UK Research Identifies How Patient Navigators Improve Cervical Cancer Prevention Care
LEXINGTON, Ky. (Jan. 29, 2013) — University of Kentucky College of Communication and Information faculty members Elisia L. Cohen, associate professor, and Allison M. Scott, assistant professor, collaborated with Carol R. White, assistant research professor, and Mark B. Dignan, professor in the UK College of Medicine, to explore opportunities for improving patient adherence to follow-up cervical cancer care through the use of patient navigators.
Their research study, which evaluated the report of patients' needs after abnormal Pap test results and patient navigators' communication effectiveness, was featured in the January special issue of the Journal of Communication.
The project was funded by a grant from the National Cancer Institute (NCI). Cervical cancer, a disease that is both preventable and treatable, remains a national public health concern particularly for women in medically underserved communities. Despite available screening with the Pap test, women from Appalachian Kentucky are more likely to die from cervical cancer than women residing elsewhere in the United States.
“In dealing with disparate communities, it is important to recognize that we are dealing with a lot of blind alleys,” Dignan said. “We’re not just dealing with the obvious barriers that are instrumental in providing health services, such as transportation and financial assistance. Appalachian women are faced with other issues that can only be overcome by understanding their culture and community norms.”
Among these barriers is the general uncertainty patients feel about abnormal Pap test results and the availability of follow-up care. It is common for women with a previous history of abnormal Pap tests to assume that the abnormality will resolve itself and dismiss the need for follow-up care, allowing an untreated, low-grade abnormality to develop into invasive cervical cancer.
In partnership with rural Health Departments in eastern Kentucky, the researchers were able to identify and train individuals who could provide local knowledge, personal advocacy, and a lay perspective on health services and cervical cancer knowledge. These “navigators” have effectively reduced disparities in many populations by helping patients understand and make informed decisions about obtaining follow-up care.
According to Dignan, “The value of hiring in a local area is that residents know how people think and feel about these sensitive issues. We can train them to deliver the correct information about cervical cancer, and then they can do so in a culturally acceptable manner that comforts and reassures the patient.”
Not surprisingly, the research team found that the local patient navigators successfully helped provide support to women in managing their uncertainties related to their health. By reframing patients’ views of the screening results, the women were more likely to return for follow-up care. Without the instrumental support and local knowledge of the lay patient navigators, Appalachian women may not have been empowered to receive appropriate follow-up care.
“These findings show that beyond help with the financial and logistical aspects of receiving care, navigators provide a vital role in improving patient understanding of clinical communication,” explained Cohen. “Ultimately this could improve patient outcomes, leading to more timely, effective coordinated care and overall reduced health care costs."
By assisting with information management, emotional validation, and social support, patient navigation programs can encourage women to receive appropriate follow-up care. The researchers hope that by developing long-term partnerships between patient navigators and Health Department nurses, cervical cancer rates could potentially drop in medically underserved populations.
“It’s exciting to be at the interface of health care and what the patients actually take away,” Dignan said. “I’m interested in developing health education as a way for people to take better care of themselves.”
These findings highlight the recent success of a cervical cancer intervention in a medically underserved population. The researchers hope to help raise awareness throughout the month of January, National Cervical Cancer Awareness Month. To learn more about what you can do, please visit the Cervical Cancer-Free America website at www.cervicalcancerfreeamerica.org.