Grant Number:	7R21CA161077-02 Interpret this number
Primary Investigator:	Wells, Kristen
Organization:	San Diego State University
Project Title:	Developing and Piloting a Patient Navigation Program for Breast Cancer Survivors
Fiscal Year:	2013

DESCRIPTION (provided by applicant): Despite life-saving benefits of anti-hormonal medications, surveillance mammography, and physical exams, many breast cancer survivors do not adhere to these recommendations and experience decreased physical quality of life due to the adverse effects of cancer and its treatment. Research also indicates that some racial and ethnic minority women and women of low socioeconomic status (hereafter described as underserved), are less likely to get optimal health care following treatment for breast cancer than Caucasian women and women of higher socioeconomic status. Patient navigation, a barrier-focused intervention designed to reduce health care disparities, has demonstrated some degree of efficacy in improving adherence to breast cancer screening and diagnostic services. No known research has focused on development and evaluation of patient navigation interventions during the cancer survivorship period. Therefore, the objectives of the proposed project are to develop and pilot test a culturally relevant patient navigation program focused on underserved breast cancer survivors prescribed anti-hormonal medications. It is expected that a nurse patient navigation intervention can improve access and adherence to breast cancer survivorship care and quality of life in underserved hormone receptor positive breast cancer survivors who have completed surgery, chemotherapy, and radiation. The proposed project will be conducted in two phases. In Phase I, a patient navigation intervention will be developed using the structure of two existing patient navigation programs combined with information obtained from qualitative data collected through in-depth interviews. In Phase II, the patient navigation intervention will be pilot-tested to evaluate its feasibility and potential in improving adherence to survivorship care recommendations and quality of life for underserved breast cancer survivors by comparing it to receipt of usual medical care plus the National Cancer Institute's booklet entitled Facing Forward: Life After Cancer Treatment. Hormone receptor positive breast cancer survivors randomized to patient navigation will receive the services of a patient navigator for 8 months. Adherence and quality of life outcomes will be evaluated at 4 and 8 month follow ups. The specific aims of the study are to (1) evaluate underserved breast cancer survivors' facilitating factors (resources) and barriers related to obtaining survivorship care; and (2) develop a patient navigation intervention, infused with the results of qualitative research, designed to improve adherence to survivorship care and quality of life in underserved hormone receptor positive breast cancer survivors; and (3) conduct a pilot test of the patient navigation intervention by evaluating its effect on adherence to survivorship care and quality of life in underserved hormone receptor positive breast cancer survivors. The implementation of the proposed project is consistent with the long-term objective of this line of research: to develop, evaluate, and disseminate culturally, literacy, and linguistically relevant interventions to improve quality of life and adherence to recommended health care in underserved breast cancer survivors.




The psychosocial needs of underserved breast cancer survivors and perspectives of their clinicians and support providers.
Authors: Wells K.J. , Drizin J.H. , Ustjanauskas A.E. , Vázquez-Otero C. , Pan-Weisz T.M. , Ung D. , Carrizosa C. , Laronga C. , Roetzheim R.G. , Johnson K. , et al. .
Source: Supportive Care In Cancer : Official Journal Of The Multinational Association Of Supportive Care In Cancer, 2021-07-07 00:00:00.0; , .
EPub date: 2021-07-07 00:00:00.0.
PMID: 34231040
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Theory-Guided Randomized Neural Networks for Decoding Medication-Taking Behavior.
Authors: Kaur N. , Gonzales M. , Garcia Alcaraz C. , Barnes L.E. , Wells K.J. , Gong J. .
Source: ... Ieee-embs International Conference On Biomedical And Health Informatics. Ieee-embs International Conference On Biomedical And Health Informatics, 2021 Jul; 2021, .
EPub date: 2021-08-10 00:00:00.0.
PMID: 34505062
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Leveraging Mobile Sensing to Understand and Develop Intervention Strategies to Improve Medication Adherence.
Authors: Baglione A.N. , Gong J. , Boukhechba M. , Wells K.J. , Barnes L.E. .
Source: Ieee Pervasive Computing, 2020 Jul-Sep; 19(3), p. 24-36.
EPub date: 2020-06-26 00:00:00.0.
PMID: 33510585
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Patient Satisfaction with Navigator Interpersonal Relationship (PSN-I): item-level psychometrics using IRT analysis.
Authors: Jean-Pierre P. , Shao C. , Cheng Y. , Wells K.J. , Paskett E. , Fiscella K. .
Source: Supportive Care In Cancer : Official Journal Of The Multinational Association Of Supportive Care In Cancer, 2020 Feb; 28(2), p. 541-550.
EPub date: 2019-05-10 00:00:00.0.
PMID: 31076896
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Effects of patient navigation on satisfaction with cancer care: a systematic review and meta-analysis.
Authors: Wells K.J. , Campbell K. , Kumar A. , Clark T. , Jean-Pierre P. .
Source: Supportive Care In Cancer : Official Journal Of The Multinational Association Of Supportive Care In Cancer, 2018 May; 26(5), p. 1369-1382.
EPub date: 2018-03-01 00:00:00.0.
PMID: 29497815
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A Social Cognitive Theory-based Framework for Monitoring Medication Adherence Applied to Endocrine Therapy in Breast Cancer Survivors.
Authors: Boukhechba M. , Baee S. , Nobles A.L. , Gong J. , Wells K. , Barnes L.E. .
Source: ... Ieee-embs International Conference On Biomedical And Health Informatics. Ieee-embs International Conference On Biomedical And Health Informatics, 2018 Mar; 2018, p. 275-278.
EPub date: 2018-04-09 00:00:00.0.
PMID: 29862383
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Barriers and facilitators to endocrine therapy adherence among underserved hormone-receptor-positive breast cancer survivors: a qualitative study.
Authors: Wells K.J. , Pan T.M. , Vázquez-Otero C. , Ung D. , Ustjanauskas A.E. , Muñoz D. , Laronga C. , Roetzheim R.G. , Goldenstein M. , Carrizosa C. , et al. .
Source: Supportive Care In Cancer : Official Journal Of The Multinational Association Of Supportive Care In Cancer, 2016 Oct; 24(10), p. 4123-30.
PMID: 27146492
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Patient Navigation In Breast Cancer Treatment And Survivorship: A Systematic Review
Authors: Baik S.H. , Gallo L.C. , Wells K.J. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2016-07-25 00:00:00.0; , .
PMID: 27458298
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Facilitators of Survivorship Care Among Underserved Breast Cancer Survivors: a Qualitative Study.
Authors: Ustjanauskas A.E. , Quinn G.P. , Pan T.M. , Rivera M. , Vázquez-Otero C. , Ung D. , Roetzheim R.G. , Laronga C. , Johnson K. , Norton M. , et al. .
Source: Journal Of Cancer Education : The Official Journal Of The American Association For Cancer Education, 2016-07-07 00:00:00.0; , .
EPub date: 2016-07-07 00:00:00.0.
PMID: 27385123
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Training in Patient Navigation: A Review of the Research Literature.
Authors: Ustjanauskas A.E. , Bredice M. , Nuhaily S. , Kath L. , Wells K.J. .
Source: Health Promotion Practice, 2016 May; 17(3), p. 373-81.
PMID: 26656600
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Acceptability of a Virtual Patient Educator for Hispanic Women.
Authors: Wells K.J. , Vàzquez-Otero C. , Bredice M. , Meade C.D. , Chaet A. , Rivera M.I. , Arroyo G. , Proctor S.K. , Barnes L.E. .
Source: Hispanic Health Care International : The Official Journal Of The National Association Of Hispanic Nurses, 2015; 13(4), p. 179-85.
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