Need for Navigation and Utilization of Cancer Patient Navigators (CPNs) among Breast Cancer Patients in Nova Scotia

Abstract

Background: The Cancer Patient Navigator (CPN) program aims to reduce burdens of care coordination, emotional stress and logistical challenges on cancer patients in Nova Scotia (NS). There is concern that some patients with higher need for navigation are not accessing CPN. Methods: This was a sequential mixed methods study. Interviews and a Delphi survey of CPNs in NS identified factors that increase patients’ need for navigation. In a population-based cohort of NS breast cancer patients, we analyzed the association between CPN use and the factors identified from interviews. Results: CPNs identified sociodemographic factors (especially low socioeconomic status [SES]) as important influences on need for navigation. However, we observed no association between SES and CPN use, even after adjustment for need variables. Conclusions: Despite the expectation of greater CPN use among patients of low SES, this was not observed. This suggests that certain patients with higher need are not accessing CPN.