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Collaborative Oncology Navigation Key to Tackling Racial Gap in Breast Cancer Survival

October 11, 2021 | AONN+ Blog | Breast Cancer, Barriers to Care, Research
Featuring:
Mu Lin
Digital Content Writer
The Lynx Group

Yale University researchers say a community-based, collaborative oncology navigation approach is needed to address barriers to cancer care among underserved ethnic minorities and populations.

Why Minority Women Are at Higher Risk for Breast Cancer

Research studies have shown that underserved ethnic minority women face a myriad of adverse social barriers to care access, resources, and optimal treatment, resulting in a higher risk of breast cancer.

Such social barriers may include lack of health insurance, financial needs related to food, transportation, out-of-pocket medical costs, and nonmedical expenses, and an explicit need for legal assistance with financial, domestic, and social issues, as well as a variety of psychosocial issues.

For instance, researchers found that among underserved African-American women with breast cancer, their lack of insurance or inadequate insurance resulted in missed, delayed, or fewer treatment opportunities. The financial burden of cancer was not limited to the acute treatment phase; there was also extreme economic hardship resulting from this disease into long-term survivorship.1

The underserved minority women with breast cancer may also have unmet legal needs, such as those relating to insurance benefits and denials, workplace accommodations, protection from debt harassment, the Family Medical Leave Act, housing, immigration issues, and a host of other concerns.2

Together, these social barriers contribute to the disparities in breast cancer outcomes among underserved ethnic minority women. As a result, interventions to promote better access to recommended treatment are critically needed.

Collaborative Navigation Program Helps Address Unmet Needs

In a 2021 research report,3 a group of Yale University researchers discussed a collaborative oncology navigation approach that can better help the underserved minority women with breast cancer.

According to the Yale researchers, the services currently provided by nursing, social work, and supportive care resources are primarily hospital-based with significant barriers to time and expertise. To address this issue, the researchers designed a pilot program to minimize barriers to care and increase referrals and access to resources for medically underserved women with breast cancer.

The pilot program included a dedicated oncologist, bilingual nurse coordinator, social worker, and a newly created community cancer care navigator. Partnerships with community agencies and a legal assistance association were established.

A total of 101 underserved women with breast cancer participated. The average age was 57.3 years, 54.8% were ethnic minorities, 45.5% had government insurance, 6% had no insurance, and English was a second language or not spoken for 13.9%.

The findings of this pilot program confirmed the evidence in the literature on risk factors and unmet needs. This group of women with breast cancer reported multiple unmet needs. There were 120 referrals primarily for nonmedical needs (48.3% financial, 3.3% housing, 17.5% legal issues, 20.8% transportation).

Looking at the results, researchers say if interventions such as this pilot program are implemented, there is the opportunity to alter adverse outcomes, such as unfavorable therapeutic response and decreased disease-free and overall survival and improve optimal receipt of recommended therapies and patient-perceived quality of survival.

References

  1. Darby K, Davis C, Likes W, Bell J. Exploring the financial impact of breast cancer for African American medically underserved women: a qualitative study. J Health Care Poor Underserved. 2009;20:721-728.
  2. Retkin R, Antoniadis D, Pepitone DF, Duval D. Legal services: a necessary component of patient navigation. Semin Oncol Nurs. 2013;29:149-155.
  3. Knobf, M. Tish, et al. “Bridging the Care Continuum: A Pilot Program for Underserved Women with Breast Cancer.” Journal of Oncology Navigation & Survivorship. 2021;12:247-251.
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