The purpose of this demonstration is to evaluate the effectiveness of using community outreach workers (navigators) to help American Indians living in rural areas overcome barriers to appropriate cancer screening, diagnosis, and treatment.
Even for American Indians who have coverage with Medicare, disparities have been noted in the provision of cancer screening, diagnosis, and treatment. These disparities have been related to a variety of health-system, health-financing, geographic, and cultural barriers. We hypothesize that the use of lay community outreach workers will be an effective means of identifying and overcoming these barriers in order to improve the proportion of Medicare-eligible American Indians who receive recommended screening and diagnosis for prostate, breast, colon, and cervical cancer, and the proportion of individuals receiving appropriate treatment for prostate, breast, colon, cervical, and lung cancer. Community clusters randomized to this form of cancer navigation will be compared with community clusters randomized to receive educational outreach only.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SCREENING
Masking
NONE
Enrollment
1,800
Navigators (community health workers) identify and assist in overcoming barriers to appropriate cancer care.
Community health workers provide cancer education appropriate for Medicare participants.
Sletten Cancer Institute
Great Falls, Montana, United States
Huntsman Cancer Institute
Salt Lake City, Utah, United States
Proportion of individuals receiving recommended screening for prostate, breast, colorectal, and cervical cancer.
Time frame: four years
Proportion of individuals receiving recommended diagnostic follow-up for prostate, breast, colorectal, and cervical cancer.
Time frame: four years
Proportion of individuals receiving recommended treatment for prostate, breast, colorectal, cervical, and lung cancer.
Time frame: four years
Cost-effectiveness of using community navigators to improve cancer care among rural Native Americans.
Time frame: 10 years
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