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Patient Navigation 2.0: Addressing the Challenge of Scaling Navigation through Checklist-based Implementation

Award Number: R01CA163830
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 03/15/2012
PERIOD OF PERFORMANCE END DATE: 07/31/2025

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Patient Navigation 2.0: Addressing the Challenge of Scaling Navigation through Checklist-based Implementation - Through the work of a well-established research partnership among the Chinese American Service League (CASL), Mercy Hospital & Medical Center (Mercy), and Northwestern University (NU), our team completed a trial evaluating a one-on-one patient navigation (PN) intervention for breast and cervical cancer tailored to Chicago’s Chinatown. Our completed trial and others have demonstrated that PN is effective in improving consistency of cancer care and addressing Social Determinants of Health (SDoH) among underserved populations. Unfortunately, current standard one-on-one PN is difficult to scale and sustain without intensive financial resources, which limits one-on-one cancer PN to a temporary “Band-Aid” for fragmented healthcare systems. We have an opportunity to apply our team’s lessons learned from our completed PN trial in order to create a paradigm shift in PN to produce systems change in cancer care delivery to meet the needs of underserved populations. To do so, we propose a learning health system PN 2.0 Checklist implementation strategy that scales implementation of PN across cancers and builds a sustainable team-based checklist that will support coordination and integration of SDoH-related efforts across community oncology and community social service settings. In Aim 1, we will employ a design-thinking framework of co-creation and iterative prototyping to develop the PN 2.0 Checklist, transforming one-on-one PN into a learning health system PN approach centered around a team-based checklist that leverages the PN evidence base and active participation of community oncology and community social service stakeholders. In Aim 2, through a Hybrid Type 2 randomized effectiveness- implementation pragmatic trial, we will compare the effectiveness (non-inferiority) of the PN 2.0 Checklist relative to one-on-one PN in resolving SDoH barriers and increasing patient receipt of clinical cancer preventive services. N=600 Chinese adults recruited from Chicago’s Chinatown will be randomized to standard one-on-one cancer PN (control) or cancer PN 2.0 Checklist (intervention). The primary outcome is an adjusted, composite proportion of SDoH barriers resolved and completion of U.S. Preventive Services Task Force recommended cancer-related screenings, behavioral counseling, and immunizations, collected via chart review and patient surveys. We will explore the effect of the PN 2.0 Checklist on organizational change and patient assessment of care team quality using pre/post surveys. Secondary outcomes include time to diagnostic resolution and time to treatment initiation. In Aim 3, we will use the Consolidated Framework for Implementation Research (CFIR) and mixed-methods (process evaluation, qualitative interviews, cost analysis) to evaluate the implementation of the learning health system PN 2.0 Checklist strategy. Results will have important implications for implementation, sustainability, and scaling of PN in community oncology settings where medically underserved U.S. immigrant populations, such as linguistically isolated Chinese, receive the bulk of their cancer care.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $502,590 )
2024	2024	NORTHWESTERN UNIVERSITY	633 CLARK ST	EVANSTON	IL	60208	COOK	USA	Cancer Cause and Prevention Research	000	11	7/19/2024	NON-COMPETING CONTINUATION	$502,590
														Subtotal = $502,590

Issue Date FY: 2023 ( Subtotal = $520,527 )
2023	2023	NORTHWESTERN UNIVERSITY	633 CLARK ST	EVANSTON	IL	60208	COOK	USA	Cancer Cause and Prevention Research	000	10	7/10/2023	NON-COMPETING CONTINUATION	$520,527
														Subtotal = $520,527

Issue Date FY: 2022 ( Subtotal = $522,596 )
2022	2022	NORTHWESTERN UNIVERSITY	633 CLARK ST	EVANSTON	IL	60208	COOK	USA	Cancer Cause and Prevention Research	001	9	8/9/2022	NON-COMPETING CONTINUATION	$522,596
2022	2021	NORTHWESTERN UNIVERSITY	633 CLARK ST	EVANSTON	IL	60208	COOK	USA	Cancer Cause and Prevention Research	000	8	4/27/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $522,596

