May 2016 VOL 7, NO 4

← Back to Issue

Breast Cancer, Original Research

A Feasibility Study of a Virtual Navigation Program for Low-Income Breast Cancer Patients

Kathy J. Helzlsouer; Susan E. Appling; Susan Scarvalone; Shannon Manocheh; Ryan MacDonald; Lisa Gallicchio; Dawn Henninger; Arti P. Varanasi 


Background: Socioeconomic disparities negatively impact completion of adjuvant breast cancer treatment. Navigation programs may improve treatment completion but may not be accessible to all patients, especially in low-resource communities.

Objective: A randomized trial was conducted to determine the feasibility of a web-based navigation program to improve adjuvant breast cancer treatment completion among low-income patients.

Methods: Patients (N = 101) were recruited and randomized to either information access only (comparison arm) or to the web-based navigation program with nurse/social worker support (intervention arm), and were given a netbook computer, training, and Internet access. Adherence to recommended chemotherapy, radiation therapy, and/or initiation of hormone therapy was assessed by medical record review (available for 48 patients on each study arm). Baseline characteristics and results were compared by study arm using t test, chi-square, Fisher’s exact test, and Poisson regression analyses.

Results: The majority of participants were unemployed or on disability (68%) and were nonwhite (67%). Those randomized to the intervention had lower education levels and were slightly older than those on the comparison arm (P = .04). Two patients on the intervention arm refused part or all of recommended treatments, and 6 patients on the comparison arm refused some or all recommended treatments (Padj = .08).

Discussion: Treatment completion was improved with navigator interaction compared with information access alone, but the difference was not statistically significant. Absolute benefit compared with usual care should be evaluated in a randomized trial.

Conclusion: Centralized virtual navigation is feasible for low-income populations and has the potential to improve treatment completion.

Related Articles
Breast Cancer, Original Research - April 29, 2016

Development and Evaluation of a Technology-Enhanced Interdisciplinary Navigation Program for Low-Income Breast Cancer Patients

Background: Navigators have the potential to help overcome barriers that interfere with cancer treatment adherence, but their widespread use is economically challenging, especially in rural and low-resource communities. A centrally [ Read More ]

Letters from Lillie - April 29, 2016

Celebrating 1 Year of CONQUER: the patient voice

Dear Navigators, The landscape of cancer care has evolved tremendously over the past decade in every aspect: research targets, available treatments, management strategies, and even the makeup of the oncology [ Read More ]