Racial and ethnic differences in patient navigation: Results from the Patient Navigation Research Program

Naomi Y. Ko, Frederick R. Snyder, Peter C. Raich, Electra D. Paskett, Donald J. Dudley, Ji Hyun Lee, Paul H. Levine, Karen M. Freund

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

BACKGROUND: Patient navigation was developed to address barriers to timely care and reduce cancer disparities. The current study explored navigation and racial and ethnic differences in time to the diagnostic resolution of a cancer screening abnormality. METHODS: The authors conducted an analysis of the multisite Patient Navigation Research Program. Participants with an abnormal cancer screening test were allocated to either navigation or control. The unadjusted median time to resolution was calculated for each racial and ethnic group by navigation and control. Multivariable Cox proportional hazards models were fit, adjusting for sex, age, cancer abnormality type, and health insurance and stratifying by center of care. RESULTS: Among a sample of 7514 participants, 29% were non-Hispanic white, 43% were Hispanic, and 28% were black. In the control group, black individuals were found to have a longer median time to diagnostic resolution (108 days) compared with non-Hispanic white individuals (65 days) or Hispanic individuals (68 days) (P<.0001). In the navigated groups, black individuals had a reduction in the median time to diagnostic resolution (97 days) (P<.0001). In the multivariable models, among controls, black race was found to be associated with an increased delay to diagnostic resolution (hazard ratio, 0.77; 95% confidence interval, 0.69-0.84) compared with non-Hispanic white individuals, which was reduced in the navigated arm (hazard ratio, 0.85; 95% confidence interval, 0.77-0.94). CONCLUSIONS: Patient navigation appears to have the greatest impact among black patients, who had the greatest delays in care. Cancer 2016.

Original languageEnglish (US)
Pages (from-to)2715-2722
Number of pages8
JournalCancer
Volume122
Issue number17
DOIs
StatePublished - Sep 1 2016

Keywords

  • cancer
  • disparities
  • patient navigation
  • race and ethnicity
  • screening

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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