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Evaluating a bilingual patient navigation program for uninsured women with abnormal screening tests for breast and
Melissa A Simon1, Laura S Tom, Narissa J Nonzee
1Melissa A. Simon is with the Departments of Obstetrics and Gynecology and Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, and the Robert H. Lurie Comprehensive Cancer Center, Chicago. Laura S. Tom and Narissa J. Nonzee are with the Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University. Kara R. Murphy and Richard Endress are with Access DuPage, Wheaton, IL. XinQi Dong is with the Institute for Healthy Aging, Rush University Medical Center, Chicago. Joe Feinglass is with the Departments of General Internal Medicine and Geriatrics and Preventive Medicine, Feinberg School of Medicine, Northwestern University.
Objectives:
The DuPage Patient Navigation Collaborative evaluated the Patient Navigation Research Program (PNRP) model for uninsured women receiving free breast or cervical cancer screening through the Illinois Breast and Cervical Cancer Program in DuPage County, Illinois.
Methods:
We used medical records review and patient surveys of 477 women to compare median follow-up times with external Illinois Breast and Cervical Cancer Program and Chicago PNRP benchmarks of performance. We examined the extent to which we mitigated community-defined timeliness risk factors for delayed follow-up, with a focus on Spanish-speaking participants.
Results:
Median follow-up time (29.0 days for breast and 56.5 days for cervical screening abnormalities) compared favorably to external benchmarks. Spanish-speaking patients had lower health literacy, lower patient activation, and more health care system distrust than did English-speaking patients, but despite the prevalence of timeliness risk factors, we observed no differences in likelihood of delayed (> 60 days) follow-up by language.
Conclusions:
Our successful replication and scaling of the PNRP navigation model to DuPage County illustrates a promising approach for future navigator research.
