TY - JOUR
T1 - Navigating veterans with an abnormal prostate cancer screening test
T2 - A quasi-experimental study
AU - Simon, Melissa A.
AU - Nonzee, Narissa J.
AU - McKoy, June M.
AU - Liu, Dachao
AU - Luu, Thanh Ha
AU - Byer, Peter
AU - Eklund, Elizabeth A.
AU - Richey, Elizabeth A.
AU - Wu, Zhigang
AU - Dong, Xinqi
AU - Rademaker, Alfred W.
N1 - Funding Information:
We thank the Chicago VA nurses, physicians, staff, and especially our Veteran participants. The guidance from Drs. Steven Rosen and Charles Bennett, efforts from our patient navigators and community advisory board, and data management by Samie Martinez are also gratefully acknowledged. This work was supported by National Institutes of Health (NIH)/National Cancer Institute (NCI) U01 CA116875 (Rosen), Veterans Affairs Research and Development, NIH/National Institute of Child Health & Human Development K12 HD050121 (Bulun), NIH/NCI K01 CA134554 (McKoy), and NIH/NCI P30 CA060553 (Rosen).
PY - 2013
Y1 - 2013
N2 - Background: Prostate cancer disproportionately affects low-income and minority men. This study evaluates the impact of a patient navigation intervention on timeliness of diagnostic resolution and treatment initiation among veterans with an abnormal prostate cancer screen. Methods. Participants were enrolled between 2006 and 2010. The intervention involved a social worker and lay health worker navigation team that assisted patients in overcoming barriers to care. For navigated (n = 245) versus control (n = 245) participants, we evaluated rates of diagnostic resolution and treatment and adjusted for race, age, and Gleason score. Results: Of 490 participants, 68% were African American, 47% were ≥ 65 years old, and 35% had cancer. Among those with an abnormal screen, navigation did not have a significant effect on time to diagnostic resolution compared to controls (median days of 97 versus 111; adj. HR 1.17, 95% CI, 0.96-1.43, p = 0.12). On analysis of the period beyond 80 days, navigated men reached resolution faster than controls (median of 151 days versus 190 days; adj. HR 1.41, 95% CI, 1.07-1.86, p = 0.01). Among those with cancer, navigation did not have a significant effect on time to treatment initiation compared to controls (median of 93 days versus 87 days; adj. HR 1.15, 95% CI, 0.82-1.62, p = 0.41). Conclusion: Our navigation program did not significantly impact the overall time to resolution or treatment for men with prostate cancer compared to controls. The utility of navigation programs may extend beyond targeted navigation times, however, and future studies focusing on other outcomes measures are therefore needed.
AB - Background: Prostate cancer disproportionately affects low-income and minority men. This study evaluates the impact of a patient navigation intervention on timeliness of diagnostic resolution and treatment initiation among veterans with an abnormal prostate cancer screen. Methods. Participants were enrolled between 2006 and 2010. The intervention involved a social worker and lay health worker navigation team that assisted patients in overcoming barriers to care. For navigated (n = 245) versus control (n = 245) participants, we evaluated rates of diagnostic resolution and treatment and adjusted for race, age, and Gleason score. Results: Of 490 participants, 68% were African American, 47% were ≥ 65 years old, and 35% had cancer. Among those with an abnormal screen, navigation did not have a significant effect on time to diagnostic resolution compared to controls (median days of 97 versus 111; adj. HR 1.17, 95% CI, 0.96-1.43, p = 0.12). On analysis of the period beyond 80 days, navigated men reached resolution faster than controls (median of 151 days versus 190 days; adj. HR 1.41, 95% CI, 1.07-1.86, p = 0.01). Among those with cancer, navigation did not have a significant effect on time to treatment initiation compared to controls (median of 93 days versus 87 days; adj. HR 1.15, 95% CI, 0.82-1.62, p = 0.41). Conclusion: Our navigation program did not significantly impact the overall time to resolution or treatment for men with prostate cancer compared to controls. The utility of navigation programs may extend beyond targeted navigation times, however, and future studies focusing on other outcomes measures are therefore needed.
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U2 - 10.1186/1472-6963-13-314
DO - 10.1186/1472-6963-13-314
M3 - Article
C2 - 23947435
AN - SCOPUS:84881453231
SN - 1472-6963
VL - 13
JO - BMC health services research
JF - BMC health services research
IS - 1
M1 - 314
ER -
