Assessing Patient Navigation Activities

Coping with abnormal results in cancer screenings or an actual diagnosis of cancer can be very challenging even under the best of circumstances. Research has shown that ethnicity, socioeconomic status and geography can all act as barriers to seeking, obtaining and completing the healthcare needed to diagnose and treat cancer promptly. Delays in diagnosis and treatment, in turn, contribute to the higher cancer mortality rates among patients from racial or ethnic minority groups, patients who are economically disadvantaged and patients who live in medically underserved areas.


Eloise Caggiano, Program Director, Avon Walk for Breast Cancer; Olivia Simonetti, Dr. Battaglia’s daughter; Taisy Conk, Patient Navigator, Women’s Health Unit, Boston Medical Center; Tracy Battaglia, MD, MPH; Assistant Professor of Medicine and Epidemiology; Associate Program Director, Preventive Medicine Residency Program, Boston University School of Medicine; Karen Freund, MD, MPH; Professor of Medicine and Epidemiology; Chief, Women’s Health Unit, Women’s Health Interdisciplinary Research, Center Boston University School of Medicine; LaVondea Elow, Administrative Assistant, Boston University School of Medicine; Marc Hurlbert, PhD; Director, Avon Foundation Breast Cancer Crusade; Samantha Simonetti, Dr. Battaglia’s daughter

Interest in using patient navigation to assist the most vulnerable patient populations has grown over the past decade. Patient navigators may be healthcare professionals or laypersons. They are often members of the communities they serve. The tasks performed by patient navigators vary widely, but examples of typical activities include:

  • scheduling medical examinations and tests
  • accompanying patients to medical appointments
  • securing financial assistance to cover medical costs, time lost from work and other expenses
  • facilitating insurance claims or other paperwork
  • providing translation services
  • arranging needed services at home, such as child or elder care, while the patient attends appointments or is hospitalized
  • assisting with other family, social or legal issues that make it difficult for the patient to obtain the medical care needed

As part of its mission, the Avon Foundation has provided more than $450 million in funding to support a number of breast health programs and medical research across the United States. Many of the community and public hospitals use some form of patient navigation. However, to date, the scope of these programs and the activities that comprise the work of the patient navigators have not been assessed. The lack of a systematic assessment makes it difficult to identify and promote successful navigation practices and programs.

To address this need, the Avon Foundation is sponsoring a two-year study of its funded programs. A team of researchers, led by Dr. Victoria Parker at the Boston University School of Public Health and Dr. Tracy Battaglia at the Boston University School of Medicine, will document the variety and scope of navigation activities currently provided at Avon-funded breast health sites. The goal is to understand how patient navigation works and to answer key questions such as: What makes a navigator effective? Do successful navigation programs have certain features in common?

In the first phase of the study, the team will conduct a comprehensive inventory of breast health program activities offered at Avon-funded sites across the United States. In the second phase, the researchers will select 10 sites for more detailed observation of navigators’ activities. The goal will be to learn from the navigators themselves how the challenging work of patient navigation is performed.

For further information about this study, please contact Jenniffer Leyson at (617) 638-5849. To learn more about the Avon Foundation, please visit