Prostate Cancer, Colorectal Cancer, Breast Cancer, Cervical Cancer, Lung Cancer
Conditions
Keywords
Cancer Screening, Navigators, Community Outreach, Behavioral Change, Access
Brief summary
The purpose of this demonstration is to evaluate the effectiveness of using community outreach workers (navigators) to help American Indians living in rural areas overcome barriers to appropriate cancer screening, diagnosis, and treatment.
Detailed description
Even for American Indians who have coverage with Medicare, disparities have been noted in the provision of cancer screening, diagnosis, and treatment. These disparities have been related to a variety of health-system, health-financing, geographic, and cultural barriers. We hypothesize that the use of lay community outreach workers will be an effective means of identifying and overcoming these barriers in order to improve the proportion of Medicare-eligible American Indians who receive recommended screening and diagnosis for prostate, breast, colon, and cervical cancer, and the proportion of individuals receiving appropriate treatment for prostate, breast, colon, cervical, and lung cancer. Community clusters randomized to this form of cancer navigation will be compared with community clusters randomized to receive educational outreach only.
Interventions
BEHAVIORALNavigation Services
Navigators (community health workers) identify and assist in overcoming barriers to appropriate cancer care.
BEHAVIORALCancer education
Community health workers provide cancer education appropriate for Medicare participants.
Sponsors
Sletten Cancer Institute
Centers for Medicare and Medicaid Services
University of Utah
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SCREENING
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* Enrolled in Medicare Part B * Self-reported American Indian
Exclusion criteria
* Have cancer other than study cancer * Medicare Part C enrolled
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Proportion of individuals receiving recommended screening for prostate, breast, colorectal, and cervical cancer. | four years |
Secondary
| Measure | Time frame |
|---|---|
| Proportion of individuals receiving recommended diagnostic follow-up for prostate, breast, colorectal, and cervical cancer. | four years |
| Proportion of individuals receiving recommended treatment for prostate, breast, colorectal, cervical, and lung cancer. | four years |
| Cost-effectiveness of using community navigators to improve cancer care among rural Native Americans. | 10 years |
Countries
United States
Outcome results
None listed