Issue Date FY: 2021 ( Subtotal = $575,170 )
2021	2021	NORTHWESTERN UNIVERSITY	633 CLARK ST	EVANSTON	IL	60208	COOK	USA	Cancer Cause and Prevention Research	000	8	3/10/2021	NON-COMPETING CONTINUATION	$575,170
														Subtotal = $575,170

Issue Date FY: 2020 ( Subtotal = $620,419 )
2020	2020	NORTHWESTERN UNIVERSITY	633 CLARK ST	EVANSTON	IL	60208	COOK	USA	Cancer Cause and Prevention Research	000	7	3/20/2020	COMPETING CONTINUATION	$620,419
														Subtotal = $620,419

Issue Date FY: 2019 ( Subtotal = -$79,910 )
2019	2017	NORTHWESTERN UNIVERSITY	633 CLARK ST	EVANSTON	IL	60208	COOK	USA	Cancer Cause and Prevention Research	000	6	7/10/2019	NON-COMPETING CONTINUATION	-$79,910
														Subtotal = -$79,910

Issue Date FY: 2017 ( Subtotal = $523,819 )
2017	2017	NORTHWESTERN UNIVERSITY	633 CLARK ST	EVANSTON	IL	60208	COOK	USA	Cancer Cause and Prevention Research	001	6	6/7/2017	NON-COMPETING CONTINUATION	$20,971
2017	2017	NORTHWESTERN UNIVERSITY	633 CLARK ST	EVANSTON	IL	60208	COOK	USA	Cancer Cause and Prevention Research	000	6	2/17/2017	NON-COMPETING CONTINUATION	$502,848
														Subtotal = $523,819

Issue Date FY: 2016 ( Subtotal = $513,045 )
2016	2016	NORTHWESTERN UNIVERSITY	633 CLARK STREET	EVANSTON	IL	60208	COOK	USA	Cancer Cause and Prevention Research	000	5	3/4/2016	EXTENSION WITH OR WITHOUT FUNDS	$513,045
														Subtotal = $513,045

Issue Date FY: 2015 ( Subtotal = $524,244 )
2015	2015	NORTHWESTERN UNIVERSITY	633 CLARK STREET	EVANSTON	IL	60208	COOK	USA	Cancer Cause and Prevention Research	000	4	2/20/2015	NON-COMPETING CONTINUATION	$524,244
														Subtotal = $524,244

Issue Date FY: 2014 ( Subtotal = $496,397 )
2014	2014	NORTHWESTERN UNIVERSITY	633 CLARK STREET	EVANSTON	IL	60208	COOK	USA	Cancer Cause and Prevention Research	000	3	3/5/2014	NON-COMPETING CONTINUATION	$460,575
2014	2014	NORTHWESTERN UNIVERSITY	633 CLARK STREET	EVANSTON	IL	60208	COOK	USA	Cancer Cause and Prevention Research	001	3	4/23/2014	NON-COMPETING CONTINUATION	$35,822
														Subtotal = $496,397

Issue Date FY: 2013 ( Subtotal = $1 )
2013	2013	NORTHWESTERN UNIVERSITY	633 CLARK STREET	EVANSTON	IL	60208	COOK	USA	Cancer Cause and Prevention Research	000	2	7/25/2013	NON-COMPETING CONTINUATION	$1
														Subtotal = $1

Issue Date FY: 2012 ( Subtotal = $602,190 )
2012	2012	NORTHWESTERN UNIVERSITY	633 CLARK STREET	EVANSTON	IL	60208	COOK	USA	Cancer Cause and Prevention Research	000	1	3/9/2012	NEW	$602,190
														Subtotal = $602,190

Grand Total All Awards = $5,321,088

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Patient Navigation 2.0: Addressing the Challenge of Scaling Navigation through Checklist-based Implementation

Award Number: R01CA163830

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 03/15/2012

PERIOD OF PERFORMANCE END DATE: 07/31/2025

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