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Oncology Nurse and Peer Navigation: A Promising Model for Hispanic/Latina Women with Breast Cancer

E. L. Saavedra Ferrer, W. L. Hine, S. L. Arellano, P. Ortega de Corona, M. C. Cardenas, B. Vicuna Tellez

University of New Mexico, Albuquerque, NM

Background: Breast cancer is the most common cancer among New Mexico Hispanic women, and Hispanic women are less likely to be diagnosed with early-stage cancer compared with Anglo women.¹ Hispanic/Latina women have lower mammography screening rates for breast cancer compared with Anglo women.² Breast cancer screening disparities are persistent among Hispanic/ Latina women. The Comadre a Comadre Program is a multilevel, community-based, peer-led, culturally and linguistically competent intervention designed to improve the breast health and breast cancer outcomes among Hispanic/Latina women in New Mexico. It is important to explore the effectiveness of tailored navigation models for specific populations and settings. Oncology nurse navigation in cancer care is a vital component of patient care. The nurse navigator serves as a clinical resource with expertise in oncology care management.³-⁷ Underserved women with cancer face additional barriers, which are outside the domain of the medical facility setting and the clinical aspects of cancer. These barriers, or social determinants of health, can be cultural (eg, privacy norms that discourage discussion about their bodies), logistical (eg, transportation to hospitals), language-based (eg, lack of understanding despite the use of medical interpreters), and emotionally based (eg, a fatalistic view of cancer).8 Community based peer navigation, when implemented in conjunction with clinic-based oncology nurse navigation, could be a promising navigation model.⁹-¹²


• To examine the types of practical, structural, and nonclinical support provided to the women by lay peer navigators (community-based)

• To examine the clinical aspects of the role of the oncology nurse navigator in this cancer setting

• To examine the characteristics of women who most benefited from navigation efforts

Method: Peer navigators completed 2 different types of tracking data forms following individual encounters with participants. The Clinic Tracking and the Non- Clinic Tracking forms are used when the peer navigator either meets the participant at the clinic for her medical appointment (clinic form) or conducts other navigation on her behalf, either face-to-face or by telephone (non-clinic form). The forms track dichotomous variables, recorded by checking yes or no on the form. The Clinic Tracking form variables include providing emotional support at the medical appointment, accessing types of cancer services (medical language interpreter, social worker, etc). The Non-Clinic Tracking form variables include advocacy, program support, navigation to other agencies, and follow-up with the patient. Participants also complete a project-developed demographic survey. Quantitative data collected from peer navigators (tracking form data and demographic data) for the period 2018 to 2020 will be the focus of the analysis. Five to 10 encounters per woman, for 100 women, will be analyzed. The oncology nurse navigator completes referral forms for participants in the program. Reason(s) provided for referrals will be examined qualitatively, analyzing emergent themes and core competencies of oncology nurse and lay patient navigators.

Results: Results from this analysis will include demographic data that include variables such as income, self-identify, education, etc. In an earlier analysis (2014) of the Comadre Program, we found emotional support, financial navigation, and language access to be the most frequent types of support provided by the navigators. We anticipate we will find similar patterns in these data. We are currently in the final stages of analysis for the period of 2018 to 2020.

Conclusion: The findings gleaned from this analysis will show that the types of support provided by these 2 navigator types (lay and nurse oncology navigation) can work in a complementary manner and be effective in improving cancer care for Hispanic/Latina women.


1. Meisner A, Wiggins C. A Brief Update on Cancer in New Mexico. Paper presented at: New Mexico Cancer Council; July 18, 2018; Albuquerque, NM.

2. American Cancer Society. Cancer Facts & Figures for Hispanics/Latinos 2018-2020. Atlanta, GA: American Cancer Society; 2018.

3. Shockney LD. The evolution of breast cancer navigation and survivorship care. Breast J. 2015;21:104-110.

4. Blaseg KD, Daugherty P, Gamblin KA. Oncology Nurse Navigation: Delivering Patient-Centered Care Across the Continuum. Pittsburgh, PA: Oncology Nursing Society; 2014.

5. Shockney LD, ed. Team-Based Oncology Care: The Pivotal Role of Oncology Navigation. Cham, Switzerland: Springer International Publishing AG; 2018.

6. Burhansstipanov L, Shockney LD, Gentry S. History of Oncology Patient and Nurse Navigation. In: Shockney LD, ed. Team-Based Oncology Care: The Pivotal Role of Oncology Navigation. Cham: Springer International Publishing; 2018:13-42.

7. Malone P, Bruno L, Hayden B, Carlson J. Development and evolution of an oncology nurse navigation program: from formation to fruition. Journal of Oncology Navigation & Survivorship. ber-2014-vol-5-no-5/1283-development-and-evolution-of-an-oncologynurse- navigation-program-from-formation-to-fruition. 2014.

8. Wheeler SB, Reeder-Hayes KE, Carey LA. Disparities in breast cancer treatment and outcomes: biological, social, and health system determinants and opportunities for research. Oncologist. 2013;18:986-993.

9. Burhansstipanov L. The art of community-based patient navigation. Journal of Oncology Navigation & Survivorship. 2017;8(8):370-374.

10. Maskarinec G, Sen C, Koga K, Conroy SM. Ethnic differences in breast cancer survival: status and determinants. Womens Health (Lond). 2011;7:677-687.

11. Freeman HP. Patient navigation: a community centered approach to reducing cancer mortality. J Cancer Educ. 2006;21(1 Suppl):S11-S14.

12. Baik SH, Gallo LC, Wells KJ. Patient navigation in breast cancer treatment and survivorship: a systematic review. J Clin Oncol. 2016;34:3686-3696.

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University of New Mexico, Center Collaborative Research and Community Engagement (CCRCE), COEHS