Northwest Tribal Cancer Navigator Project

Project Overview

In an effort to understand the cancer care and services for American Indian communities of the Northwest, the Northwest Tribal Epidemiology Center (EpiCenter) is conducting a five year research program to assess the effectiveness of the Navigator model in reducing cancer morbidity.  This program is called the Northwest Tribal Cancer Navigator Program (NTCNP).  NTCNP is one of nine projects funded nationally by the National Cancer Institute (NCI) through the Center to Reduce Cancer Health Disparities.  Of the nine projects, NTCNP is the only community based project and the only project serving AI/AN communities specifically.

The long-term goal of the Northwest Tribal Cancer Navigator Program is to ensure AI/AN patients have access to the same cancer care and services available to other groups.  Eight tribes have been recruited to participate in this evaluation, four intervention and four comparison.  The intervention tribes employ “Navigators” - nurses or lay health workers - at their clinics to coordinate patients’ cancer care and help patients overcome barriers to appropriate diagnosis and treatment of cancer. Comparison tribes receive stipends and documentation of their cancer patient populations but do not employ “Navigators”.  Data is collected on all patients with abnormal screenings for and/or diagnosis of breast, colorectal, prostate, or cervical cancer.

The findings will allow for a comprehensive evaluation of the effectiveness of the Navigator model in Northwest tribal communities.  If proven effective, the findings of NTCNP will provide policy-makers solid evidence on which to base funding decisions regarding use of this method of reducing the burden of cancer among American Indians and Alaska Natives.

Background
For many cancer sites, American Indians /Alaska Natives (AI/AN) experience worse outcomes and lower survival than other racial/ethnic groups in the United States.  Lack of access to adequate cancer screening and treatment remain key causes of higher cancer morbidity in tribal communities.  Funding limitations, cultural and social practices, and geographic barriers to cancer care are further challenges specific to AI/AN communities.  While the Patient Navigator model has been shown to be effective in reducing barriers to care in other underserved communities, it has not been widely implemented in AI/AN communities.

The long-term goal of the Northwest Tribal Cancer Navigator Program is to ensure AI/AN patients have access to the same cancer care and services available to other groups.  Eight tribes have been recruited to participate in this evaluation, four intervention and four comparison.  The intervention tribes employ “Navigators” - nurses or lay health workers - at their clinics to coordinate patients’ cancer care and help patients overcome barriers to appropriate diagnosis and treatment of cancer. Comparison tribes receive stipends and documentation of their cancer patient populations but do not employ “Navigators”.  Data is collected on all patients with abnormal screenings for and/or diagnosis of breast, colorectal, prostate, or cervical cancer.
The findings will allow for a comprehensive evaluation of the effectiveness of the Navigator model in Northwest tribal communities.  If proven effective, the findings of NTCNP will provide policy-makers solid evidence on which to base funding decisions regarding use of this method of reducing the burden of cancer among American Indians and Alaska Natives.

Mission:

Our mission is to ensure that AI/AN patients have access to the same cancer care and services that are available to other groups. “Navigators” – nurses or lay health workers – will help patients overcome barriers to appropriate diagnosis and treatment for cancer.

Goals:

The findings will allow for a comprehensive evaluation of the effectiveness of the Navigator model in Northwest tribal communities.  If proven effective, the findings of NTCNP will provide policy-makers solid evidence on which to base funding decisions regarding use of this method of reducing the burden of cancer among American Indians and Alaska Natives.

Strategies:

We will evaluate the cancer navigator model using the following specific aims:
1) Determine if the Northwest Tribal Cancer Navigator Program can reduce the proportion of cancers diagnosed at a late stage among tribal people;
2) Determine if the Northwest Tribal Cancer Navigator Program can improve the continuity of health care for cancer patients;
3) Determine if the Northwest Tribal Cancer Navigator Program can reduce cancer-related morbidity among tribal members;
4) Determine if the Northwest Tribal Cancer Navigator Program can improve the quality of life and subjective well being of navigated cancer patients;
5) Determine if the Northwest Tribal Cancer Navigator Program is a cost-effective way to reduce cancer care disparities for screenable cancers among American Indian and Alaska Native patients.

Tribes Served:

The Northwest Tribal Cancer Navigator Project works with eight tribal communities throughout Idaho, Oregon, and Washington.

Funding:

Project activities are funded by the National Cancer Institute through a five-year grant, which began in November 2005. Award Number: U01/CA116925-01.