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Crafting a policy-relevant research agenda for patient navigation in cancer care.

Journal:  Cancer, 117: 3563–3572. doi: 10.1002/cncr.26269
Authors: B. Ashleigh Guadagnolo MD, MPH, Daniel Dohan PhD, Peter Raich MD
Article first published online: 20 JUL 2011

Abstract
BACKGROUND:
Racial and ethnic minorities as well as other vulnerable populations experience disparate cancer-related health outcomes. Patient navigation is an emerging health care delivery innovation that offers promise in improving quality of cancer care delivery to these patients who experience unique health-access barriers. Metrics are needed to evaluate whether patient navigation can improve quality of care delivery, health outcomes, and overall value in health care during diagnosis and treatment of cancer.

METHODS:
Information regarding the current state of the science examining patient navigation interventions was gathered via search of the published scientific literature. A focus group of providers, patient navigators, and health-policy experts was convened as part of the Patient Navigation Leadership Summit sponsored by the American Cancer Society. Key metrics were identified for assessing the efficacy of patient navigation in cancer diagnosis and treatment.

RESULTS:
Patient navigation data exist for all stages of cancer care; however, the literature is more robust for its implementation during prevention, screening, and early diagnostic workup of cancer. Relatively fewer data are reported for outcomes and efficacy of patient navigation during cancer treatment. Metrics are proposed for a policy-relevant research agenda to evaluate the efficacy of patient navigation in cancer diagnosis and treatment.

CONCLUSIONS:
Patient navigation is understudied with respect to its use in cancer diagnosis and treatment. Core metrics are defined to evaluate its efficacy in improving outcomes and mitigating health-access barriers.

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La Vida Mia portrays the life of a Latina agricultural worker who is experiencing domestic violence in her personal life.  The video depicts the reality that abuse victims face and the effect the abuse has on their life.  Warning, this video may contain graphic scenarios as it displays abusive situations.  

This photonovella accompanies the video "La Vida Mia"

Please contact Adrian Velasquez, Family Violence Initiative Coordinator at MCN if you would like to receive a DVD version of this educational video.

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Asthma Action Plan for Adults and Children. An asthma action plan completion/instructions form is also included.

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Three printable brochures on Asthma, Lead and Pesticides produced by Farmworker Justice. 

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A one-page patient education handout that simply discusses self-management goal setting.
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A self management tool to help patients manage their own asthma.
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This chart shows which vaccinations you should have to protect your health.
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This flyer gives what to do and not do while traveling. Created by Migrant Clinicians Network Diabetes Program Funding provided by the Diabetes Program, Texas Department of Health. Available in Spanish and English.

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This flyer describes oral health for the diabetic.  It is in English and Spanish. 

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This flyer explains diabetes and kidney disease.  Available in Spanish and English.

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This flyer describes depression and the steps to health living.  Available in Spanish and English. 

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To provide the RN with guidelines to assure that the basic elements of diabetes management are taught to patients with diabetes.

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The Denver Foundation is a community foundation. Community foundations are endowments - a permanent pool of money contributed by numerous local donors to benefit charitable causes.
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Are You Ready? provides a step-by-step approach to disaster preparedness by walking the reader through how to get informed about local emergency plans, how to identify hazards that affect their local area, and how to develop and maintain an emergency communications plan and disaster supplies kit. Other topics covered include evacuation, emergency public shelters, animals in disaster, and information specific to people with disabilities.

Are You Ready? also provides in-depth information on specific hazards including what to do before, during, and after each hazard type.

This link takes you directly to the full PDF document.

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Use the link below to access MCN's Rapid Assessment Tool to help adolescent farmworkers identify agricultural tasks they perform in agriculture and facilitate clinician understanding about the health risks associated with it.  Youth worker images are adapted and reproduced with permission from the National Children Center for Rural and Agricultural Health and Safety. Images copyrighted through Marshfield Clinic, Marshfield, Wisconsin.

If computers and internet access are unavailable where patient care is provided, the worker assessment sheet and clinician information grid are available in PDF.

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The aim of this paper is to describe various approaches that have been taken or could be taken to avoid the linguistic incompatibility that impedes full and equal access to health care on the part of health care providers and their patients when they do not speak the same language.

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Issue Brief Co-Authored by Health Outreach Partners and the Kaiser Family Foundation
Information provided by the Kaiser Commission on Medicaid and the Uninsured
Publication Number: 8249
Publish Date: 2011-10-27

This brief examines how the Affordable Care Act (ACA) may impact immigrant families based on data collected from Outreach/Eligibility Workers in four regions of the country and supported by needs data from several health outreach programs around the country.  You will note that the pivotal role of Community Health Centers (CHCs)  to connect immigrant families to coverage and care is highlighted.  Migrant Health Centers and Homeless Health Centers are specifically cited because of their history of pioneering and strengthening many of the models and strategies that will be needed to connect immigrant families to health coverage and care come 2014.

Download report here.

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EthnoMed contains information about cultural beliefs, medical issues and related topics pertinent to the health care of immigrants to Seattle or the US, many of whom are refugees fleeing war-torn parts of the world. Search the site via culture and clinical topics.

