabler P, Whitman S, Ferrans C, Burgess-Bishop J, Murray LR, Rao R, Marcus E (2009) A community effort to reduce the black/white breast cancer mortality disparity in Chicago. Cancer Causes Control 20(9):1681–1688. doi:10.1007/s10552-009-9419-7

    Article  PubMed  Google Scholar 

  2. 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(2 Suppl):359–367. doi:10.1002/cncr.22354

    Article  PubMed  Google Scholar 

  3. Cancer., Commission on. (2012). Cancer program standards 2012: ensuring patient centered care. Chicago, IL: American College of Surgeons

  4. Coronado, Gloria D., Ricardo Jimenez, Javiera Martinez-Gutierrez, Dale McLerran, India Ornelas, Donald Patrick, Robert Gutierrez, Sonia Bishop, and Shirley A. A. Beresford (2014) Multi-level intervention to increase participation in mammography screening: ¡Fortaleza Latina! study design. Contemporary Clinical Trials 38 (2):350-354. doi:http://dx.doi.org/10.1016/j.cct.2014.06.008

  5. Department of Health and Human Services. Centers for Disease Control and Prevention. Breast and Cervical Cancer Early Detection and Control Advisory Committee Meeting (2011): record of the proceedings. June 16-17

  6. Detailed Tables for the National Vital Statistics Report (NVSR) (2015) “Deaths: final data for 2013.” http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf. Accessed April 15

  7. Dignan MB, Burhansstipanov L, Hariton J, Harjo L, Rattler T, Lee R, Mason M (2005) A comparison of two Native American Navigator formats: face-to-face and telephone. Cancer Control 12(suppl 2):28–33

    PubMed  PubMed Central  Google Scholar 

  8. Ell K, Vourlekis B, Lee P-J, Xie B (2007) Patient navigation and case management following an abnormal mammogram: a randomized clinical trial. Prev Med 44(1):26–33

    Article  PubMed  Google Scholar 

  9. Fernandez ME, Gonzales A, Tortolero-Luna G, Williams J, Saavedra-Embesi M, Chan W, Vernon SW (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. doi:10.2105/ajph.2008.136713

    Article  PubMed  PubMed Central  Google Scholar 

  10. Ferrante JM, Chen PH, Kim S (2008) The effect of patient navigation on time to diagnosis, anxiety, and satisfaction in urban minority women with abnormal mammograms: a randomized controlled trial. J Urban Health 85(1):114–124. doi:10.1007/s11524-007-9228-9

    Article  PubMed  Google Scholar 

  11. Finkelstein, Sarah L. Taubman, L. Allen Heidi, J. Wright Bill, Baicker Katherine, and N. Amy (2014) Medicaid increases emergency-department use: evidence from Oregon’s Health Insurance Experiment. doi:10.1126/science.1246183

  12. Fouad MN, Nagy MC, Johnson RE, Wynn TA, Partridge EE, Dignan M (2004) The development of a community action plan to reduce breast and cervical cancer disparities between African-American and White women. Ethn Dis 14(3 Suppl 1):S53–60

    PubMed  Google Scholar 

  13. Fouad, M. N., E. Partridge, M. Dignan, C. Holt, R. Johnson, C. Nagy, S. Person, T. Wynn, and I. Scarinci (2010) Targeted intervention strategies to increase and maintain mammography utilization among African American women. Am J Public Health 100 (12):2526-2531. doi:100/12/2526 [pii]10.2105/AJPH.2009.167312

  14. Freeman HP (2006) Patient navigation: a community based strategy to reduce cancer disparities. J Urban Health 83(2):139–141. doi:10.1007/s11524-006-9030-0

    Article  PubMed  PubMed Central  Google Scholar 

  15. Freeman HP (2006) Patient navigation: a community centered approach to reducing cancer mortality. J Cancer Educ Off J Am Assoc Cancer Educ 21(1 Suppl):S11

    Article  Google Scholar 

  16. Gabram SG, Lund MJ, Gardner J, Hatchett N, Bumpers HL, Okoli J, Rizzo M, Johnson BJ, Kirkpatrick GB, Brawley OW (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(3):602–607. doi:10.1002/cncr.23568

    Article  PubMed  Google Scholar 

  17. Gutierrez Kapheim M, Campbell J (2014) Best practice guidelines for implementing and evaluating community health worker programs in health care settings Chicago. Sinai Urban Health Institute, IL

