Using Community-Based Research Methods to Design Cancer Patient Navigation Training

Background: Cancer mortality continues to be higher in Native Hawaiians than whites, and research has identified numerous barriers to good cancer care. Cancer navigator programs provide individualized assistance to patients and family members to overcome barriers, promoting early diagnosis and timely and complete treatment.

Objectives: Our purpose was to design a training curriculum to provide community-based outreach workers serving Native Hawaiians with cancer patient navigator skills.

Methods: The Ho`okele i ke Ola (Navigating to Health) curriculum was informed by data gathered from Native Hawaiian cancer patients and their family members, outreach workers in Native Hawaiian communities, and cancer care providers. Based on findings, the 48-hour curriculum focused on cancer knowledge, cancer resources, and cancer communications. Three versions were developed: (1) six days of training and on-site tours in urban Honolulu; (2) four days of training on a neighbor island, with 2 days of on-site tours in Honolulu; and (3) a 3-credit community college independent study course. Graduates were interviewed after each session and 3 months after graduation about application of navigation skills.

Results: In 18 months, 62 health workers from community-based, clinical, and community college settings were trained —31 in Honolulu-based trainings, 29 in neighbor island trainings where earlier graduates served as co-faculty, and 2 through Maui Community College (MCC). Follow-up data suggest increased knowledge, skills, capacity, and feelings of competence among trainees.

Conclusions: All three versions of the Ho`okele i ke Ola cur-riculum, developed with community input, have proven successful in increasing cancer patient navigation skills of trainees.