Patient Navigation Can Improve Breast Cancer Outcomes among African American Women in Chicago: Insights from a Modeling Study

African American (AA) women experience much greater mortality due to breast cancer (BC) than non-Latino Whites (NLW). Clinical patient navigation is an evidence-based strategy used by healthcare institutions to improve AA women’s breast cancer outcomes. While empirical research has demonstrated the...

Full description

Saved in:
Bibliographic Details
Published in:Journal of urban health 2022-10, Vol.99 (5), p.813-828
Main Authors: Khanna, Aditya S., Brickman, Bryan, Cronin, Michael, Bergeron, Nyahne Q., Scheel, John R., Hibdon, Joseph, Calhoun, Elizabeth A., Watson, Karriem S., Strayhorn, Shaila M., Molina, Yamilé
Format: Article
Language:English
Subjects:
Breast cancer
Diagnosis
Diagnostic systems
Epidemiology
Health Informatics
Mammography
Medicine
Medicine & Public Health
Navigation behavior
Patients
Public Health
Simulation
Social networks
Social organization
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:African American (AA) women experience much greater mortality due to breast cancer (BC) than non-Latino Whites (NLW). Clinical patient navigation is an evidence-based strategy used by healthcare institutions to improve AA women’s breast cancer outcomes. While empirical research has demonstrated the potential effect of navigation interventions for individuals, the population-level impact of navigation on screening, diagnostic completion, and stage at diagnosis has not been assessed. An agent-based model (ABM), representing 50–74-year-old AA women and parameterized with locally sourced data from Chicago, is developed to simulate screening mammography, diagnostic resolution, and stage at diagnosis of cancer. The ABM simulated three counterfactual scenarios: (1) a control setting without any navigation that represents the “standard of care”; (2) a clinical navigation scenario, where agents receive navigation from hospital-affiliated staff; and (3) a setting with network navigation, where agents receive clinical navigation and/or social network navigation (i.e., receiving support from clinically navigated agents for breast cancer care). In the control setting, the mean population-level screening mammography rate was 46.3% (95% CI: 46.2%, 46.4%), the diagnostic completion rate was 80.2% (95% CI: 79.9%, 80.5%), and the mean early cancer diagnosis rate was 65.9% (95% CI: 65.1%, 66.7%). Simulation results suggest that network navigation may lead up to a 13% increase in screening completion rate, 7.8% increase in diagnostic resolution rate, and a 4.9% increase in early-stage diagnoses at the population-level. Results suggest that systems science methods can be useful in the adoption of clinical and network navigation policies to reduce breast cancer disparities.
ISSN:1099-3460
1468-2869
DOI:10.1007/s11524-022-00669-9