Integrative patient navigation programs increase treatment compliance
NEW ORLEANS—An integrative cancer care navigation program can significantly improve treatment compliance and wellness practices in underserved populations, according to research presented at the Oncology Nursing Society 37th Annual Congress.
Patient navigation is a relatively young and minimally tested practice in which an individual—a patient navigator—provides assistance to patients at diagnosis and during treatment. Despite this service, demand has grown for improved psychosocial support and comprehensive care throughout the cancer journey.
At Integrative Patient Navigation Services, Smith Center for Healing and the Arts, Washington, DC, Laura Pole, MSN, and Carole O'Toole decided to expand the concept of patient navigation by offering an integrative program at their inner-city hospital, which provides care to many underserved African-Americans and African immigrants. They discovered that cancer was often not discussed, and that patients desired support services particularly in the areas of exercise and nutrition.
Pole and O'Toole developed an integrative navigation model that would facilitate healing on all levels, from diagnosis and recovery to recurrence and end-of-life. The model utilized medical intervention as well as psychosocial support and complementary modalities, placing emphasis on care for the whole patient. “We adopt the system to the patient as much as possible,” said Pole.
The program included Wellness Works/Healthy U, which included educated about how patients could adopt easy, affordable wellness practices as well as a 6-week series on nutrition, exercise, and other health-related topics. Approximately 220 residents attended the initiative.
In order to implement the program at a community level, they partnered with churches, community service providers, and local organizations to serve an estimated 12,000 underserved city residents who otherwise may not have been reached.
Initially, the hospital employed five navigators consisting of church leaders, African immigrants, and cancer survivors. The navigators offered support wherever their patients convened—at soccer games, at church, and even at the beauty shop.
Data collection and evaluation have indicated that the program has increased treatment completion rates by 15%. Surveys show that the programs are highly valued by church leaders and the community. Participants were also making significant, long-term improvements in wellness practices such as exercise, healthy eating, and stress management.
Pole attributed the program's success to four factors: 1) fostering community partnerships, 2) never underestimating the power of survivors, 3) investing in quality training of the navigators, and training them in integrative nutrition, and 4) developing an education and outreach program that was dynamic and consistent.
Based on the program's success, the institution now offers an innovative, nationwide navigation training program.
“Oncology nurse navigators and researchers are ideally suited to influence, define, and test integrative patient navigation services,” the researchers said.
The cancer navigators were able to significantly impact each person's cancer experience, allowing space for the love necessary for healing, Pole added during her presentation at the conference.