Patient Navigation Approach to Tobacco Prevention, Assessment & Intervention

Project Overview:

The Maine Primary Care Association (MPCA) proposes to build off the success of patient navigation for cancer prevention in community health centers, applying the model to tobacco assessment and cessation in two rural community health centers (CHCs). This project would expand and refine the concept of patient navigation in community health center settings to an area where they have not traditionally utilized the practice – tobacco intervention.

The concept of patient navigation originated with Dr. Harold P. Freeman in 1990 for the purpose of eliminating barriers to timely cancer screening, diagnosis, treatment, and supportive care. A review of the literature has found great variation in the personnel providing patient navigation services. For example, patient navigation services have frequently been provided by a lay patient navigator, while several programs characterized varied backgrounds for those performing the navigator function. The first patient navigation programs combined community and culturally sensitive care-coordination with aspects of disease management programs to reduce racial, ethnic, and poverty-driven disparities in care. 

The Challenge:

While Maine health centers excel at screening for tobacco use (2013 average tobacco use screening rate of 93.7% statewide), only 77.5% of tobacco users are provided cessation counseling. By applying the patient navigation process, health centers will reduce barriers to tobacco cessation intervention, thus increasing the number of individuals connected to appropriate counseling or follow up treatment for tobacco use.

Project Benefits:

This project focuses on improving screening and intervention for tobacco use in two rural community health centers: Islands Community Services, Inc. and St. Croix Regional Family Health Center. The lessons learned at these two sites will be aggregated and shared broadly with the patient navigation network. The benefits of our efforts will be felt by the patients at the health centers, as well as the health centers themselves as they see improved health outcomes for their patients. We also plan to share the results of this pilot to test the patient navigation approach for tobacco with other CHCs around the state and region.

Ultimately, MPCA seeks to improve patient care at the point of service and reduce the gap between tobacco screening and connection to cessation intervention services for health center patients. We propose doing this through adapting the patient navigation model for use with tobacco cessation, and to spread the learnings through the patient navigation online forum for others to use.

The long-term aim of our project is to facilitate systemic changes in health center settings for tobacco intervention. This will consist of an internal review of workflows, policies and procedures. Upon review of existing health center operations, each site will complete two quality improvement cycles and improve upon identified gaps in workflow, policies or procedures.

This effort has the potential to be spread through the patient navigation stakeholder group, which includes a statewide network of primary care and community stakeholders. This could be done through disseminating best practices aligned with patient navigation, inclusion of both the clinical and community approaches to intervention and support; and keeping the patient’s needs and preferences at the center of the care.

Maine Primary Care Association
Grant Amount Given: 
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Types of Cancer: 

Maine Cancer Foundation Grants to this Organization:

Year Program Amount Category Organization
2015 Patient Navigation Approach to Tobacco Prevention, Assessment & Intervention $30,000 Screening Maine Primary Care Association