The Implementation Guide is a resource for implementing this program. It provides important information about the staffing and functions necessary for administering this program in the user's setting. Additionally, the steps needed to carry out the research-tested program, relevant program materials, and information for evaluating the program are included. The Implementation Guide can be viewed and downloaded in the Products page.
Kukui Ahi (Light the Way): Patient Navigation
|Program Title||Kukui Ahi (Light the Way): Patient Navigation|
|Purpose||Designed to promote cancer screening among adults. (2015)|
|Program Focus||Awareness building and Behavior Modification|
|Topic||Breast Cancer Screening, Cervical Cancer Screening, Colorectal Cancer Screening|
|Age||This information has not been reported.|
|Gender||This information has not been reported.|
|Race/Ethnicity||This information has not been reported.|
|Setting||This information has not been reported.|
|Funded by||NCI (Grant number(s): U54-CA153459), CMS (Grant number(s): Contract 500-00-0024)|
|User Reviews||(Be the first to write a review for this program)|
Racial and ethnic disparities exist in use of cancer screening. For example, Asian Americans are less likely than non-Hispanic Whites to undergo timely cervical and colorectal screening, and Native Hawaiians are less likely than non-Hispanic Whites to get a mammogram. Interventions designed to increase cancer screening among racial minorities and specifically Asian and Pacific Islanders are needed.
Patient navigators receive a 48-hour evidence-based training and subsequently participate in quarterly training to further improve their skills. Over a 6-day period, navigators learn about Health Insurance Portability and Accountability Act regulations, how to probe using open-ended questions, how to maintain patient records, how to access web resources on cancer, and other skills related to working with patients. Under the supervision of health care providers, navigators support Medicare recipients by educating them about cancer screening; reminding them by phone and mail to schedule screenings; scheduling appointments and providing transportation; and helping them complete paperwork, talk with doctors and staff, and find ways to pay for care.
-- 48 hours for navigator training (plus quarterly continuing education sessions)
-- Approximately 2 hours for navigators to support each patient
-- Training Agendas for Days 1‒6
-- Sample Facility Tour Itinerary
-- Facility Tour Worksheet
-- Addressing Barriers Worksheet
-- Role Play Observation Checklist
-- Navigator Training Certificate
-- Navigation Training Evaluation
-- Intake Form
-- Appointment Reminder Card
-- Sample Database for Patient Tracking
For costs associated with this program, please contact the developers, Kathryn L. Braun and JoAnn U. Tsark. (See products page on the RTIPs website for developer contact information.)
Patient navigators helped those in the experimental group complete colorectal, cervical, breast, and prostate cancer screening available through Medicares preventative medicine coverage. The majority of the participants were at least 65 (50% were 65‒75, and 23% were older), and slightly more than half were female (53%). The ethnicities of participants were as follows: 45% Hawaiian, 35% Filipino, 11% Japanese, 8% other, and 1% Chinese. More than a third of participants (37%) had less than a high school education, 31% were high school graduates, and 32% had some college or training after high school. The two study groups did not differ significantly on any of the demographic variables.
The primary outcomes were completion of FOBT within the past 12 months, flexible sigmoidoscopy or colonoscopy within the past 5 years, Pap test within the past 24 months, mammogram within the past 12 months, and PSA test within the past 12 months. Screening rates were assessed through self-report survey data. The study groups did not differ significantly on baseline rates of FOBT, endoscopy, Pap test, mammogram, or PSA test.
- At exit, the percentage of participants who received an FOBT within the past 12 months was higher in the experimental group than the control group (20.7% vs. 12.6%; p=.02).
- At exit, the percentage of participants who received flexible sigmoidoscopy or colonoscopy within the past 5 years was higher in the experimental group than the control group (43.0% vs. 27.2%; p<.001).
- At exit, the percentage of female participants who received a Pap test within the past 24 months was higher in the experimental group than the control group (57.0% vs. 36.4%; p=.001).
- At exit, the percentage of female participants who received a mammogram within the past 12 months was higher in the experimental group than the control group (61.7% vs. 42.4%; p=.003).
- At exit, the percentage of male participants who received a prostate-specific antigen test within the past 12 months was higher in the experimental group than the control group (54.4% vs. 36.0%; p=.008).
Braun KL, Thomas WL Jr, Domingo JL, Allison AL, Ponce A, Haunani Kamakana P, Brazzel SS, Emmett Aluli N, Tsark JU. (2015). Reducing cancer screening disparities in medicare beneficiaries through cancer patient navigation. Journal of the American Geriatrics Society, 63 , 365-370.
Braun KL, Kagawa Singer M, Holden AR, Burhansstipanov L, Tran JH, Seals B, Corbie-Smith G, Tsark JU, Harjo L, Foo MA, Ramirez A. (2012). Lay navigator tasks across the cancer care continuum. Journal of Health Care for the Poor and Underserved, 23 , 398-413.
Domingo JB, Davis EL, Allison AL, Braun KL. (2011). Cancer patient navigation case studies in Hawai'i: the complimentary role of clinical and community navigators. Hawaii Medical Journal, 70 , 257-261.
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