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Thursday, April 19, 2007

A National Patient Navigator Training Program

Elizabeth Calhoun, PhD, University of Illinois, Chicago, 1603 West Taylor Street, #789, Chicago, IL 60612, Elizabeth Whitley, PhD, RN, Community Voices, Denver Health, 777 Bannock St MC 7779, Denver, CO 80204, Angelina Esparza, RN, Health Promotions, American Cancer Society, 1599 Clifton Rd NE, Atlanta, GA 30329, Elizabeth Ness, MS, RN, Center for Cancer Research, National Cancer Institute, 9000 Rockville Pike, Bethesda, MD 20892, Patricia Valverde, MPH, University of Colorado at Denver Health Services Center, PO Box 6508, MS F 538, Aurora, CO 80045-0508, Amanda Greene, PhD, MPH, RN, NOVA Research, 4600 East-West Highway, Bethesda, MD 20814, and Roland Garcia, PhD, Center to Reduce Cancer Health Disparities, National Cancer Institute, 6118 Executive Blvd, Suite 602, Rockville, MD 20854.

Disparities in cancer survival rates have been associated with differences in socioeconomic status and race since 1989. Patient navigation has been promoted as a effective way to address health disparities, but limited research exists. Three major patient navigation programs (The National Cancer Institute's Patient Navigation Research Program (PNRP), The American Cancer Society Patient Navigation Program, and The Center for Medicare and Medicaid's Patient Navigation Demonstration Program) are underway to address the needs of cancer patients, each with a unique approach and design. An important aspect of the development of patient navigators for patients is the need to provide training and evaluate training outcomes. Many individual programs have created navigation training, but until this training there has been no national unified training curriculum.

The curriculum for the training was jointly created by PNRP and the ACS staff. A total of 196 participants were trained over a three day period. The efficacy of training was evaluated using a pre- and post-test. Paired t-test and p-values were used in the analysis.

The data shows a statistically significant improvement of post-test scores over pretest. Additionally, greater improvement was correlated with increased education and experience, and site.

These programs pave the way for future healthcare facilities to evaluate the efficacy and cost-effectiveness of integrating patient navigation as one way to address health disparities. An anticipated research outcome of the program is that barriers to diagnosis and treatment are removed to facilitate the patient experience throughout the cancer continuum. There are plans to provide continuing education.