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Cited by 6Mobile Health and mHealth ApplicationsUsability and User Interface DesignCancer survivorship and care

An exploration of facilitators and barriers to patient navigator core functions with breast cancer patients: Implications for the development of a human-centered mHealth app

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Carr, Alaina L., Vinod, Naomi, Farha, Patrick, Lu, Tan, Farha, Maen J., Graves, Kristi D.·2023·PEC Innovation
DOI 10.1016/j.pecinn.2023.100226PMC PMC10583173
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Abstract

Objectives: To understand the barriers to core functions and workflow among patient navigators (PN) who navigate people diagnosed with breast cancer (BC). To identify how a mobile health (mHealth) app could assist PNs in providing care to BC patients. Methods: = 10). We used conventional content analysis to analyze the interview data. Results: Participants identified the following sociotechnical systems barriers in PN workflows that negatively impact BC patient care: 1) resources, 2) insurance coverage, 3) communication challenges, and 4) impact of logistical tasks. Participants identified the user experience, app features, and interoperability customizations to enhance PNs' provision of patient care as important design elements to include in a mHealth app. Conclusion: Feedback from stakeholders provided valuable insights into key design considerations, functions, and content areas for developing a mHealth app for PN use in BC care delivery. Innovation: This is one of the first studies to incorporate the human-centered design and sociotechnical systems frameworks to understand barriers to PN workflow and provision of BC patient care across the cancer care continuum.

