Overview

This project directly aligns with DHS infrastructure and operations as it aims to evaluate and inform the optimization and long-term sustainability of the DHS Cancer Navigation Program, a cancer navigation program implemented DHS wide in 2022. In 2020, LA County DHS identified cancer navigation with safety-net patients as one of the most significant factors impacting cancer patient access and outcomes, which led to the launch of a comprehensive system-wide Cancer Navigation Program (CNP) to provide equitable and effective cancer care. The CNP has now undergone 18 months of implementation across all DHS sites (LA General, Harbor-UCLA, Olive View, Martin Luther King, and High Desert) with the purpose of navigating all patients to treatment.

Through a mixed-methods, hybrid-effectiveness type II study design, we will evaluate the effectiveness of the DHS Cancer Navigation Program on improving timeliness to oncology care following cancer diagnosis, receipt of guideline-directed treatment and overall care utilization. We will evaluate implementation outcomes, guided by the RE-AIM framework, to assess reach, adoption, implementation, and overall program maintenance and sustainability across DHS sites and cancer lines. The evaluation design, measures, and data analysis and qualitative data collection process will be informed by leaders of the Cancer Navigation Program using a learning health systems perspective within the DHS clinic sites that the program is currently operating.

This study's aims are:
1) Evaluate the effectiveness of the DHS Cancer Navigation Program on improving cancer care access, quality, equity, and patient experience among DHS patients;
2) Assess the implementation outcomes of the DHS Cancer Navigation Program and identify core components and practices that are needed to enhance sustainability, optimization and scale-up.

While there is ample literature on the importance of patient navigation and care coordination for oncology patients, few studies are based in large municipal health systems, and none have focused on settings the size of DHS. Thus, this study would contribute to our understanding of best practices and effective strategies for oncology navigation within one of the largest county municipal health systems, shedding light on the benefits of investing in care navigation for public-safety net populations and beyond.

NIH Funding Acknowledgment: Important - All publications resulting from the utilization of SC CTSI resources are required to credit the SC CTSI grant by including the NIH funding acknowledgment and must comply with the NIH Public Access Policy.