    Google Scholar 

  18. Hansen, L. K., P. Feigl, M. R. Modiano, J. A. Lopez, S. Escobedo Sluder, C. M. Moinpour, D. K. Pauler, and F. L. Meyskens (2005) An educational program to increase cervical and breast cancer screening in Hispanic women: a Southwest Oncology Group study. Cancer Nurs 28 (1):47-53. doi:00002820-200501000-00007

  19. Hunt BR, Allgood K, Sproles C, Whitman S (2013) Metrics for the systematic evaluation of community-based outreach. J Cancer Educ 28(4):633–638. doi:10.1007/s13187-013-0519-4

    Article  PubMed  Google Scholar 

  20. Hunt BR, Whitman S, Hurlbert MS (2014) Increasing Black:White disparities in breast cancer mortality in the 50 largest cities in the United States. Cancer Epidemiol 38(2):118–123. doi:10.1016/j.canep.2013.09.009

    Article  PubMed  Google Scholar 

  21. Kapheim, Melissa Gutierrez, Jessica Ramsay, Tala Schwindt, Bijou R. Hunt, and Helen Margellos-Anast (2015) Utilizing the Community Health Worker Model to communicate strategies for asthma self-management and self-advocacy among public housing residents. Journal of Communication in Healthcare 8 (2):95-105. doi:doi:10.1179/1753807615Y.0000000011

  22. Livaudais JC, Coronado GD, Espinoza N, Islas I, Ibarra G, Thompson B (2010) Educating Hispanic women about breast cancer prevention: evaluation of a home-based promotora-led intervention. J Womens Health (15409996) 19(11):2049–2056. doi:10.1089/jwh.2009.1733

    Article  Google Scholar 

  23. Margolis KL, Lurie N, McGovern PG, Tyrrell M, Slater JS (1998) Increasing breast and cervical cancer screening in low-income women. J Gen Intern Med 13(8):515–521

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Paskett E, Tatum C, Rushing J, Michielutte R, Bell R, Long Foley K, Bittoni M, Dickinson SL, McAlearney AS, Reeves K (2006) Randomized trial of an intervention to improve mammography utilization among a triracial rural population of women. J Natl Cancer Inst 98(17):1226–1237. doi:10.1093/jnci/djj333

    Article  PubMed  PubMed Central  Google Scholar 

  25. Richards, M. A., A. M. Westcombe, S. B. Love, P. Littlejohns, and A. J. Ramirez. (1999) Influence of delay on survival in patients with breast cancer: a systematic review. Lancet 353 (9159):1119-1126. doi:S0140673699021431

  26. Shah AM, Whitman S, Silva A (2006) Variations in the health conditions of 6 Chicago community areas: a case for local-level data. Am J Public Health 96(8):1485–1491. doi:10.2105/ajph.2004.052076

    Article  PubMed  PubMed Central  Google Scholar 

  27. Support for community health workers to increase health access and to reduce health inequities Washington (DC): American Public Health Association, 2009; Contract No.: Policy no. 20091

  28. Weber BE, Reilly BM (1997) Enhancing mammography use in the inner city. A randomized trial of intensive case management. Arch Intern Med 157(20):2345–2349

    Article  CAS  PubMed  Google Scholar 

  29. Wells KJ, Battaglia TA, Dudley DJ, Garcia R, Greene A, Calhoun E, Mandelblatt JS, Paskett ED, Raich PC (2008) Patient navigation: state of the art or is it science? Cancer 113(8):1999–2010. doi:10.1002/cncr.23815

    Article  PubMed  PubMed Central  Google Scholar 

  30. Wells KJ, Luque JS, Miladinovic B, Vargas N, Asvat Y, Roetzheim RG, Kumar A (2011) Do community health worker interventions improve rates of screening mammography in the United States? A systematic review. Cancer Epidemiol Biomarkers Prev 20(8):1580–1598. doi:10.1158/1055-9965.epi-11-0276

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

The program described herein was made possible by funding from the Avon Foundation for Women, Susan G. Komen Chicago, The Lynn Sage Cancer Research Foundation, and The Barbara Bates Foundation. The authors wish to acknowledge Dr. Steve Whitman, Ami Shah, and Dr. Chela Sproles for their contributions to the program and its management and development.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Bijou R. Hunt.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hunt, B.R., Allgood, K.L., Kanoon, J.M. et al. Keys to the Successful Implementation of Community-Based Outreach and Navigation: Lessons from a Breast Health Navigation Program. J Canc Educ 32, 175–182 (2017). https://doi.org/10.1007/s13187-015-0904-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13187-015-0904-2

Keywords

Navigation