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  1. [1]Lei S. Zheng R. Zhang S. Global patterns of breast cancer incidence and mortality: a population-based cancer registry data analysis from 2000 to 2020 Cancer Commun 41 2021 1183 1194 10.1002/cac2.12207 PMC8626596 34399040 · DOI
  2. [2]Ahmadi M. Shahrokhi S.N. Khavaninzadeh M. Alipour J. Development of a mobile-based self-care application for patients with breast cancer-related lymphedema in Iran Appl Clin Inform 13 2022 935 948 10.1055/s-0042-1757295 36198310 PMC9534597 · DOI
  3. [3]Stanley S. Arriola K.J. Smith S. Reducing barriers to breast cancer care through Avon patient navigation programs J Public Health Manag Pract 19 2013 461 467 10.1097/PHH.0b013e318276e272 23266756 PMC12315687 · DOI
  4. [4]Cai T. Huang Y. Zhang Y. Mobile health applications for the care of patients with breast cancer: a scoping review Int J Nurs Sci 8 2021 470 476 10.1016/j.ijnss.2021.07.003 34631997 PMC8488816 · DOI · Paper page
  5. [6]Baik S.H. Gallo L.C. Wells K.J. Patient navigation in breast cancer treatment and survivorship: a systematic review J Clin Oncol 34 2016 3686 3696 10.1200/JCO.2016.67.5454 27458298 PMC5065113 · DOI
  6. [7]Aversano J. Boehmer L.M. Spira A. Improving cancer care delivery: learnings for oncology nurses and patient navigation from a National Quality Survey J Adv Pract Oncol 13 2022 484 493 10.6004/jadpro.2022.13.5.2 35910500 PMC9328452 · DOI
  7. [8]Mootz A. Arjmandi F. Dogan B.E. Evans W.P. Health care disparities in breast cancer: the economics of access to screening, diagnosis, and treatment J Breast Imag 2 2020 524 529 10.1093/jbi/wbaa093 38424864 · DOI
  8. [9]Dixit N. Rugo H. Burke N.J. Navigating a path to equity in cancer care: the role of patient navigation Am Soc Clin Oncol Educ Book 2021 10.1200/EDBK_100026 33830828 · DOI
  9. [10]Veluswamy R.R. Kinberg E.C. Bickell N.A. Strategies to improve breast cancer care in vulnerable populations Breast Cancer Manag 2 2013 431 439 10.2217/bmt.13.42 · DOI
  10. [11]Bernardo B.M. Zhang X. Beverly Hery C.M. The efficacy and cost-effectiveness of patient navigation programs across the cancer continuum: a systematic review Cancer 125 2019 2747 2761 10.1002/cncr.32147 31034604 · DOI
  11. [14]Oncology Nursing Society Association of Oncology Social Work National Association of Social Workers Oncology Nursing Society, the Association of Oncology Social Work, and the National Association of Social Workers joint position on the role of oncology nursing and oncology social work in patient navigation Oncol Nurs Forum 37 2010 251 252 20439209
  12. [15]Weber J.J. Mascarenhas D.C. Bellin L.S. Patient navigation and the quality of breast cancer care: an analysis of the breast cancer care quality indicators Ann Surg Oncol 19 2012 3251 3256 10.1245/s10434-012-2527-8 22814513 · DOI
  13. [16]Battaglia T.A. Darnell J.S. Ko N. The impact of patient navigation on the delivery of diagnostic breast cancer care in the National Patient Navigation Research Program: a prospective meta-analysis Breast Cancer Res Treat 158 2016 523 534 10.1007/s10549-016-3887-8 27432417 PMC5216421 · DOI
  14. [17]Wells K.J. Valverde P. Ustjanauskas A.E. What are patient navigators doing, for whom, and where? A national survey evaluating the types of services provided by patient navigators Patient Educ Couns 101 2018 285 294 10.1016/j.pec.2017.08.017 28935442 PMC5808907 · DOI
  15. [19]Freund K.M. Battaglia T.A. Calhoun E. Impact of patient navigation on timely cancer care: the patient navigation research program J Nat Cancer Inst 106 2014 10.1093/jnci/dju115 PMC4072900 24938303 · DOI
  16. [20]Braun K.L. Kagawa-Singer M. Holden A.E.C. Cancer patient navigator tasks across the cancer care continuum J Health Care Poor Underserved 23 2012 398 413 10.1353/hpu.2012.0029 22423178 PMC3302357 · DOI
  17. [22]Cantril C. Christensen D. Moore E. Standardizing roles: evaluating oncology nurse navigator clarity, educational preparation, and scope of work within two healthcare systems Clin J Oncol Nurs 23 2019 52 59 10.1188/19.CJON.52-59 30681989 · DOI
  18. [23]Kline R.M. Rocque G.B. Rohan E.A. Patient navigation in cancer: the business case to support clinical needs J Oncol Pract 15 2019 585 590 10.1200/JOP.19.00230 31509483 PMC8790714 · DOI
  19. [24]Phillips S. Raskin S. Zhang Y. Pratt-Chapman M. Perspectives from oncology patient navigation programs on information management practices and needs: a descriptive study Support Care Cancer 28 2020 515 524 10.1007/s00520-019-04837-7 31073852 PMC6954125 · DOI
  20. [25]Kerch S. Brazinskaite R. Khalaf M. Technical assistance and training needs of comprehensive cancer control programs: a qualitative analysis J Cancer Educ 2022 1 8 10.1007/s13187-022-02131-5 PMC8726518 34984659 · DOI
  21. [28]Oosthuizen R. Pretorius L. Assessing the impact of new technology on complex sociotechnical systems South African J Indust Eng 27 2016 10.7166/27-2-1144 · DOI
  22. [29]Yardley L. Morrison L. Bradbury K. Muller I. The person-based approach to intervention development: application to digital health-related behavior change interventions J Med Internet Res 17 2015 e30 10.2196/jmir.4055 PMC4327440 25639757 · DOI · Paper page
  23. [30]Van Kessel R. Roman-Urrestarazu A. Anderson M. Mapping factors that affect the uptake of digital therapeutics within health systems: scoping review J Med Internet Res 25 2023 e48000 10.2196/48000 PMC10410406 37490322 · DOI
  24. [32]Melles M. Albayrak A. Goossens R. Innovating health care: key characteristics of human-centered design International J Qual Health Care 33 2021 37 44 10.1093/intqhc/mzaa127 PMC7802070 33068104 · DOI
  25. [35]Moser E.C. Narayan G. Improving breast cancer care coordination and symptom management by using AI driven predictive toolkits Breast 50 2020 25 29 10.1016/j.breast.2019.12.006 31978814 PMC7375673 · DOI
  26. [36]Lau G.J. Loiselle C.G. E-health tools in oncology nursing: perceptions of nurses and contributions to patient care and advanced practice Can Oncol Nurs J 28 2018 118 124 10.5737/23688076282118124 31148816 PMC6516906 · DOI
  27. [37]Basch E. Leahy A.B. Dueck A.C. Benefits of digital symptom monitoring with patient-reported outcomes during adjuvant cancer treatment J Clin Oncol 39 2021 701 703 33507823
  28. [39]Basch E. Stover A.M. Schrag D. Clinical utility and user perceptions of a digital system for electronic patient-reported symptom monitoring during routine cancer care: findings from the PRO-TECT trial JCO Clin Cancer Inform 2020 947 957 10.1200/CCI.20.00081 33112661 PMC7768331 · DOI · Paper page
  29. [40]Mobasheri M.H. Johnston M. King D. Smartphone breast applications – What’s the evidence? Breast 23 2014 683 689 10.1016/j.breast.2014.07.006 25153432 · DOI · Paper page
  30. [41]Nasi G. Cucciniello M. Guerrazzi C. The role of mobile technologies in health care processes: the case of cancer supportive care J Med Internet Res 17 2015 e26 10.2196/jmir.3757 PMC4342745 25679446 · DOI
  31. [42]Vokes E.E. 2022 presidential address: advancing equitable cancer care through innovation JCO 40 2022 2859 2862 10.1200/JCO.22.01305 35797507 · DOI
  32. [43]Ponder M. Venkatraman V. Charalambous L. Mobile health application for patients undergoing breast cancer surgery: feasibility study JCO Oncol Pract 17 2021 e1344 e1353 10.1200/OP.20.01026 34097502 · DOI
  33. [44]Madore S. Kilbourn K. Valverde P. Feasibility of a psychosocial and patient navigation intervention to improve access to treatment among underserved breast cancer patients Support Care Cancer 22 2014 2085 2093 10.1007/s00520-014-2176-5 24639035 · DOI
  34. [45]Brown J. Athens A. Tait D.L. A comprehensive program enabling effective delivery of regional genetic counseling Int J Gynecol Cancer 28 2018 996 1002 10.1097/IGC.0000000000001256 29664846 · DOI
  35. [46]Schuler D. Namioka A. Participatory design: Principles and practices 1993 CRC Press
  36. [48]Birnbaum F. Lewis D. Rosen R.K. Ranney M.L. Patient engagement and the design of digital health Acad Emerg Med 22 2015 754 756 10.1111/acem.12692 25997375 PMC4674428 · DOI
  37. [49]Shannon Sarah E. Three Approaches to Qualitative Content Analysis - Hsiu-Fang Hsieh 2005 https://journals.sagepub.com/doi/10.1177/1049732305276687. Accessed 2 Aug 2023 16204405 · DOI · Paper page
  38. [51]Krippendorff K. Estimating the reliability, systematic error and random error of interval data Educ Psychol Meas 30 1970 61 70 10.1177/001316447003000105 · DOI
  39. [52]Lin C.J. Schwaderer K.A. Morgenlander K.H. Factors associated with patient navigators’ time spent on reducing barriers to cancer treatment J Natl Med Assoc 100 2008 1290 1297 10.1016/s0027-9684(15)31507-8 19024225 · DOI
  40. [53]Jacob C. Sezgin E. Sanchez-Vazquez A. Ivory C. Sociotechnical factors affecting patients’ adoption of Mobile health tools: systematic literature review and narrative synthesis JMIR Mhealth Uhealth 10 2022 e36284 10.2196/36284 PMC9121221 35318189 · DOI
  41. [54]Offodile A.C. Gallagher K. Angove R. Financial navigation in cancer care delivery: state of the evidence, opportunities for research, and future directions JCO 40 2022 2291 2294 10.1200/JCO.21.02184 35353552 · DOI

