Ethnic and racial minorities and low-income patients often encounter barriers to cancer treatment and care, and one proven strategy to reduce such health disparities is to provide ethnically and linguistically appropriate lay patient navigators (LPNs). A new study by researchers at the Centinela Freeman Medical Research Center in Inglewood, CA, identified the most problematic barriers experienced by a group of 493 African American and Latino cancer patients. Strategic intervention by LPNs reduced the average time to overcoming them from 42 days to a single day.

Dr. David Khan and colleagues from the Urban Latino African American Cancer Disparities Project (ULAAC) developed a program tailored to low-income populations using the continuous quality improvement (CQI) approach. Volunteer LPNs were trained and then monitored as they counseled patients in the cohort. Tracking of these interventions and focus groups with LPNs led to the evolution of solutions for the specific barriers faced by this patient group, 60 percent of whom accepted help.

A half dozen barriers recurred among these 300-some patients: transportation was cited most often, with 167 patients needing help; followed by psychosocial issues, financial issues, a fear of cancer, issues related to caregivers, and language issues.

Another goal of the project was to increase participation by these target populations in clinical trials. Using the CQI process, ULAAC found that the navigators possessed biases against clinical trials similar to those in the target population. LPNs were retrained and again intervened with patients, 29 of whom eventually joined clinical trials.

"These patient navigator programs should become an essential part of our health care delivery system," concludes Dr. Khan.