Native Americans have the lowest five-year cancer survival rate of any population in the United States. The Patient Navigator Program at Huntsman Cancer Institute (HCI) grew out of HCI’s commitment to reduce cancer health disparities in underserved and minority populations, and its goal is to reduce the barriers Native Americans face in accessing better cancer care. Originally begun in 2006 with a grant from the Center for Medicare and Medicaid Services, the program has now been extended through a federal grant awarded in 2010 by the Health Resources and Services Administration (HRSA).
The Patient Navigator Program aims to provide better health care and education about cancer risk and prevention to Native Americans through “navigators,” individuals recruited from the community who are trained to negotiate the health care system. Navigators give personalized attention to people in need of care by helping with everything from scheduling appointments to transportation to understanding insurance coverage.
Randall Rupper, MD, MPH, assistant professor in the Department of Internal Medicine at the University of Utah and a member of HCI’s Cancer Control and Population Sciences Program, says that the new grant will focus on more than just cancer. “We have recognized that individuals we’re interacting with tend not to focus just on their cancer screening or care but also on other chronic medical conditions. So for the HRSA grant, we’re expanding the range of conditions that the navigators will be addressing, and that will include efforts to reduce cardiovascular risk.”
Recruiting navigators from the Native American community is a key concept, says Rupper. “Negotiating your way around cancer care can be very complex. But the community networks, the resource networks, the social support—those are also complex.” It is much more effective, he says, to teach someone in the tribal community about the health care system than to teach non-tribal health care workers about the community and expect the same cultural sensitivity. “It’s a really personal connection we’re trying to make with patients,” he says, “and it’s going to be easier for someone from that community to make that connection.”
Program leaders have found that once they educate navigators about cancer care, it begins to spread to the rest of the community. “We find the navigators can become cancer care champions in their community and within their families for good cancer care and prevention,” he says. Tribal elders hold a special position of respect, Rupper adds, “and if you can get elders in the tribe to champion cancer screening, then the benefits really grow from there.”
Feedback from the program has been very positive. “People appreciate the personal attention from the health care system, especially the people who have been screened and found out they caught a problem early,” says Rupper. “They’re very grateful for the program.”
Read about the original Native American Patient Navigator Grant in the 2006 Annual Report.