Document Detail

Patients' barriers to receipt of cancer care, and factors associated with needing more assistance from a patient navigator.
MedLine Citation:
PMID:  22046847     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Racial minorities have poorer cancer survival in the United States compared to whites. The purpose of this study was to better understand patients' barriers to cancer care and to determine which patients have a greater need for assistance from a patient navigator.
METHODS: Community health workers assisted newly-diagnosed breast and colorectal cancer patients during a randomized trial of patient navigation and collected information about patients' barriers. Barriers to care were characterized and compared between non-Hispanic white and minority patients. A multivariate model was constructed of factors associated with increased log navigation time, a measure of patients' need for assistance.
RESULTS: Patients' (n = 103) most commonly identified barriers to care included a lack of social support, insurance/financial concerns, and problems communicating with health care providers. Barriers differed between nonminority and minority patients, and minority patients faced a greater number of barriers (p = .0001). In univariate analysis, log navigation time was associated with race/ethnicity, education, income, employment, insurance type, health literacy, marital status, language, and comorbidity. A multivariate model (R2 = 0.43) for log navigation time was created using stepwise selection, and included the following factors: minority race/ethnicity (p = .032), non-full-time employment (p = .0004), unmarried status (p = .085), university center (p = .0005), and months in study (p <.0001).
CONCLUSIONS: Newly diagnosed cancer patients' most common barriers to care include lack of social support, insurance/financial concerns, and problems with health care communications. In this sample of patients, a greater need for assistance was independently associated with minority race/ethnicity and unemployment. These data may help in the design and targeting of interventions to reduce cancer health disparities.
Samantha Hendren; Nancy Chin; Susan Fisher; Paul Winters; Jennifer Griggs; Supriya Mohile; Kevin Fiscella
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of the National Medical Association     Volume:  103     ISSN:  0027-9684     ISO Abbreviation:  J Natl Med Assoc     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-11-03     Completed Date:  2011-12-07     Revised Date:  2013-07-18    
Medline Journal Info:
Nlm Unique ID:  7503090     Medline TA:  J Natl Med Assoc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  701-10     Citation Subset:  IM    
University of Michigan, General Surgery, 2124 Taubman Ctr, 1500 E. Medical Center Dr. SPC 5343, Ann Arbor, MI 48109, USA.
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MeSH Terms
Health Services Accessibility* / organization & administration
Health Services Research
Healthcare Disparities / organization & administration*,  statistics & numerical data
Insurance, Health
Minority Groups / statistics & numerical data*
Neoplasms / therapy*
Patient Advocacy*
Social Support
Socioeconomic Factors
Grant Support
U01 CA116924/CA/NCI NIH HHS; U01 CA116924-01/CA/NCI NIH HHS

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