Engaging limited English proficient and ethnically diverse low-income women in health research: A randomized trial of a patient navigator intervention.
Alyssa Nickell, Susan L Stewart, Nancy J Burke and 6 others
PMID 30772115WHAT IT FOUND
Patient navigator education did not increase breast cancer patients' and survivors' independent health research information-seeking.
It improved knowledge that research is not only drug trials, but only 30% in each arm sought information.
Key findings
01There was no statistically significant difference between the navigator intervention and the card-only control in seeking information about health research; 30% of participants in each arm reported talking to someone, calling a number, or visiting a website listed on the card.
02The intervention increased knowledge that not all health research studies are about drugs or treatments, from 32% to 48%, while the control group did not increase, from 43% to 30%; the difference between arms was statistically significant.
03In multivariable analysis, higher pre-test knowledge and greater pre-post knowledge gain were associated with seeking information, while greater distrust in doctors was associated with less seeking; study arm was not associated.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was conducted in one community organization with women breast cancer patients and survivors who had low care navigation needs, spoke English, Cantonese or Spanish, and had completed active treatment or were involved in wellness activities, so it may not apply to patients needing intensive navigation, other languages, or earlier treatment. The intervention bundled five navigator-delivered components, so the contribution of any single component cannot be separated. The primary outcome was null. Secondary knowledge findings were positive, but they do not show that the intervention changed information-seeking. Follow-up was one month after enrollment, so the study does not show longer-term research participation. The paper does not report the number analysed or dropout details after recruitment and randomization. The online resource remained English-only for study information, many listed studies were not aligned with participants' interests, and observational studies often had English-only surveys, limiting the usefulness of the resources. Qualitative interviews included only 11 intervention-arm participants, so themes are not generalizable to all trial participants.
Declared interests
The authors have no conflicts of interest.
The easy way to misread this
Do not conclude that the navigator intervention increased health research information-seeking. The primary outcome was null; only a secondary knowledge outcome improved, and confidence in finding information did not change.