Patient Navigators for the Cancer Care Continuum
The purpose of this American Recovery and Reinvestment Act (ARRA) project was to build on community partnerships to advance the elimination of breast cancer disparities in the St. Louis region. This project draws upon PECaD’s ongoing, collaborative relationship with the Betty Jean Kerr People’s Health Centers (PHC), a local federally qualified health center and member of the St. Louis Integrated Health Network (IHN). The IHN was formed based upon a recommendation of the St. Louis Regional Health Commission that existing health care providers in the St. Louis region form a permanent regional network to integrate and coordinate services to better serve citizens.
PECaD's Breast Cancer Community Partnership and Disparities Elimination Advisory Committee identified gaps in cancer screening and treatment in local underserved communities. Prior to the collaboration between PHC and PECaD on this project, PHC had capacity to conduct mammograms at only one of its three locations. However, they had secured a second mammography unit from another institution that was to be placed at their second-largest and fastest-growing location (north St. Louis site). Despite the need for these services, PHC did not have the resources to start providing mammography services in north St. Louis.
To address this potential gap in services, PHC and PECaD worked together to obtain ARRA funds and implement a patient navigation program in an area of high need within the St. Louis safety net. Funds were awarded for the patient navigation project on Sept. 30, 2009, and the project was able to initiate mammography and navigation services at PHC's north St. Louis location on Oct. 1, 2009. The ARRA project provided funding to hire a patient navigator, a mammogram technologist and a data coordination assistant. The new patient navigator focused specifically on boosting the use of breast cancer screening and timely diagnosis and treatment for the north county site. These positions have been sustained by PHC after ARRA funding ended.
During the project's two years, mammograms overall increased at PHC, including the north St. Louis location. At the north St. Louis location, of women that were identified by the patient navigator as being eligible and overdue for a mammogram (using American Cancer Society guidelines), 94.8 percent received navigation services. Of those who were navigated, 94.5 percent got a mammogram during the study period.
The results of this study were presented at several academic meetings and community events, including the American Association of Cancer Research’s Conference on the Science of Cancer Disparities in 2010; the Missouri Cancer Summit in 2011; and a breast health retreat sponsored by the Siteman Cancer Center.
National Cancer Institute at the National Institutes of Health (U01 CA114594-05S2 and U54 CA153460)
Graham Colditz, MD, DrPH (Primary Investigator, Washington University)
Bettina Drake, MPH (Co-Investigator, Washington University)
Victoria Anwuri, MPH (Project Manager, Washington University)
Jennifer Tappenden, RHIA (Data Manager, Washington University)
Lawrence Pruitt (Program Coordinator, Betty Jean Kerr People’s Health Centers)
Shivon Tannan (Program Coordinator, Betty Jean Kerr People’s Health Centers)
Graham Colditz, MD, DrPH