Reducing time-to-treatment in underserved Latinas with breast cancer: the Six Cities Study.
BACKGROUND
The interaction of clinical and patient-level challenges following a breast cancer diagnosis can be a significant source of health care disparities. Failure to address specific cultural features that create or exacerbate barriers can lead to less-than optimal navigation results, specifically in Hispanic/Latino women.


METHODS
To address these disparities, the study leaders in San Antonio, Texas, and 5 other regional partners of the federally-funded Redes En Acción: The National Latino Cancer Research Network developed a culturally-tailored patient navigation intervention model for Latinas with breast cancer.


RESULTS
Compared with control patients, a higher percentage of navigated subjects initiated treatment within 30 days (69.0% versus 46.3%, P = .029) and 60 days (97.6% versus 73.1%, P = .001) following their cancer diagnosis. Time from cancer diagnosis to first treatment was lower in the navigated group (mean, 22.22 days; median, 23.00 days) than controls (mean, 48.30 days; median, 33.00 days). These results were independent of cancer stage at diagnosis and numerous characteristics of cancer clinics and individual participants.


CONCLUSIONS
Successful application of patient navigation increased the percentage of Latinas initiating breast cancer treatment within 30 and 60 days of diagnosis. This was achieved through navigator provision of services such as accompaniment to appointments, transportation arrangements, patient telephone support, patient-family telephone support, Spanish-English language translation, and assistance with insurance paperwork.
University of Texas, Health Science Center at San Antonio, Epidemiology and Biostatistics, Institute for Health Promotion Research, San Antonio, Texas.
Amelie
A
Ramirez
Eliseo
E
Perez-Stable
Frank
F
Penedo
Gregory
G
Talavera
J Emilio
JE
Carrillo
María
M
Fernández
Alan
A
Holden
Edgar
E
Munoz
Sandra
S
San Miguel
Kipling
K
Gallion
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000473:pathology / Q000628:therapy*; D003144:Communication Barriers; D003466:Cultural Characteristics; D005260:Female; D054625:Healthcare Disparities / Q000639:trends; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health; D007802:Language; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D062526:Patient Navigation; D012944:Social Support; D013997:Time Factors; D061665:Time-to-Treatment; D014177:Translations; D014481:United States / Q000453:epidemiology; D035862:Vulnerable Populations / Q000208:ethnology / Q000706:statistics & numerical data
Latinas; breast cancer; culture; patient navigation; time-to-treatment