Culturally Appropriate Cancer Patient Navigator Pilot Program Helps American Indians/Alaska Natives Secure Diagnoses, Care

American Indians/Alaska Natives face numerous cultural, socioeconomic, and institutional barriers to cancer diagnosis and care.
American Indians/Alaska Natives face numerous cultural, socioeconomic, and institutional barriers to cancer diagnosis and care.

Cultural navigators can help American Indians/Alaska Natives circumvent barriers to cancer diagnosis and care, according to a study performed in Idaho and Oregon.1 Patients assigned a navigator after abnormal cancer screening results were 3.6 times as likely as others to have received a definitive diagnosis within a year, the study authors reported.

Forty American Indians/Alaska Natives with cancer were surveyed using an in-depth, culturally sensitive questionnaire developed with tribal community members.

American Indians/Alaska Natives face numerous cultural, socioeconomic, logistical, and institutional barriers to timely cancer diagnosis and care, not least of these being reliable transportation and distance from hospitals and cancer centers for residents of remote reservations. Another barrier to care is the often-slow and potentially bewilderingly complex system of tribal clinic care and referrals to specialists in the US Indian Health Service system of clinics and hospitals. And in some Native cultures, discussion of illness, and cancer in particular, is traditionally avoided or taboo.

One result of such barriers to care has been a disparity in 5-year cancer survivorship among Natives compared with other US populations, despite comparable incidence rates for most cancers.

Patients reported "physical, emotional, financial, and transportation barriers to care, but most did not feel there were any cultural barriers to receiving care," the authors reported. Navigators helped patients with referrals, transportation, appointment scheduling, communication, and decisionmaking.

"Satisfaction with the program was high" among the patients, who expressed appreciation for the program's respect for their culture. The questionnaire could be adapted for use in other populations, the authors noted.

References

1. Grimes C, Dankovchik J, Cahn M, Warren-Mears V. American Indian and Alaska Native cancer patients' perceptions of a culturally specific patient navigator program [published online November 12, 2016]. J Primary Prev. doi: 10.1007/s10935-016-0458-z.

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