Cited by

Sorted by citations

  • User-Centered Design for Digital Patient-Navigation Tools in Oncology: Scoping Review

    Kheirinejad, S., White, B. M., Kheirkhah Rahimabad, P., Zink, J. A., Hashtarkhani, S., Kumsa, F. A., Rashid, R., Chinthala, L., Brett, C. L., Davis, R. L., et al. (2026) · JMIR Human Factors · doi:10.2196/87686

    “As examples in early discovery, Carr et al [12] examined barriers in the workflows of patient navigators supporting patients with breast cancer and explored how an mHealth app could help improve their care delivery and coordination, Ankrah et al [24] interviewed childhood cancer survivors and…”

Authors
Carr, A. L., Vinod, N., Farha, P., Lu, T., Farha, M. J., & Graves, K. D.
Affiliations
  • Georgetown University (US)
  • Howard University (US)
  • MedStar Good Samaritan Hospital (US)
Corresponding author
Carr, Alaina L.
ORCID
Venue
PEC Innovation
Publisher
Elsevier BV
Published
2023-12
Volume
3
Pages
100226
ISSN
2772-6282 (ISSN-L)
DOI
10.1016/j.pecinn.2023.100226
PMC
PMC10583173
OpenAlex
W4387341597
Cited by
6
References
7
Citations by year
2026: 4 · 2025: 1 · 2024: 1
FWCI
2.12
Type
journal article
Language
en
Open access
Licence
Locations
  • PEC Innovation (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Small Business Innovation Research (75N91020C00033)
  • SBIR STTR
  • National Cancer Institute (1K99CA277588-01, T32CA261787)
Topics
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Physical Sciences › Computer Science › Human-Computer Interaction › Usability and User Interface Design
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
Keywords
patient navigators, breast cancer, mobile health apps, socio-technical systems, workflow barriers, human-centered design, interoperability, insurance coverage, communication difficulties, cancer care continuum

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