Main Session
Sep
28
SS 11 - Interventions to Advance Healthcare Access in Radiation Oncology
149 - Impact of Patient Navigation in a Cancer Center-Community Partnership on Short-Course Radiation Therapy Access for African-American Breast Cancer Patients: Early Results of the Navigator-Assisted Hypofractionation (NAVAH) Program
Presenter(s)
Afua Ofori-Darko, BS, MPH - Case Western Reserve School of Medicine, Cleveland, OH
A. Ofori-Darko1,2, M. Walker1, U. J. Burnette1,3, V. Moise1, and S. McClelland III4; 1University of Oklahoma Departments of Radiation Oncology and Neurological Surgery, Oklahoma City, OK, 2Case Western Reserve School of Medicine, Cleveland, OH, 3Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, 4University of Oklahoma Stephenson Cancer Center, oklahoma, OK
Purpose/Objective(s):
African-American breast cancer patients experience persistent barriers to optimal radiation therapy (RT) access, including logistical, informational, and system-level challenges; these barriers contribute to the 40% increased breast cancer mortality African-Americans face compared with Whites, making African-Americans a high-risk mortality population for breast cancer mortality. Patient navigation may mitigate these barriers, particularly within cancer center-community partnerships. The Navigator-Assisted Hypofractionation (NAVAH) program integrates structured navigation into the delivery of adjuvant short-course hypofractionated RT. We report early patient-reported outcomes evaluating access-related experiences before and after RT from the ongoing NAVAH Phase I clinical trial.Materials/Methods:
NAVAH is a cancer center–community partnership that enrolls high-risk breast cancer patients receiving adjuvant hypofractionated RT. Patient-reported surveys were administered before initiation of navigation and at one month following completion of RT. Survey items measured access-related domains including logistical burden, perceived choice of care location, clarity of information, and interpersonal care experiences. Responses were summarized descriptively at the patient level and compared across domains between pre- and post-intervention time points.Results:
Pre-RT surveys (n = 41) demonstrated high perceived autonomy and referral access but substantial structural concerns, including perceived racial prejudice in hospitals (53.7%), self-identified low income (51.2%), and transportation cost as a potential barrier to care (31.7%). Post-RT surveys (n = 26) showed uniformly positive care experiences, with 100% of respondents reporting feeling welcome, having adequate time to ask questions, and receiving clear explanations about their condition. Fourteen of 26 patients (53.8%) reported actively utilizing patient navigator services; the remaining patients did not report active use despite universal availability of navigation support. These patients consistently rated navigation as helpful for answering questions, coordinating care, and providing emotional support. High treatment adherence was observed post-intervention, with 88.5% reporting no missed RT appointments. Together, these findings suggest that patient navigation may play an important role in supporting communication, continuity, and access during active cancer treatment.Conclusion:
Early results from the NAVAH Phase I clinical trial suggest that patient navigation within radiation oncology is associated with improved access-related patient-reported experiences among African-American breast cancer patients receiving RT. Navigation appears to support clearer communication, care coordination, and continuity during active treatment, highlighting its potential role in advancing more equitable, patient-centered cancer care delivery.