Avon Foundation Patient Navigation Initiative
Patient navigators use innovative approaches to reduce cancer health disparities along each step of the breast cancer care continuum: screening, diagnosis, treatment, survivorship, and rehabilitation. Patient navigation has proven to be an effective strategy to reduce cancer mortality.
Avon Patient Navigators are located at safety net hospitals around the country and help patients, families, and caregivers navigate the medical and financial maze of the health care system, from an abnormal screen through diagnosis, treatment, and survivorship.
Dr. Harold Freeman at New York’s Harlem Hospital developed the first patient navigation program in the 1990s to help low-income women overcome barriers to breast cancer screening and follow-up care. Despite continuous advancements in breast cancer care, not all patients have equal access to these advancements.
Patient navigators help low-income, underinsured, and racial/ethnic minority populations overcome the barriers they may face when dealing with breast cancer screenings and follow-up care. Barriers can include:
- psychological (fear or mistrust)
- medical system (missed appointments, lost records)
- other barriers such as a lack of transportation or child care
In 2001, the Avon Foundation piloted navigation programs at Emory University and San Francisco General Hospital. The programs quickly demonstrated a positive impact, including:
- diagnosing more women at earlier stages
- increasing attendance rates of scheduled medical appointments
- decreasing the delays between diagnosis and the beginning of treatment
Based on early signs of improvements at these sites, in 2004 the Avon Foundation expanded the program and has provided support for Avon Patient Navigators at more than 150 hospitals around the country.
Rigorous Progress Reporting and Tracking
Avon Patient Navigator Programs report back information every six months. In 2013, Avon Foundation-funded programs:
- provided patients with nearly 400,000 educational contacts
- enabled access to nearly 250,000 mammograms
- navigated nearly 14,000 medically underserved women and men diagnosed with breast cancer
In addition, tens of thousands of new and previously diagnosed patients received more than 214,000 navigation services during or after treatment. Examples of these types of services include language translation, financial assistance referrals, transportation assistance, and support group referrals (see Figure 1).
Clients served by Avon programs come from the communities most in need from our society. Of clients served by Avon programs, 63% had no private health insurance, 58% had annual household incomes of less than $15,000, and 24% had less than a high school education.
Avon programs help women and men from every state in the country. 57% of clients served live in a city/urban area, while 13% are in sub-urban areas. 22% of clients lived in rural areas and 2.3% lived on an Indian reservation or other area.
In addition to rigorous progress reporting, Avon-funded patient navigator programs are further developed and refined through a webinar series and a biennial conference (the Avon Breast Cancer Forum).
The webinar series includes approximately 16 webinars each year, covering breast cancer research updates and topics relevant to patients, such as issues with intimacy after a breast cancer diagnosis, how to prevent lymphedema, and related clinical issues so that navigators are armed with the latest information to share with their clients.
The Avon Foundation thanks Genentech for its generous support of this initiative.
Figure 1: Avon 2013 Patient Navigator Activities.
In 2013, Avon Patient Navigators provided 214,000 patient navigation services. Nearly 2/3 involved language translation services. Navigators also link clients to financial assistance, transportation assistance, second opinions, support programs and provide material support services.
Figure 2: Racial/Ethnic Diversity of Clients Served by Avon Programs in 2013.
Figure shows data available on 108,045 clients served by Avon programs in 2013.