In the diverse community of Chelsea, Mass., where people speak languages ranging from Bhutanese to Spanish, cancer patients often need help in navigating their healthcare journey.
To serve this need, a generous two-year grant from Golf Fights Cancer is helping Massachusetts General Hospital Chelsea HealthCare Center deliver world-class medical services to the people of this multiethnic community. The grant is funding a new cancer patient navigator position designed to improve access to cancer prevention and treatment.
The new position dedicates a trained staff member to lower barriers to care and guide underserved patients along the complicated pathways of cancer detection and treatment. It is an important component of Mass General’s wider efforts to provide high-quality healthcare to several Boston area communities.
To support this effort, Golf Fights Cancer, a Norton, Mass., nonprofit, taps the generosity of enthusiastic golfers committed to using well-targeted donations to make a difference in the battle against cancer.
Chelsea: A Multicultural Community
Chelsea is home to immigrants and refugees from all over the globe. Two-thirds of Chelsea residents report that English is not their first language.
We’re constantly trying to adapt our programming and our languages to meet the needs of our patients.
“We’re constantly trying to adapt our programming and our languages to meet the needs of our patients,” says Sarah Abernethy Oo, MSW, director of Community Health Improvement at MGH Chelsea HealthCare Center.
In 2001, The Avon Foundation for Women funded the first patient navigator program at MGH Chelsea to assist women who had an abnormal mammogram or breast exam. Since then, other grants have expanded navigator assistance to patients with cervical cancer, colon cancer and, most recently, lung cancer. Now, for the first time, the program will be unrestricted by type of cancer.
“What’s especially wonderful about the Golf Fights Cancer grant is that it targets all cancers,” says Ms. Oo. “We’ve never had the funding before to help people who have brain cancer or lymphoma, for example.”
Patient Navigator Guides Treatment
Patient navigators are community health workers who typically share a culture or language with their clients. During intensive training, MGH Chelsea patient navigators learn to build trust, wrangle appointments and resources, and help people understand unfamiliar procedures and treatments.
“We work with a lot of patients from different countries who don’t know about preventive cancer screenings,” says Joanne Toussaint, a Spanish-speaking patient navigator. “And if people do get diagnosed with cancer, there’s a lot to take in.”
At one time, Chelsea patients had a lower rate of colonoscopy — a screening test for colon cancer — than any other location served by Mass General. Assigning a patient navigator to encourage Spanish-speaking patients to come in for colonoscopies closed that healthcare gap.
“We increased the colonoscopy rate so much that there is no longer a disparity,” Ms. Oo says.
Financial Obstacles to Health Care
When people struggle financially, finding food and shelter often take priority over health. A language barrier may make scheduling appointments or locating offices difficult. Lining up transportation, childcare, time off work, or money for copays and other costs creates serious burdens.
“Going to Boston to the main MGH campus can be overwhelming,” says Ms. Toussaint, “especially if people don’t speak English or have physical impairments that might prevent them from going.” So navigators help patients setup and get to appointments with specialists at MGH Boston.
The patient navigator must listen carefully to patients, advocate for appointments beyond work hours or connect patients to free or low-cost transportation, a food pantry, a social worker or funds from a charitable organization.
To be effective, a navigator must listen carefully to patients to identify possible barriers to their health care. The navigator may advocate for appointments beyond work hours or connect patients to free or low-cost transportation, a food pantry, a social worker or funds from a charitable organization. Providing a highlighted map or note to show at the hospital — and, occasionally, even an escort to a first appointment — can smooth a patient’s path. Translation skills are essential, too.
A Worthy Goal
Ms. Toussaint recalls that after an abnormal mammogram, one patient from Honduras, who spoke only Spanish, needed many appointments: first for additional imaging, then for a biopsy, and later for breast cancer treatments, including a lumpectomy and six weeks of radiation therapy.
“She had no family in Chelsea,” recalls Ms. Toussaint. On weekdays, she woke at 4:30 am to walk to work, walk home, and then go for treatments.
Patient navigators at MGH Chelsea HealthCare helped orient her to MGH Boston by escorting her to her first appointment. Grocery cards were donated by the Ellie Fund. A grant covered the nearly impossible hurdle of $6 daily round-trips from Chelsea for six weeks. Securing evening radiation appointments allowed her to continue working throughout treatment, a financial necessity.
“It’s very rewarding to connect patients and see that they’re getting the healthcare they need,” Ms. Toussaint says. Thanks to Golf Fights Cancer, this worthy goal seems several steps closer.
For more information or to support the patient navigator program, please contact us.