title: Lay navigator model for impacting cancer health disparities.
abstract: This paper recounts experiences, challenges, and lessons learned when implementing a lay patient navigator program to improve cancer care among medically underserved patients who presented in a primary care clinic with a breast or colorectal cancer abnormality. The program employed five lay navigators to navigate 588 patients. Central programmatic elements were the following: (1) use of bilingual lay navigators with familiarity of communities they served; (2) provision of training, education, and supportive activities; (3) multidisciplinary clinical oversight that factored in caseload intensity; and (4) well-developed partnerships with community clinics and social service entities. Deconstruction of healthcare system information was fundamental to navigation processes. We conclude that a lay model of navigation is well suited to assist patients through complex healthcare systems; however, a stepped care model that includes both lay and professional navigation may be optimal to help patients across the entire continuum.
authors.affiliation: Division of Population Science, Moffitt Cancer Center, 12902 Magnolia Drive, Fow-Edu, Tampa, FL, 33612, USA, cathy.meade@moffitt.org.
authors.forename: Cathy D
authors.initials: CD
authors.lastname: Meade
authors.forename: Kristen J
authors.initials: KJ
authors.lastname: Wells
authors.forename: Mariana
authors.initials: M
authors.lastname: Arevalo
authors.forename: Ercilia R
authors.initials: ER
authors.lastname: Calcano
authors.forename: Marlene
authors.initials: M
authors.lastname: Rivera
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Sarmiento
authors.forename: Harold P
authors.initials: HP
authors.lastname: Freeman
authors.forename: Richard G
authors.initials: RG
authors.lastname: Roetzheim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000208:ethnology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017145:Models, Educational; D009369:Neoplasms / Q000208:ethnology* / Q000628:therapy*; D010344:Patient Advocacy; D062526:Patient Navigation; D055815:Young Adult