title: Impact of patient navigation on cancer diagnostic resolution among Northwest Tribal communities.
abstract: The patient navigator model has not been widely implemented in American Indian/Alaska Native (AI/AN) communities, but may be effective in improving cancer outcomes for this population. Subjects were enrolled from eight clinics at Tribes throughout the Northwest (n = 1,187). Four clinics received navigation. Time between abnormal finding and definitive diagnosis was recorded. We examined whether odds of obtaining definitive diagnosis by 60, 90, and 365 days differed between the two groups. The odds of definitive diagnosis within 365 days for navigated subjects was 3.6 times (95 % CI, 1.47, 8.88; p = 0.01) the odds for control subjects. The outcome at 60 and 90 days did not significantly differ between the two groups. Our findings indicate that patient navigation did not significantly impact chance of diagnosis by 60 or 90 days from abnormal finding. However, it did improve the chance of avoiding extreme delays in obtaining a definitive diagnosis.
authors.affiliation: Northwest Tribal Epidemiology Center, Northwest Portland Area Indian Health Board, Portland, OR 97201, USA. vwarrenmears@npaihb.org
authors.forename: Victoria
authors.initials: V
authors.lastname: Warren-Mears
authors.forename: Jenine
authors.initials: J
authors.lastname: Dankovchik
authors.forename: Meena
authors.initials: M
authors.lastname: Patil
authors.forename: Rongwei
authors.initials: R
authors.lastname: Fu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D054525:Minority Health / Q000706:statistics & numerical data*; D009369:Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000517:prevention & control; D062526:Patient Navigation; D013997:Time Factors; D055815:Young Adult