Table 1 General characteristics of the studies included

Donaldson (2012)

959 breast cancer and 411 colorectal cancer patients; African American, White, Hispanic and other race; Low-income/ underserved populations.

Breast, Colorectal

Screening to diagnostic resolution

Characteristics: lay patient navigator (Washington, DC); non-clinically licensed patient navigator (Kentucky); non-clinically licensed patient navigator, nurse-LPN, bilingual outreach worker (Louisiana)

Tasks: Unspecified

2 arms among 3 community hospitals: comparison between usual care (1), PN program (2)

12 months

Elkin (2012)

25,481 low-income, high risk, urban, majority Hispanic

Colorectal

To Screening

Characteristics: Lay health educators

Tasks: 1. appointment reminders; 2. colonoscopy and bowel preparation education; 3. management of patient concerns; 4. referral to financial services

Quasi-experimental with pre-post; 2 arms (3 intervention and 3 comparison hospitals); usual care (1), PN program (2)

Pre-program period: 12 months

Post-program period: 1 month

Jandorf (2013)

Socioeconomically disadvantaged

700 patients referred for colonoscopy by primary care providers between May 2008–May 2010, age 50+, due for colorectal screening (colonoscopy > 5 years, not up to date with other forms of screening)

Colorectal

To Screening

Health worker

Characteristics: 3 types of navigators were used due to objectives for a different study using same patient population: 1. Professional navigators with formal health education training, African American race concordant; 2. Peer navigators (“lay” individuals > 50 years old from East Harlem who had undergone colonoscopy) with study-provided training, African American race concordant; 3. Professional navigators, language concordant but not necessarily race concordant for non-African American patients

Tasks: 1. Appointment scheduling; 2. Patient education on colonoscopy procedure and preparation; 3. Appointment reminder calls (multiple); 4. Transportation needs assessment; 5. Confirmation that mailed information was received; 6. Concerns addressed; 7. Depending on study arm, script about importance of colorectal cancer screening, discussion of navigator’s colonoscopy experience, and/or impact of colorectal cancer on African Americans.

RCT

Single-arm (4 navigation arms for separate RCT study were aggregated and not compared in this study)

24 months

Bensink (2014)

10,521 patients with breast, prostate, colorectal or cervical cancer screening abnormalities (5063 navigated, 5458 usual care). Mostly minority (39% Hispanic, 32% African American), 40% publically insured adult population.

Breast, Prostate, Colorectal, Cervical

Screening to diagnostic resolution

Characteristics: Professional health workers and/or lay persons

Tasks: 1. “support and guidance for timely access to the cancer care system,” 2. “addressing barriers,” 3. “facilitating quality care.”

Research designs varied among sites: Individually RCT (2 sites); Group RCT (2 sites); Quasi-experimental (5 sites)

12 months

Ladabaum (2015)

Hypothetical cohort of 10,000 adults (43% African American, 49% Hispanic, 4% white, 4% other) entered into model at age 50 and followed until age 100 or death

Colorectal

To Screening

Characteristics: Unspecified

Tasks: Unspecified

Comparison between (1) usual care (2) PN program (3) Fecal occult blood test or fecal immunochemical test.

Life time

Lairson (2014)

945 patients age 50–79 noncompliant with USPSTF colorectal cancer screening recommendations, with visit at participating practice in the last 2 years), mostly White

Colorectal

To Screening

Characteristics: Nurse navigator

Tasks: 1. Structured follow up call to confirm receipt of mailed CRC screening materials and to answer questions; 2. Reassessment of screening preference; 3. Encourage screening completion; 4. Provide instructions for stool blood test or identify colonoscopy locations (no appointment scheduling); 5. Provision of additional information if screening preference changed.

RCT, pre-post, 3 arms (usual care; mailed information and referral phone number; mailed information and nurse navigator follow up)

12 months

Blakely (2015)

Stage III colon cancer patients

Colorectal

Diagnosis through Treatment and End of Life

Characteristics: hospital-based

clinical nurse specialist

Tasks: 1. “providing information and support for the patient,” 2. “identifying and addressing patient barriers to accessing care (transport/ financial/ social)”, 3. “coordinating arrangements for pre-operative assessments and hospital admission,” 4. “optimising post-operative care,” 5. “Tracking investigations and appointments,” 6. “ensuring the patient is discussed at a multidisciplinary team meeting,” 7. “Making referrals as necessary,” 8. “acting on any administrative delays.”

Comparison between (1) Usual care; (2) PN program.

Lifetime after diagnosis

Meenan (2015)

Patients due for colorectal screening (colonoscopy > 9 years, sigmoidoscopy > 4 years, fecal occult blood test > 9 months)

Colorectal

To Screening

Characteristics: 2 part-time nurse navigators (combined 10% full-time equivalent weekly)

Tasks: 1. assistance with colorectal screening decision-making; 2. follow up on fecal occult blood tests with no laboratory results after 3 weeks; 3. assessment of colorectal cancer risk; 4. review of procedural risk; 5. motivational counseling to define patient screening intent; 6. creation of patient-shared screening action plan; 7. referrals assistance; 8. appointment assistance; 9. endoscopy preparation assistance; 10. test completion tracking.

RCT, 4 arms: (1) usual care; (2) automated electronic health record-linked mailings; (3) automated mailing with telephone assistance; (4) automated mailing, telephone assistance, and nurse navigation services

24 months

Wilson (2015)

461 Hispanic men, low-income, uninsured, 50+ years old, member of Bexar County’s financial assistance program, with no colorectal cancer screening in the last 10 years.

Colorectal

To Screening

Characteristics: Bilingual community health worker, Bilingual program coordinator

Tasks: 1. colorectal cancer and colonoscopy patient education; 2. discussions on colorectal cancer with immediate family; 3. liaison between Hispanic communities and patient care services; 4. encouragement of colonoscopy appointment scheduling; 5. addressing questions and concerns throughout process, 6. home visits as needed, 7.transportation assistance, 8. Social support, 9. Appointment coordination and scheduling, 10. Setup of appointment reminders.

Comparison between (1) Usual care, (2) PN program.

24 months