title: Establishing a patient navigator program to reduce cancer disparities in the American Indian communities of Western South Dakota: initial observations and results.
abstract: BACKGROUND
  American Indians (AIs) in the Northern Plains region suffer disproportionately high cancer mortality rates compared with the general US population and with AIs from other regions in the United States.
  
  
  METHODS
  The National Cancer Institute developed the Cancer Disparity Research Partnership to address these inequities. This initiative in Rapid City, South Dakota, attempts to lower cancer mortality rates for AIs by access to innovative clinical trials, behavioral research, and a genetic study. Patient navigation is a critical part of the program. Two navigation strategies are described: navigators at the cancer center and navigators on each reservation. A retrospective analysis was performed to determine if navigated patients (n = 42) undergoing potentially curative radiotherapy had fewer treatment interruptions compared with nonnavigated patients (n = 74).
  
  
  RESULTS
  A total of 213 AIs with cancer have undergone patient navigation. For those undergoing cancer treatment, the median number of patient navigation interactions was 15 (range 1 to 95), whereas for those seen in follow-up after their cancer treatment, the median number of contacts was 4 (range 1 to 26). AIs who received navigation services during curative radiation treatment had on average 3 fewer days of treatment interruptions compared to AIs who did not receive navigation services during curative radiation treatment (P = .002, N = 116).
  
  
  CONCLUSIONS
  Early findings suggest that patient navigation is a critical component in addressing cancer disparities in this population. The program has established trust with individual cancer patients, with the tribal councils, and with the general population on each of the three reservations of western South Dakota.
authors.affiliation: Department of Radiation Oncology, John T. Vucurevich Regional Cancer Care Institute, Rapid City Regional Hospital, 353 Fairmont Boulevard, Rapid City, SD 57701, USA. dpetereit@rcrh.org
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Petereit
authors.forename: Kevin
authors.initials: K
authors.lastname: Molloy
authors.forename: Mary L
authors.initials: ML
authors.lastname: Reiner
authors.forename: Petra
authors.initials: P
authors.lastname: Helbig
authors.forename: Kristin
authors.initials: K
authors.lastname: Cina
authors.forename: Raylene
authors.initials: R
authors.lastname: Miner
authors.forename: Caroline
authors.initials: C
authors.lastname: Spotted Tail
authors.forename: Catherine
authors.initials: C
authors.lastname: Rost
authors.forename: Patricia
authors.initials: P
authors.lastname: Conroy
authors.forename: Chester R
authors.initials: CR
authors.lastname: Roberts
mesh_terms: D006297:Health Services Accessibility; D006801:Humans; D007198:Indians, North American; D009017:Morbidity / Q000639:trends; D009369:Neoplasms / Q000208:ethnology*; D016730:Program Development; D013023:South Dakota / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends