79 - Navigating Black Patients Through Racism and Bias in Healthcare Course: Describing and affirming a national need to support changes in workforce development

Abstract Information:

Background: A recent landscape analysis1 of ten U.S. metropolitan cities concluded that disproportionate breast cancer outcomes observed by Black women are further exacerbated, in part, by systemic racism and cultural barriers. While patient navigation is an effective tool that can be utilized to improve breast health outcomes through relational and cultural compatibility between patients and navigators2, there is an identified gap in availability of trained navigators that are knowledgeable and capable of equitability navigating patients through these identified barriers. In December 2021, in support of closing this gap, Susan G. Komen developed, Navigating Black Patients Through Racism and Bias in Healthcare, an online training course to diversify the navigation workforce. Utilizing findings from the landscape analysis, recruitment for course participation was prioritized in ten metropolitan areas, known as priority areas, with the highest breast cancer inequities among Black women – Atlanta, GA; Chicago, IL; Dallas-Fort Worth, TX; Houston, TX; Los Angeles, CA; Memphis, TN; Philadelphia, PA; St. Louis, MO; Virginia Beach, VA; and National Capital Area. With a full year since the course was implemented, we seek to describe and reaffirm the specific need for a diverse patient navigation workforce, especially in priority areas, by describing the course registrant population.

Methods: This study analyzes the group of people that registered for the Navigating Black Patients Through Racism and Bias in Healthcare. Utilizing one year of registration data at the national level, the study conducted a descriptive analysis of registrants’ characteristics including geographic location, understanding and self-efficacy related to navigating racism and bias, and their course expectation prior to starting the course. To support alignment with findings from the landscape analysis, the study further assesses a subgroup of registrants located in priority areas.

Results: An occupationally diverse group of 200 people registered for the course in the first year, with the majority (67%) being racial or ethnic minorities and 60% living in or near a priority area. Registration data revealed that over 80% of registrants believe they lacked understanding of how to navigate patients through racism and 97% expressed moderate to significant need for support to adequately navigate patients through these barriers. Comparatively, registrants in priority areas rated themselves as having a lower understanding compared to the larger group, while racial and ethnic registrants expressed having a slightly higher understanding. Nearly all registrants voiced a course expectation for better understanding of racism and biases in the healthcare setting and/or strategies to reduce health disparities and improve health outcomes.

Conclusions: Based on study findings, we can reaffirm the need for this course as it highlights the deficiency in readily prepared professionals to address systemic racism and bias in healthcare, especially in areas with the largest observed breast cancer disparities among Black women. Data also illustrate there is public interest to increase one’s knowledge and ability to create equitable spaces for patients in healthcare. As such, Komen will continue training and diversifying a professional workforce to drive equitable breast health outcomes and will reassess future registrant characteristics to ensure audience alignment.

Relevance Statement: 1. Susan G. Komen. (2021). Closing the Breast Cancer Gap: A Roadmap to Save the Lives of Black Women in America. https://www.komen.org/wp-content/uploads/Landscape_Analysis_Summary.pdf 2. Dixit, N., Rugo, N., Burke, N. (2021). Navigating a Path to Equity in Cancer Care: The Role of Patient Navigation. American Society of Clinical Oncology Educational Book. 3-10. DOI: 10.1200/EDBK_100026. Relevance: This study emphasizes the importance of affirming the alignment of need for this training course through describing the characteristics of registrants with the findings of a landscape analysis. Through this process evaluation, we sought to support the need of this program to strengthening the patient navigation workforce with professionals that are capable of addressing and navigating Black women through racism and bias. Data from this assessment confirm the need for this course to assist with improving health breast health inequities.