Department of Surgery, University of Michigan, Ann Arbor, MI, USA.
BMC Cancer. 2010 Oct 13;10:551. doi: 10.1186/1471-2407-10-551.
Cancer health disparities affecting low-income and minority patients are well documented. Root-causes are multifactorial, including diagnostic and treatment delays, social and financial barriers, and poor communication. Patient navigation and communication coaching (activation) are potential interventions to address disparities in cancer treatment. The purpose of this clinical trial is to test the effectiveness of an intervention combining patient navigation and activation to improve cancer treatment.
METHODS/DESIGN: The Rochester Patient Navigation Research Program (PNRP) is a National Cancer Institute-sponsored, patient-level randomized trial (RCT) of patient navigation and activation, targeting newly-diagnosed breast and colorectal cancer patients in Rochester, NY. The goal of the program is to decrease cancer health disparities by addressing barriers to receipt of cancer care and promoting patient self-efficacy. The intervention uses trained, paraprofessional patient navigators recruited from the target community, and a detailed training and supervisory program. Recruited patients are randomly assigned to receive either usual care (except for baseline and follow-up questionnaires and interviews) or intervention. The intervention patients receive tailored assistance from their patient navigators, including phone calls, in-person meetings, and behind-the-scenes coordination of care. A total of 344 patients have been recruited. Outcomes measured at three month intervals include timeliness of care, patient adherence, patient satisfaction, quality of life, self-efficacy, health literacy, and cancer knowledge.
This unique intervention combining patient navigation and patient activation is designed to address the multifactorial problem of cancer health disparities. If successful, this study will affect the design and implementation of patient navigation programs.
clinicaltrials.gov identifier NCT00496678.
影响低收入和少数族裔患者的癌症健康差距是有据可查的。根本原因是多方面的，包括诊断和治疗延误、社会和经济障碍以及沟通不畅。患者导航和沟通辅导（激活）是解决癌症治疗差异的潜在干预措施。本临床试验的目的是测试结合患者导航和激活以改善癌症治疗的干预措施的有效性。
方法/设计：罗切斯特患者导航研究计划（PNRP）是一项由美国国立卫生研究院资助的患者水平随机试验（RCT），针对纽约罗切斯特的新诊断乳腺癌和结直肠癌患者，旨在通过解决获得癌症护理的障碍和提高患者自我效能来减少癌症健康差距。该计划使用从目标社区招募的经过培训的准专业患者导航员，以及详细的培训和监督计划。招募的患者被随机分配接受常规护理（除了基线和随访问卷和访谈）或干预。干预患者接受其患者导航员的个性化协助，包括电话、面对面会议和幕后协调护理。共招募了 344 名患者。在三个月的间隔内测量的结果包括护理及时性、患者依从性、患者满意度、生活质量、自我效能、健康素养和癌症知识。
这种结合患者导航和患者激活的独特干预措施旨在解决癌症健康差距的多因素问题。如果成功，这项研究将影响患者导航计划的设计和实施。
clinicaltrials.gov 标识符 NCT00496678。
