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Latino cancer survivors who have a “next-level” patient navigator—one who regularly calls to offer support and culturally tailored materials—have better health-related quality of life than survivors with a more passive navigator, according to a new study by UT Health San Antonio, University of Miami, and Northwestern University.
The study, published in the journal Cancer, provided patient navigation services to 288 Latino breast, prostate, and colon cancer survivors in San Antonio and Chicago.
Half of survivors got access to a typical navigator.
They could reach out to their navigator for help with paperwork, transportation, appointment scheduling, translation, accompaniment, and more.
The other half got access to a “next-level” patient navigator who offers the same services and—in addition—regular phone calls, connections to community services, and culturally relevant online and written educational materials as part of the LIVESTRONG Cancer Navigation Services program.
“We found that enhanced patient navigation led to significant improvement in quality of life for colon cancer survivors,” said Amelie G. Ramirez, DrPH, chair and professor of population health sciences, director of the Institute for Health Promotion Research, and director of the Salud America! program at UT Health San Antonio. “The impact wasn’t as strong for breast and prostate cancer survivors.”
The Need for Patient Navigation for Cancer Survivors
Patient navigation is proven to reduce Latinas’ delay between abnormal screening results and cancer diagnosis and treatment, according to Ramirez’s past studies.
But little is known about how navigation impacts Latino survivors’ quality of life.
Latinos—expected to face a 142% rise in cancer cases by 2030—report worse health-related quality of life than their peers after cancer.
In fact, Ramirez recently found that Latino cancer survivors who were less satisfied with their care had lower quality of life and less confidence dealing with their doctor, emotional distress, and daily activities than those more satisfied with their care.
“We wanted to see how different levels of patient navigation could help Latino cancer survivors improve their quality of life,” Ramirez said.
How Next-Level Patient Navigation Impacted Latino Cancer Survivors
Ramirez’s new study provided patient navigation services for 3 months.
Her team then measured health-related quality of life among survivors who received regular patient navigation or “next-level” navigation at 3, 9, and 15 months.
- Latino male colorectal cancer survivors with next-level navigation showed significantly greater health-related quality of life than those with regular navigation at 3 months. Similarly, Latina colorectal cancer survivors with next-level navigation showed significantly greater health-related quality of life at 3, 9, and 15 months.
- Next-level navigation had no positive or negative impact on Latino prostate cancer survivors.
- Latina breast cancer survivors with next-level navigation showed significantly worse health-related quality of life than those with regular navigation.
- In all cases, Latino survivors who had better health-related quality of life at the start of the study had smaller changes in their quality of life after receiving either level of navigation.
- Latino survivors with a junior-college or more education showed greater improvement in quality of life than those with high-school or less education.
“Latino colorectal cancer survivors get quality-of-life benefits from enhanced patient navigation. This means we the need navigation programs that offer resources like phone calls and online materials for this patient population,” Ramirez said.
Ramirez also said additional research is needed.
“Because mixed and null effects were observed in Latino prostate and breast cancer survivors, studies should focus on developing and testing patient navigation programs to try to improve quality of life among these survivors,” she said.
Additional study authors from UT Health San Antonio include Byeong Yeob Choi, PhD, of the Department of Population Health Sciences, and Edgar Munoz, of the Institute for Health Promotion Research, as well as former employees Kipling J. Gallion and Arely Perez. Study authors from the University of Miami include Frank J. Penedo, PhD. Study authors from Northwestern University include Patricia I. Moreno, PhD.
What’s Next in Patient Navigation and Latino Cancer?
Ramirez is applying patient navigation to new areas.
Her team at the Institute for Health Promotion Research at UT Health San Antonio is creating a bilingual, culturally relevant phone app and navigation services to help local breast cancer patients stick with their prescribed therapy.
“We believe this intervention will not only improve breast cancer survival rates and quality of life among local women, but also will provide a system that can be replicated for broad use among patients using oral anticancer agents in other areas, too,” Ramirez said.
Also, Dr. Dan Hughes, part of Ramirez’s team at UT Health San Antonio, is leading a new pilot intervention that takes a holistic approach to improve cancer survivors’ quality of life.
Hughes has designed a holistic intervention to optimize physical, mental, and spiritual aspects of quality of life for any adult cancer survivor who seeks to enter the program.
“Exercise is a part of it, but it’s only one part of it,” Hughes said. “The intervention also includes, diet, spirituality, meditation, yoga, and tailored psycho-social support.”
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Want to try patient navigation at your organization?
Use Ramirez’s online bilingual Patient Navigator Manual: Developing and Implementing a Patient Navigator Program. The manual outlines the necessary steps and provides tools to incorporate navigation for Latinos at any organization.