Engaging limited English proficient and ethnically diverse low-income women in health research: A randomized trial of a patient navigator intervention

Abstract

Objective: Evaluate a community-based navigator intervention to increase breast cancer patients' and survivors' access to information about health research participation opportunities.

Methods: In the context of a Community Based Participatory Research collaboration, we conducted a prospective randomized controlled trial of the Health Research Engagement Intervention with pre- and post-intervention surveys (n = 133). The primary outcome was health research information-seeking behavior. Secondary outcomes were health research knowledge, willingness to participate in health research, and health empowerment. Qualitative interviews (n = 11) elucidated participant perspectives on the intervention.

Results: There was no statistically significant difference between intervention and control groups' information-seeking behavior. Knowledge that not all health research studies are about drugs or treatments increased significantly from pre- to post-test among intervention group participants (32% to 48%, p = 0.012), but not in the control group (43% to 30%, p = 0.059); the difference between arms was statistically significant (p = 0.0012). Although survey responses indicated willingness to participate, qualitative interviews identified competing priorities that limited participants' motivation to seek enrollment information.

Conclusions and practice implications: Community-based navigators are a trusted, and therefore promising link between health research and low-income underserved communities. However, systemic barriers in health research infrastructures need to be addressed to include low income, LEP and immigrant populations.

Keywords: CBPR; Cancer; Clinical trials; Community based participatory research; Disparities; Information-Seeking behavior; LEP; Limited English proficient; Patient navigation.