An examination of the implementation of a patient navigation program to improve breast and cervical cancer screening rates of Chinese immigrant women: a qualitative study
Abstract Background Chinese Americans have lower breast and cervical cancer screening rates than the national average and experience multiple barriers to cancer care. Patient navigators have improved screening and follow-up rates for medically underserved populations, yet investigations of cancer na...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-02-01
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| Series: | BMC Women's Health |
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| Online Access: | https://doi.org/10.1186/s12905-022-01610-7 |
| _version_ | 1798023922917048320 |
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| author | Marquita W. Lewis-Thames Laura S. Tom Ivy S. Leung Anna Yang Melissa A. Simon |
| author_facet | Marquita W. Lewis-Thames Laura S. Tom Ivy S. Leung Anna Yang Melissa A. Simon |
| author_sort | Marquita W. Lewis-Thames |
| collection | DOAJ |
| description | Abstract Background Chinese Americans have lower breast and cervical cancer screening rates than the national average and experience multiple barriers to cancer care. Patient navigators have improved screening and follow-up rates for medically underserved populations, yet investigations of cancer navigation programs and their implementation among Chinese Americans are limited. To address this gap, we used the Consolidated Framework for Implementation Research (CFIR) to examine facilitators and barriers to implementing the Chicago-based Chinatown Patient Navigation Program (CPNP) for breast and cervical cancer screening, follow-up, and treatment. Methods Stakeholders from clinical care, supportive care services, and community organizations were invited to participate in qualitative interviews to illuminate implementation processes and stakeholder perspectives of facilitators and barriers to implementing the CPNP. Interviews were audio-recorded, transcribed, and deductively coded according to CFIR domains, including (1) intervention characteristics; (2) outer setting; (3) inner setting; and (4) the implementation process. Results We interviewed a convenience sample of 16 stakeholders representing a range of roles in cancer care, including nurses, clinical team members, administrators, physicians, a community-based organization leader, and a CPNP navigator. Findings detail several facilitators to implementing the CPNP, including patient navigators that prepared Chinese-speaking patients for their clinic visits, interpretation services, highly accessible patient navigators, and high-quality flexible services. Barriers to program implementation included limited regular feedback provided to stakeholders regarding their program involvement. Also, early in the program’s implementation there was limited awareness of the CPNP navigators’ roles and responsibilities, insufficient office space for the navigators, and few Chinese language patient resource materials. Conclusions These findings provide valuable information on implementation of future patient navigation programs serving Chinese American and other limited-English speaking immigrant populations. |
| first_indexed | 2024-04-11T17:54:11Z |
| format | Article |
| id | doaj.art-4ac4fc4f3c054d8887324d7b513bf9c6 |
| institution | Directory Open Access Journal |
| issn | 1472-6874 |
| language | English |
| last_indexed | 2024-04-11T17:54:11Z |
| publishDate | 2022-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Women's Health |
| spelling | doaj.art-4ac4fc4f3c054d8887324d7b513bf9c62022-12-22T04:10:57ZengBMCBMC Women's Health1472-68742022-02-0122111310.1186/s12905-022-01610-7An examination of the implementation of a patient navigation program to improve breast and cervical cancer screening rates of Chinese immigrant women: a qualitative studyMarquita W. Lewis-Thames0Laura S. Tom1Ivy S. Leung2Anna Yang3Melissa A. Simon4Department of Medical Social Science, Center for Community Health, Northwestern University Feinberg School of MedicineDepartment of Obstetrics and Gynecology, Northwestern University Feinberg School of MedicineDepartment of Obstetrics and Gynecology, Northwestern University Feinberg School of MedicineDepartment of Obstetrics and Gynecology, Northwestern University Feinberg School of MedicineDepartment of Medical Social Science, Center for Community Health, Northwestern University Feinberg School of MedicineAbstract Background Chinese Americans have lower breast and cervical cancer screening rates than the national average and experience multiple barriers to cancer care. Patient navigators have improved screening and follow-up rates for medically underserved populations, yet investigations of cancer navigation programs and their implementation among Chinese Americans are limited. To address this gap, we used the Consolidated Framework for Implementation Research (CFIR) to examine facilitators and barriers to implementing the Chicago-based Chinatown Patient Navigation Program (CPNP) for breast and cervical cancer screening, follow-up, and treatment. Methods Stakeholders from clinical care, supportive care services, and community organizations were invited to participate in qualitative interviews to illuminate implementation processes and stakeholder perspectives of facilitators and barriers to implementing the CPNP. Interviews were audio-recorded, transcribed, and deductively coded according to CFIR domains, including (1) intervention characteristics; (2) outer setting; (3) inner setting; and (4) the implementation process. Results We interviewed a convenience sample of 16 stakeholders representing a range of roles in cancer care, including nurses, clinical team members, administrators, physicians, a community-based organization leader, and a CPNP navigator. Findings detail several facilitators to implementing the CPNP, including patient navigators that prepared Chinese-speaking patients for their clinic visits, interpretation services, highly accessible patient navigators, and high-quality flexible services. Barriers to program implementation included limited regular feedback provided to stakeholders regarding their program involvement. Also, early in the program’s implementation there was limited awareness of the CPNP navigators’ roles and responsibilities, insufficient office space for the navigators, and few Chinese language patient resource materials. Conclusions These findings provide valuable information on implementation of future patient navigation programs serving Chinese American and other limited-English speaking immigrant populations.https://doi.org/10.1186/s12905-022-01610-7Patient navigationHealth educationImmigrant populationsChinese AmericanMinority health |
| spellingShingle | Marquita W. Lewis-Thames Laura S. Tom Ivy S. Leung Anna Yang Melissa A. Simon An examination of the implementation of a patient navigation program to improve breast and cervical cancer screening rates of Chinese immigrant women: a qualitative study BMC Women's Health Patient navigation Health education Immigrant populations Chinese American Minority health |
| title | An examination of the implementation of a patient navigation program to improve breast and cervical cancer screening rates of Chinese immigrant women: a qualitative study |
| title_full | An examination of the implementation of a patient navigation program to improve breast and cervical cancer screening rates of Chinese immigrant women: a qualitative study |
| title_fullStr | An examination of the implementation of a patient navigation program to improve breast and cervical cancer screening rates of Chinese immigrant women: a qualitative study |
| title_full_unstemmed | An examination of the implementation of a patient navigation program to improve breast and cervical cancer screening rates of Chinese immigrant women: a qualitative study |
| title_short | An examination of the implementation of a patient navigation program to improve breast and cervical cancer screening rates of Chinese immigrant women: a qualitative study |
| title_sort | examination of the implementation of a patient navigation program to improve breast and cervical cancer screening rates of chinese immigrant women a qualitative study |
| topic | Patient navigation Health education Immigrant populations Chinese American Minority health |
| url | https://doi.org/10.1186/s12905-022-01610-7 |
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