By Ebun Ebunlomo, PhD, faculty member of public health at American Public University
I don't know about you, but I can't imagine driving without my GPS in the glove box of my car. Even when I know my trip route, I still have an extra sense of security that if my phone dies, or I take the wrong turn accidentally, I can always turn on my GPS and get re-routed. I got my Garmin Nuvi 1490T as a birthday gift after several years of pent-up frustration from getting lost on the seemingly convoluted roads of Houston. Now, I don't leave home without making sure my little electronic friend - Hank - is intact, charged and ready to go in my car.
Navigating the healthcare system can be similar to driving on the complicated streets of Houston, if one is not familiar with the territory. In essence, people often get lost on the complex "roads" to healthcare services in this country. In light of this, several studies have shown the positive impact of patient navigators, those I refer to as Patient GPS. A Patient GPS in the area of women's health can guide women from the side streets of preventive services like mammograms to the complicated highways of understanding and selecting treatment options if or when diagnosed with breast cancer. This short video clip gives a good overview of a Patient GPS's characteristics in the breast cancer healthcare service area.1
The American Cancer Society recommends the following for women to prevent breast cancer:2
- Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health.
- Clinical breast exam about every three years for women in their 20s and 30s and every year for women 40 and over.
- Women should know how their breasts normally look and feel and report any breast change promptly to their healthcare provider. Breast self-exam is an option for women starting in their 20s.
Although annual mammography screening is recognized as effective in reducing breast cancer-related deaths, immigrant and refugee women are still less likely to have mammography screenings due to the fact that they are less familiar with the U.S. healthcare system.3-5 Immigrant women, racial/ethnic minorities and women from low-income backgrounds are most affected by breast cancer.6-11 A recent study about Bosnian refugee women in Massachusetts found that patient navigation worked to significantly increase mammogram rates among this group of women.12 Just like my friend, Hank, a Patient GPS can keep women (especially immigrant and refugee women) from getting lost on the busy roads and various detours of the U.S. healthcare system.
What ways do you think a patient GPS can support breast cancer survivors in staying healthy? What other areas of our lives do you think a human GPS can help us?
1. Flager Hospital Cancer Institute. (2010). Role of a cancer patient navigator. Retrieved from http://www.youtube.com/watch?v=RbUkwzTj_mg&feature=related
2. American Cancer Society. (2014). American Cancer Society recommendations for early breast cancer detection in women without breast symptoms. Retrieved from http://www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-acs-recs
3. Norman, S.A., et al. (2006). Benefit of screening mammography in reducing the rate of late-stage breast cancer diagnoses (United States). Cancer Causes and Control, 17(7), 921-929.
4. Norman, S.A., et al. (2007). Protection of Mammography Screening against Death from Breast Cancer in Women Aged 40-64 years. Cancer Causes and Control, 18(9), 909-918.
5. Sabatino, S.A., Coates, R.J., Uhler, R.J., Breen, N., Tangka, F., & Shaw, K.M. (2008). Disparities in mammography use among US women aged 40-64 years, by race, ethnicity, income, and health insurance status, 1993 and 2005. Medical Care, 46(7), 692-700.
6. Andreeva, V.A., Unger, J.B., & Pentz, M.A. (2007). Breast cancer among Immigrants: A systematic review and new research directions. Journal of Immigrant and Minority Health, 9(4), 307-322.
7. Echeverria, S.E., & Carrasquillo, O. (2006). The roles of citizenship status, acculturation, and health insurance in breast and cervical cancer screening among immigrant women. Medical Care, 44(8), 788-792.
8. Israel De Alba, F., McMullin, J.M., Sweningson, J.M., & Saitz, R. (2005). Impact of US citizenship status on cancer screening among immigrant women. Journal of General Internal Medicine, 20(3), 290-296.
9. Jemal, A., Siegel, R., Ward, E., Hao, Y., Xu, J., & Thun, M.J. (2009). Cancer statistics. CA: A Cancer Journal for Clinicians, 59(4), 225-249.
10. Pasick, R.J., & Burke, N.J. (2008). A critical review of theory in breast cancer screening promotion across cultures. Annual Review of Public Health 29, 351-368.
11. Sheppard, V.B., Christopher, J., & Nwabukwu, I. (2010). Breaking the silence barrier: Opportunities to address breast cancer in African-born women. Journal of National Medical Association, 102(6), 461-468.
12. Percac-Lima, S., Milosavljevic, B., Oo SA, Marable, D., & Bond, B. (2012). Patient navigation to improve breast cancer screening in Bosnian refugees and immigrants. Journal of Immigrant and Minority Health, 14(4), 727-30.