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Abstract
American Indians (AIs) continue to have elevated cancer incidence and mortality, and most have issues accessing cancer screening services. During 2013-2014, Mayo and its partners created Native Cancer 101 Module 10 "Prevention and Early Cancer Detection" education workshop. A community-based AI organization implemented nine of these workshops during 2014-2015 via diverse venues. Nearly all participants eligible for at least one type of cancer screening participated in a workshop and consented to follow-up within 3 to 6 months to determine if screenings had been completed or scheduled. Native Cancer 101 Module 10 workshops were conducted with 150 community members of whom 6 had recently completed cancer screening (n = 144). The workshops had a 25.20% increase in knowledge, and 97.1% of subjects responded that they would recommend the workshop to their friends and family. Most (136 of 144) submitted a consent form to be contacted 3 to 6 months following the workshop. Patient navigators reached 86 (63.2%) of the consented participants in the follow-up calls after the workshop, and 63 (46.3%) self-reported that they had completed at least one cancer screening test for which they were eligible. The single implementation of the workshop influenced community participants' completion of cancer screening.
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Affiliation(s)
- Linda Burhansstipanov
- Native American Cancer Research Corporation (NACR), 3022 South Nova Road, Pine, CO, 80470-7830, USA.
| | - Lisa Harjo
- Native American Cancer Research Corporation (NACR), 3022 South Nova Road, Pine, CO, 80470-7830, USA
| | - Judith Salmon Kaur
- Native American Programs, Spirit of EAGLES, Mayo Clinic, 200 First Street, Rochester, MN, 55905, USA
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Abstract
Because of decreased access and dismal survival rates, strategies need to be developed to increase cancer awareness and facilitate cancer prevention, early detection, and screening activities within American Indian (AI) populations. The purpose of this study was to develop a locally tailored needs assessment to collect cancer prevention, control, and risk factor information and knowledge, attitude, and perceived behavior (hereafter referred to as "needs assessment") data from 500 community members living in 3 geographically diverse settings: the Southeastern USA, the Rocky Mountain region, and the Northern Plains. Needs assessment data helped identify local health priorities and create a pilot cancer prevention and early detection education intervention. There were two versions of common items of the instrument: short (~35 items) and long (55 items), and each partner added items that were recommended by their local AI Advisory Committee. Each partner collaborated with local AI organizations to identify and recruit participants at community venues. During the sessions, facilitators used Power Point® slides and ARS equipment and software to anonymously collect participants' responses. The partners collected needs assessment data from 677 community members over a 4-year period. Cancer education knowledge was low, barriers to accessing timely cancer screening and care services were excessive, tobacco use was excessive, and daily physical activity was insufficient for most participants. ARS was an effective way to collect needs assessment information. During discussions following the data collection, community members requested more cancer education opportunities, access to patient navigation services, and cultural competency training for healthcare providers.
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Affiliation(s)
- Linda Burhansstipanov
- Native American Cancer Research Corporation (NACR), 3022 South Nova Road, Pine, CO, 80470-7830, USA.
| | - Linda U Krebs
- Oncology Consultation, Education & Advocacy Network (OCEAN), 13323 W. Jewell Drive, Lakewood, CO, 80228-4221, USA
| | - Lisa Harjo
- Native American Cancer Research Corporation (NACR), 3022 South Nova Road, Pine, CO, 80470-7830, USA
| | | | - Judith Salmon Kaur
- Native American Programs, Spirit of EAGLES, Mayo Clinic, 200 First Street, Rochester, MN, 55905, USA
| | | | - Dewey Painter
- South East American Indian Council Inc. (SEAIC), 69 Copeland Street, Jacksonville, FL, 32204, USA
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Burhansstipanov L, Harjo L, Krebs LU, Marshall A, Lindstrom D. Cultural roles of native patient navigators for american Indian cancer patients. Front Oncol 2015; 5:79. [PMID: 25984483 PMCID: PMC4415406 DOI: 10.3389/fonc.2015.00079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 03/17/2015] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Lisa Harjo
- Native American Cancer Research Corporation , Pine, CO , USA
| | - Linda U Krebs
- Anschutz Medical Campus, College of Nursing, University of Colorado at Denver , Denver, CO , USA
| | - Audrey Marshall
- Native American Cancer Research Corporation , Pine, CO , USA
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Burhansstipanov L, Krebs LU, Harjo L, Watanabe-Galloway S, Pingatore N, Isham D, Duran FT, Denny L, Lindstrom D, Crawford K. Providing community education: lessons learned from Native Patient Navigators. J Cancer Educ 2014; 29:596-606. [PMID: 25087698 PMCID: PMC4158749 DOI: 10.1007/s13187-014-0690-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Native Navigators and the Cancer Continuum (NNACC) was a community-based participatory research study among five American Indian organizations. The intervention required lay Native Patient Navigators (NPNs) to implement and evaluate community education workshops in their local settings. Community education was a new role for the NPNs and resulted in many lessons learned. NPNs met quarterly from 2008 through 2013 and shared lessons learned with one another and with the administrative team. In July 2012, the NPNs prioritized lessons learned throughout the study that were specific to implementing the education intervention. These were shared to help other navigators who may be including community education within their scope of work. The NPNs identified eight lessons learned that can be divided into three categories: NPN education and training, workshop content and presentation, and workshop logistics and problem-solving. A ninth overarching lesson for the entire NNACC study identified meeting community needs as an avenue for success. This project was successful due to the diligence of the NPNs in understanding their communities' needs and striving to meet them through education workshops. Nine lessons were identified by the NPNs who provided community education through the NNACC project. Most are relevant to all patient navigators, regardless of patient population, who are incorporating public education into navigation services. Due to their intervention and budget implications, many of these lessons also are relevant to those who are developing navigation research.
