Bridging the gap to successful cancer screening with patient navigation : The PEN (Patient Education & Navigation) Project ECHO Program
Introduction
Patient navigation is an evidence-based approach to addressing barriers to cancer prevention and treatment services. In a recent study in rural and border counties within Texas, patient navigation services were found to increase breast and cervical cancer screening for patients with barriers to care (1). Patient navigation is an important intervention to address disparities throughout the cancer care continuum and has worked in Texas to increase the number of individuals undergoing cancer screening. Navigators are known to be trusted intermediaries who educate patients about diagnostic and treatment processes and support health-related decisions across the continuum of care, from screening, diagnosis, and treatment to cancer survivorship (2). Navigators are a key resource to increase screening and early diagnosis across all cancers in Texas. Training and support may increase their effectiveness within the healthcare system. Our CPRIT grant (PP220037) supports navigators by offering training and education including: 1) monthly educational sessions; 2) 1-1 regular meetings with the program manager; and 3) regular in-person training workshops. Through our continued work with patient navigators, we identified an opportunity to support ongoing training and education using telementoring. Our objective was to develop a telementoring platform to complement patient navigation training activities including education for cervical, colorectal and breast cancer screening.
Methods
The Patient Education & Navigation (PEN) ECHO (Extension for Community Healthcare Outcomes) is a virtual monthly telementoring program facilitated by The University of Texas MD Anderson Cancer Center (MD Anderson) and is run in collaboration with the Area Health Education Center (AHEC) in the Mid-Rio Grande Area of Texas. This virtual telementoring program gives navigators in Texas the opportunity to train together to increase their navigation knowledge and skills using case-based discussion. During PEN ECHO sessions, navigators have an opportunity to share experiences and challenges encountered during the process of patient navigation, including increasing screening access and navigating patients with abnormal screening tests through the evaluation and treatment process. These sessions have two components: case presentations and a short didactic on a related topic. The case presentations are presented by navigators and/or representatives from clinical staff. The didactics follow a curriculum to educate navigators on community and educational resources.
Results
From February-July, 2023, 87 navigators from across the state of Texas participated in PEN ECHOs. On average, 36 navigators participate per session. To date, 7 cases have been presented and 5 didactic lectures given. Navigators joining the sessions come from 39 organizations in 34 counties in Texas. Most of the navigators that join reside and serve in areas where screening and navigation services are limited.
Conclusion
The PEN ECHO program provides support to navigators in low-resource communities in Texas. By offering resourceful and useful educational programs to navigators residing and serving areas where screening and navigation services are limited, we can significantly bridge the gaps in the delay of screening and abnormal screening follow-ups.