Catalyzing Navigation for Breast Cancer Survivorship (CaNBCS) in Safety-Net Settings: A Mixed Methods Study

Area of Science:

• Oncology
• Public Health
• Health Services Research

Background:

• The number of breast cancer survivors (BCS) is growing, necessitating effective survivorship care plans (SCPs).
• Uncertainty exists regarding SCP benefits, particularly for low-income and minority BCS.
• Patient navigation is a promising intervention for improving adherence and experiences in cancer care.

Purpose of the Study:

• To investigate the role of lay patient navigators (LPNs) in survivorship care planning for BCS within safety-net settings.
• To assess the impact of LPNs on health-related quality of life (HRQOL) and self-efficacy in BCS.
• To explore implementation barriers and facilitators of LPN-supported SCPs.

Main Methods:

• A mixed-methods pilot randomized clinical trial was conducted in a public hospital.
• Breast cancer survivors (BCS) within 5 years of completing treatment were randomized to usual care or LPN navigation.
• LPNs provided 6-month support, including discussing SCPs and accompanying patients to primary care appointments. Qualitative interviews and focus groups assessed implementation.

Main Results:

• Forty BCS were enrolled; 20 received usual care, and 20 received LPN navigation.
• No statistically significant differences in HRQOL or self-efficacy were observed between the LPN navigation and usual care groups.
• Qualitative data revealed implementation barriers that may have limited the intervention's effectiveness.

Conclusions:

• Future SCP interventions should prioritize survivor needs and preferences.
• Dedicated resources are crucial for successful implementation of survivorship care.
• The integration of electronic health records should be considered for effective SCP delivery.