Understanding the Processes of Patient Navigation

Authors: Pascal JeanPierre Samantha Hendren Kevin Fiscella Starlene Loader Sally Rousseau Bonnie Schwartzbauer Mechelle Sanders Jennifer Carroll Ronald Epstein

Publish Date: 2010/04/21

Volume: 26, Issue: 1, Pages: 111-120

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Abstract

Patient navigation PN programs are being widely implemented to reduce disparities in cancer care for racial/ethnic minorities and the poor However few systematic studies cogently describe the processes of PN We qualitatively analyzed 21 transcripts of semistructured exit interviews with three navigators about their experiences with patients who completed a randomized trial of PN We iteratively discussed codes/categories reflective remarks and ways to focus/organize data and developed rules for summarizing data We followed a threestage analysis model reduction display and conclusion drawing/verification We used ATLASti 52 for text segmentation coding and retrieval Four categories of factors affecting cancer care outcomes emerged patients navigators navigation processes and external factors These categories formed a preliminary conceptual framework describing ways in which PN processes influenced outcomes Relationships between processes and outcomes were influenced by patient navigator and external factors The process of PN has at its core relationshipbuilding and instrumental assistance An enhanced understanding of the process of PN derived from our analyses will facilitate improvement in navigators’ training and rational design of new PN programs to reduce disparities in cancerrelated care

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