Evaluating an Online Training Course to Develop and Sustain Cancer Navigation and Survivorship Programs.

OBJECTIVES: To evaluate the impact of the Executive Training on Navigation and Survivorship (Executive Training) online training course, designed by the George Washington University Cancer Center, on nurses and other healthcare professionals. SAMPLE & SETTING: A volunteer sample of 499 healthcare professionals, including nurses and patient navigators, were recruited through multiple Internet-based channels. METHODS & VARIABLES: Participants completed questionnaires before and after each module and at the end of the training. Descriptive statistics were calculated, and paired t tests were used to assess pre- and post-test learning confidence gains for each module. Qualitative feedback from participants was also summarized. RESULTS: From pre- to post-test, each group demonstrated statistically significant improvements in confidence (p < 0.05) for all seven training modules. Confidence gains were statistically significant for 19 of 20 learning objectives (p < 0.05). Overall rating scores and qualitative feedback were positive. IMPLICATIONS FOR NURSING: The Executive Training course prepares healthcare professionals from diverse backgrounds to establish navigation and survivorship programs. In addition, the training content addresses gaps in nursing education on planning and budgeting that can improve success.

Oncology healthcare provider perspectives on caring for diverse patients fifteen years after Unequal Treatment.

OBJECTIVE: The purpose of this study was to provide a snapshot of U.S. oncology provider perspectives on caring for diverse patients, including self-rated awareness, comfort, skills, practices, challenges, facilitators, and barriers. METHODS: An online survey was administered to a convenience sample of multidisciplinary oncology providers. Descriptive statistics and bivariate analyses were computed for Likert-style items to investigate differences by level of past diversity training. Qualitative content analysis was conducted on open-response questions. RESULTS: Roughly one-third (36.7%) of the 406 survey respondents reported receiving high levels of past diversity training, with statistically significant differences by training amount for self-rated skills and select awareness and practice items (p < 0.05). Key challenges qualitatively described included language barriers (n = 143) and alternative health beliefs (n = 52). Knowledge and training (n = 62), interpretation services (n = 53), and staff attitudes (n = 46) were the most frequently mentioned factors affecting culturally sensitive care. CONCLUSION: Fifteen years after the publication of Unequal Treatment, the National Academies' landmark report on healthcare disparities, oncology healthcare providers have ongoing challenges caring for diverse patients and opportunities to implement recommendations from the report. PRACTICE IMPLICATIONS: Content of diversity trainings should focus on identified gaps and practical challenges. Multi-level supports are needed, including resources and training for oncology providers.

In their own words: patient navigator roles in culturally sensitive cancer care.

PURPOSE: Patient navigation has emerged as a promising strategy in reducing disparities among diverse cancer patients. However, little is known about navigators' own perspectives on their roles in providing culturally competent care. The purpose of the present study is to describe these self-identified roles. METHODS: Data were collected from an online survey with a convenience sample of cancer patient navigators. Using NVivo 10, qualitative content analysis was conducted on free text responses to the question: "In your opinion, what is the role of a patient navigator or nurse navigator in the provision of culturally sensitive care to patients?" Frequencies of each navigator-identified role mentioned were tabulated. RESULTS: Of 294 respondents, 50.7% (n = 149) provided a response to the question of interest. Respondents described the following 11 interrelated navigator roles in the provision of culturally competent care: (1) assess and understand patient needs, (2) tailor care to patient, (3) build rapport/open communication, (4) facilitate communication between patient and health care team, (5) educate/provide resources to the patient, (6) advocate, (7) self-motivated learning, (8) address barriers to care, (9) involve/meet the needs of family or support people, (10) educate/support health care team, and (11) support patient empowerment in care. CONCLUSIONS: Patient navigators are uniquely well-positioned to improve cultural competence of cancer care given their role as liaison to patients and providers. Cancer care settings should use navigators with direct knowledge of patient culture whenever possible; however, communication and cultural competence training is highly recommended for all navigators given the diversity of patient needs.