Standard 3.1 Patient Navigation Process A patient navigation process, driven by a triennial Community Needs Assessment is established to address health care disparities and barriers to cancer care. Resources to address identified barriers may be provided either on-site or by referral.

Standard 3.1 Patient Navigation Process Community Needs Assessment-Oncology 2017 completed and shared with Cancer Committee members. Community Outreach, Screening and Prevention planning should be based on the committee’s review of the information in the CNA.

Standard 3.1 Patient Navigation Process Meeting the standard requires identifying: Population to be served Health Disparities and barriers Description of the Navigation process to overcome barriers Documentation of activities and outcomes of the navigation process Areas for improvement, enhancement and future directions

Standard 3.1 Patient Navigation Process Highlights of CNA: 21% Hispanic; (11.69% in Northampton County) 30% living below the  200% poverty level; 10% uninsured,; 20.5% receiving Medicaid; 44% smokers (50.7% in Northampton County) 21.3% no Leisure time physical activity 78.9% inadequate fruit and vegetable consumption 25% no dental exam (27% in Northampton County) 34% no mammogram in past 2 years (Medicare enrollees) 30% no colonoscopy (36% on Northampton County) Age 50 and above – (better than Nat’l average 550 Lung screenings – less than 40 performed at 17th St. Lehigh or Northampton County had higher than national incidence rates of cancer for the following: Breast, cervical, colon, lung, prostate 183/408 lung cancers were diagnosed as stage 4 in 2016 (45%)

Standard 3.1 Patient Navigation Process Based on the info in the community assessment we propose that we focus our efforts on education about high risk behavior, primarily smoking, contributing to lung and head and neck cancers. We will plan educational activities regarding prevention and early detection of lung cancer and the value of lung screening for those eligible. We will continue our oral cancer screenings, including 17th St. Population to be served: Smokers at risk for Lung and Oral cancers

Standard 3.1 Patient Navigation Process We would like to provide education targeted to the Hispanic population regarding smoking cessation and lung cancer screening. Our goal would be to increase enrollment in smoking cessation programs, and to increase the number of lung screenings, especially at 17th St. Long term we can see if there is any impact in shifting the number of lung cancers diagnosed at an earlier stage.

Standard 3.1 Patient Navigation Process Health Disparities and barriers for Hispanics*: Lung Cancer is the leading cause of death for Hispanic males, #2 for females Less likely to be diagnosed at localized stage of disease Less likely to have received a healthcare professional’s advice to quit smoking Less likely to receive tobacco cessation services Less likely to have health insurance Lower use of preventive services such as cancer screening *Cancer Facts and Figures for Hispanics/Latinos 2015-2017 American Cancer Society

Standard 3.1 Patient Navigation Process Description of the Navigation process to overcome barriers: Planned educational activities at 17th St. utilizing bilingual staff to present on topics of lung cancer prevention, screening and tobacco cessation.(Standard 4.1) Assessment of participants as to if they meet eligibility criteria for lung screening and if they have a primary care physician. (Standard 4.1) Possibly have physician present who can assess eligibility and provide a script for lung screening. Facilitate patients referrals to lung screening and smoking cessation. (Standard 4.1 and 4.2) Oral cancer screenings (Standard 4.2)