Promotora Navigator - Culturally Appropriate Patient Navigator

Vanderbilt University Medical Center

Status: Completed

Conditions: Screening Mammography; Breast Cancer; Community Health Worker

Treatments: Other: Standard of Care Mammography; Behavioral: Mammography with Community Health Worker (group); Behavioral: Mammography with Community Health Worker (individual)

Study type: Interventional

Funder types: Other

Identifiers

NCT03557801

180276

Details and patient eligibility

About

Although there has been interval improvement in reducing disparity in mammography utilization in medically underserved communities since the 1990s, significant disparities persist and should be addressed. In the 40-65 year old age range, there is significant disparity in screening mammography utilization in Hispanic women compared to their white counterparts.

Culturally adapted patient-targeted healthcare interventions can help reduce ethnic inequalities in access to cancer screening programs. Promotoras, culturally appropriate patient navigators for the Hispanic community, have been shown to increase screening mammography rates in the Hispanic/Latino population.

However, there is little research exploring the interaction between these lay community health workers and community members. This proposal aims to assess this interaction by measuring the impact of a Promotora working with community members in either a group setting or individual setting. Understanding this interaction can lead to more effectively designed future community interventions. Primary outcomes in this study will include women's reported measures of interpersonal processes of care (communication and interpersonal style) during screening mammography care, trust in the healthcare system, and satisfaction with cancer screening care when compared to those receiving standard of care.

Enrollment: 101 patients

Sex: Female

Ages: 40 to 64 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Women
• Identifying as Hispanic ethnicity
• Age 40-64
• Tennessee resident

Exclusion criteria

• Personal history of breast cancer
• Current breast symptoms (palpable mass)

Trial design

Primary purpose: Screening

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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101 participants in 3 patient groups

Standard of Care Mammography

Active Comparator group

Description:

Immediately following consent and completion of the baseline assessment, women in the control arm will receive standard of care well woman screening. The control arm will receive screening results per standard of care protocol.

Treatment:

Other: Standard of Care Mammography

Mammography with Community Health Worker (individual)

Experimental group

Description:

Immediately following consent and completion of the baseline assessment, women in the intervention arm 1 will participate in a 20-30 minute educational session alone with the community health worker. Well woman screening will follow the educational session. The community health worker will be available to assist with questions and language interpretation as necessary. After standard delivery of screening results, the community health worker will contact these participants to answer any questions about their screening results and to assist with scheduling any additional tests necessary.

Treatment:

Behavioral: Mammography with Community Health Worker (individual)

Mammography with Community Health Worker (group)

Experimental group

Description:

Immediately following consent and completion of the baseline assessment, women in the intervention arm will participate in a 20-30 minute group educational session from the community health worker. Well woman screening will follow the educational session. The community health worker will be available to assist with questions and language interpretation as necessary. After standard delivery of screening results, the community health worker will contact these participants to answer any questions about their screening results and to assist with scheduling any additional tests necessary.

Treatment:

Behavioral: Mammography with Community Health Worker (group)