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The importance of clinical diagnostic tools and biomonitoring of exposures to pesticides as well the role of clinicians in pesticide reporting and the challenges clinicians face in accurately diagnosing patients exposed to pesticides are described in a presentation by Matthew Keifer, MD, MPH and Amy K. Liebman, MPA. Click on the link for an APHA policy resolution underscoring the need for clinical diagnostic tools and biomomitoring of exposures to pesticides. This policy supports the information outlined by in the presentation.

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HEAT ILLNESS CAN BE DEADLY. Every year, thousands of workers become sick from exposure to heat, and some even die. These illnesses and deaths are preventable.

OSHA has now posted a new Heat Illness Web Page that includes educational materials in English and Spanish, including low-literacy fact sheets for workers, worksite and community posters, and a public service announcement from Secretary of Labor Hilda Solis.  The Web page also includes a video from Assistant Secretary Dr. David Michaels (in English with a Spanish transcript).  OSHA will be posting additional materials on the Heat Illness Web page, including a lesson plan that employers can use to train their workers to stay safe in the heat and a heat index Smartphone app. 

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Three newsletters the NHSC has developed for each of its primary member segments -- Clinicians in Service, Scholars in School, and NHSC sites.

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The Health Protection Agency's role is to provide an integrated approach to protecting UK public health through the provision of support and advice to the NHS, local authorities, emergency services, other arms length bodies, the Department of Health and the devolved administrations.

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Mesothelioma is a rare cancer that occurs in the lungs. In addition to affecting the lungs, it can also result in complications that affect the heart and the abdomen. Every year, there are as many as 3,000 people diagnosed with mesothelioma. Men are four times more likely than women to be diagnosed with mesothelioma, and with the exception of benign mesothelioma all forms of the disease are terminal

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Through radiomexicointernacional, listen to unique programming to meet and know about Mexico. www.radiomexicointernacional.imer.gob.mx transmits content on a wide variety of topics in Spanish, English and French, and some Indian languages. With rich programming topics, languages and Mexican music, resurfaces Radio Mexico International, now via internet.

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Developed by MCN with funding from the Texas Department of State Health Services. This resource provides a guideline for healthy foods to eat in a page-size poster illustrating healthy foods in the right amounts, at which times, which foods to limit. Available in Spanish and English.

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Fighting cancer is difficult enough, but living with it is even tougher - and that's where the Cleaning for A Reason Foundation steps in.  This nonprofit offers free professional housecleaning, and maid services to improve the lives of women undergoing treatment for cancer - any type of cancer.

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From Health Reources and Services Administration this resource is available in Spanish and english. In an accessible, easy-to-read format, the Seasonal Flu guide provides: flu facts; every day prevention steps; and ways that community leaders can contribute to the flu prevention effort. This guide is an important fight the flu resource for our Spanish-speaking community and faith-based partners.

Order printed copies of the Seasonal Flu guide (in English or in Spanish) from the HHS Partnership Center by emailing partnerships@hhs.gov. Please include # of copies requested, mailing address (or interoffice mail stop) and person of contact in the email. Please specify if you are ordering the English or the Spanish version.

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https://www3.marshfieldclinic.org/nccrahs/default.aspx?page=nfmc_nccrahs_saghaf 

Seven guidelines in English and Spanish. Colorful, illustrated poster address supervisor responsibilities for ensuring work conditions are appropriate and adequate . Training and supervision tips, specific to teens and to each job, are provided. Developed by National Children’s Center for Rural and Agricultural Health and Safety.

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http://www.nagcat.org/nagcat/default.aspx?page=nagcat_guidelines_posters

Guidelines for parents to match child's growth and development with the requirements of different farm chores in order to lessen the risk of farm related disease or injury in children and teenagers. North American Guidelines for Children's Agricultural Tasks was developed by the National Children's Center for Rural Agricultural Health and Safety.

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The Diabetes and Healthy Eyes Toolkit helps community health workers provide sight-saving information to people with diabetes. The Toolkit is available in Spanish and English and includes a:

  • Diabetes and Healthy Eyes Flipchart to help community health workers educate people with diabetes about eye diseases in a small group setting.
  • Diabetes and Healthy Eyes Module for background information and materials to assist community health workers in using the flipchart.
  • Watch Out for Your Vision! Brochure to distribute to people with diabetes to educate them about eye disease and the importance of getting a dilated eye exam at least once a year.
  • Medicare Benefits Card to promote the glaucoma and diabetic eye disease benefit under Medicare and inform the public about eligibility.
  • Publications Order Form to obtain diabetic eye disease materials and resources for distributing to people in your community.
  • Evaluation Form to share your thoughts and experiences using the Diabetes and Healthy Eyes Toolkit.
  • CD-ROM with copies of the module, flipchart and handouts.

Additional materials include a:

  • TRACK Diabetes Magnet (English only) to provide tips to people with diabetes about keeping their health on TRACK.
  • Lo bello entra por los ojos...no deje que la diabetes cierre esa ventana (Beauty enters through the eyes. Don't let diabetes close the window.) Poster (Spanish only) to remind people with diabetes about receiving an annual dilated eye exam and offer tips about how to control diabetes.
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