Assessing the effectiveness of a learning collaborative to build capacity for community-based cancer survivorship navigation.

Abstract

213 Background: Community-based patient navigation has emerged as a highly effective strategy to increase cancer screening and early diagnosis, particularly for underserved populations. This navigation typically ends at diagnosis, when patients transition to clinical care. However, clinical navigation offers limited assistance to connect survivors with a broad range of community resources and support services. Community-based survivorship navigators have the potential to bridge this gap. We implemented a virtual learning collaborative (VLC) to build community capacity to deliver breast cancer survivorship navigation. Our research assesses the impact of the VLC on participants' behaviors, self-efficacy, and barriers to navigation. Methods: We conducted an analysis of data from the Breast Cancer Survivorship Patient Navigator Virtual Learning Collaborative (VLC), a 14-week practice-based training for community health workers and patient navigators to address the needs of breast cancer survivors. Weekly 60-minute virtual learning sessions included a brief didactic, followed by participants’ presentation of de-identified client cases. A 27-item pre-post survey was used to assess changes in behaviors, self-efficacy, and barriers to navigation. Results: A total of 40 participants completed both the pre- and post-surveys. Participants were predominantly female (98%), White (55%) or Black (30%), and non-Hispanic (68%). The majority were affiliated with community-based organizations (50%), as well as health departments (19%), and hospitals/cancer centers (19%) serving urban (50%) and suburban (33%) communities. Survey results indicate an average increase of 24% in self-efficacy, with the greatest increase in ability to serve as a consultant to others on cancer survivorship (38%), link survivors to appropriate resources and services (32%), explain how clinical trials work (32%), and work with survivors to address their needs (32%). Reductions in barriers to navigation included limited knowledge of cancer and cancer treatment (33%) and awareness of survivorship resources and services (34%). We found no change in behaviors or other barriers to navigation. Conclusions: The results of this study indicate the effectiveness of the VLC to build community-based capacity to deliver breast cancer survivorship navigation through increased navigator self-efficacy. No changes in behaviors suggests that navigators provide survivorship support whether or not they have training, and points to a key opportunity to increase their knowledge of evidence-based information and resources. Results of this research provide evidence to support recognition of the critical role of community navigators and reimbursement to ensure high quality, consistent community-based care for cancer survivors.