title: Racial and ethnic differences in patient navigation: Results from the Patient Navigation Research Program.
abstract: Patient navigation was developed to address barriers to timely care and reduce cancer disparities. The current study explored navigation and racial and ethnic differences in time to the diagnostic resolution of a cancer screening abnormality.
  
  
  
  The authors conducted an analysis of the multisite Patient Navigation Research Program. Participants with an abnormal cancer screening test were allocated to either navigation or control. The unadjusted median time to resolution was calculated for each racial and ethnic group by navigation and control. Multivariable Cox proportional hazards models were fit, adjusting for sex, age, cancer abnormality type, and health insurance and stratifying by center of care.
  
  
  
  Among a sample of 7514 participants, 29% were non-Hispanic white, 43% were Hispanic, and 28% were black. In the control group, black individuals were found to have a longer median time to diagnostic resolution (108 days) compared with non-Hispanic white individuals (65 days) or Hispanic individuals (68 days) (P<.0001). In the navigated groups, black individuals had a reduction in the median time to diagnostic resolution (97 days) (P<.0001). In the multivariable models, among controls, black race was found to be associated with an increased delay to diagnostic resolution (hazard ratio, 0.77; 95% confidence interval, 0.69-0.84) compared with non-Hispanic white individuals, which was reduced in the navigated arm (hazard ratio, 0.85; 95% confidence interval, 0.77-0.94).
  
  
  
  Patient navigation appears to have the greatest impact among black patients, who had the greatest delays in care. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2715-2722. © 2016 American Cancer Society.
authors.affiliation: Section of Hematology Oncology, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Naomi Y
authors.initials: NY
authors.lastname: Ko
authors.affiliation: NOVA Research Company, Silver Spring, Maryland.
authors.forename: Frederick R
authors.initials: FR
authors.lastname: Snyder
authors.affiliation: Denver Health, Denver, Colorado.|University of Colorado at Denver, Aurora, Colorado.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Raich
authors.affiliation: Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine and Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio.
authors.forename: Electra D
authors.identifier: 0000-0002-8247-8299
authors.initials: ED
authors.lastname: Paskett
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, Texas.|Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, Virginia.
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Dudley
authors.affiliation: University of New Mexico Comprehensive Cancer Center, University of New Mexico School of Medicine, Albuquerque, New Mexico.
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Lee
authors.affiliation: The George Washington University School of Public Health and Health Services, Washington, DC.|The George Washington Cancer Institute, Washington, DC.
authors.forename: Paul H
authors.initials: PH
authors.lastname: Levine
authors.affiliation: Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Freund
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D054625:Healthcare Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy; D062526:Patient Navigation; D011379:Prognosis; D016016:Proportional Hazards Models; D044469:Racial Groups / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data
keywords: cancer; disparities; patient navigation; race and ethnicity; screening