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Affiliation(s)
- Linda Burhansstipanov
- Native American Cancer Research Corporation (NACR), 3022 South Nova Road, Pine, CO 80470, USA
| | - Linda U. Krebs
- College of Nursing, University of Colorado, Anschutz Medical Campus, ED2N Room 4209, 13120 East 19th Avenue, Box C288, Aurora, CO 80045, USA
| | - Lisa Harjo
- Native American Cancer Research Corporation (NACR), 3110 South Wadsworth Blvd., Suite 103, Denver, CO 80227, USA
| | - Shinobu Watanabe-Galloway
- Epidemiology Department, College of Public Health, University of Nebraska Medical Center (UNMC), 984395 Nebraska Medical Center, Omaha, NE 68198-4395, USA
| | - Noel Pingatore
- Inter-Tribal Council of Michigan, Inc., 2956 Ashmun Street, Sault Ste. Marie, MI 49783, USA
| | - Debra Isham
- Oklahoma City Area, 701 Market Drive, Oklahoma City, OK 73114, USA
| | - Florence Tinka Duran
- Great Plains Tribal Chairmen's Health Board, Northern Plains Tribal Epidemiology Center, 1770 Rand Road, Rapid City, SD 57702, USA
| | | | - Denise Lindstrom
- Native American Cancer Research Corporation (NACR), 3110 South Wadsworth Blvd., Suite 103, Denver, CO 80227, USA
| | - Kim Crawford
- John T. Vucurevich Regional Cancer Care Institute, 353 Fairmont Boulevard, Rapid City, SD 57701, USA
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Braun KL, Kagawa-Singer M, Holden AEC, Burhansstipanov L, Tran JH, Seals BF, Corbie-Smith G, Tsark JU, Harjo L, Foo MA, Ramirez AG. Cancer patient navigator tasks across the cancer care continuum. J Health Care Poor Underserved 2012; 23:398-413. [PMID: 22423178 DOI: 10.1353/hpu.2012.0029] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cancer patient navigation (PN) programs have been shown to increase access to and utilization of cancer care for poor and underserved individuals. Despite mounting evidence of its value, cancer patient navigation is not universally understood or provided. We describe five PN programs and the range of tasks their navigators provide across the cancer care continuum (education and outreach, screening, diagnosis and staging, treatment, survivorship, and end-of-life). Tasks are organized by their potential to make cancer services understandable, available, accessible, affordable, appropriate, and accountable. Although navigators perform similar tasks across the five programs, their specific approaches reflect differences in community culture, context, program setting, and funding. Task lists can inform the development of programs, job descriptions, training, and evaluation. They also may be useful in the move to certify navigators and establish mechanisms for reimbursement for navigation services.
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Affiliation(s)
- Kathryn L Braun
- Public Health, University of Hawai‘i, Honolulu, HI 96813, USA.
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Dignan MB, Burhansstipanov L, Hariton J, Harjo L, Rattler T, Lee R, Mason M. A comparison of two Native American Navigator formats: face-to-face and telephone. Cancer Control 2006; 12 Suppl 2:28-33. [PMID: 16327748 PMCID: PMC3544403 DOI: 10.1177/1073274805012004s05] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The study was designed to test the relative effectiveness of a Navigator intervention delivered face-to-face or by telephone to urban Native American women. The effectiveness of the intervention was evaluated using a design that included a pretest, random assignment to face-to-face or telephone group, and posttest. The Social Cognitive Theory-based intervention was a tailored education program developed to address individual risk factors for breast cancer. At posttest, self-reported mammograms in the past year increased from 29% to 41.3% in the telephone group and from 34.4% to 45.2% in the face-to-face group. There was no difference in change from pretest to posttest between the telephone and face-to-face groups. Navigators can be effective in increasing adherence to recommendations for screening mammography among urban American Indian women.
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Affiliation(s)
- Mark B Dignan
- University of Kentucky Prevention Research Center, Lexington, KY 40504-3381, USA.
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Burhansstipanov L, Wound DB, Capelouto N, Goldfarb F, Harjo L, Hatathlie L, Vigil G, White M. Culturally relevant "Navigator" patient support. The Native sisters. Cancer Pract 1998; 6:191-4. [PMID: 9652252 DOI: 10.1046/j.1523-5394.1998.006003191.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- L Burhansstipanov
- Native American Cancer Research, Native American Cancer Research, Pine, Colorado, USA
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