Enhancing the Effectiveness of Community Health Workers to Reduce Cervical Cancer Disparities in African American Women
The hysterectomy-corrected incidence of cervical cancer (CC) is more than 40% higher among African American women than white women. Black women are also twice as likely to die from CC. It does not have to be this way. Widespread screening and proper follow-up would eliminate most new cases of CC because the natural progression of precancerous cervical lesions is slow, allowing for treatment and cure. The best evidence indicates that this is not happening. Adherence to screening guidelines is too low among Black women.
One promising solution to this problem is patient navigation (PN). PN was originally developed to help socioeconomically disadvantaged Black women overcome the systemic, provider, and personal barriers to timely cancer prevention and care using community members as lay navigators. Recently, however, there has been a general shift away from navigating poor and uninsured patients, towards higher SES patients in better funded, more comprehensive cancer care centers. While nearly all can benefit from PN, if not targeted to those most in need, delivering these services to more privileged patients can exacerbate disparities.
This project will aim to develop a mobile PN intervention for both African American women (mNav) and lay navigators (mNav-D) to reduce CC health disparities. These products are front-ends to the same server-based program, and thus fully integrated. For patients, mNav includes an integrated web-based risk assessment that allows our SMS software app to select and deliver videos and text messages specific to each woman’s particular cervical screening challenges. For lay navigators, mNav-D provides an “at a glance” overview of key performance metrics while also supporting easy entry of encounter-level patient data.