Addressing barriers to care for African American men facing prostate cancer: a scoping review of navigation programs

Abstract

Purpose: African American/Black men are disproportionately impacted by prostate cancer (PCa). Patient navigation is an evidence-based approach to address barriers to care, improve access to care and health outcomes, and reduce disparities. This scoping review provides an in-depth examination of navigation programs in PCa care across the cancer continuum, with a focus on African American/Black men in the United States. Methods: We conducted a comprehensive literature search through September 1st, 2023, in PubMed, Embase, Web of Science, and CINAHL Complete, using keywords and index terms within three main themes: PCa, patient navigation, and African American/Black men. We included studies that described or investigated navigation programs/interventions for PCa from screening through survivorship and included at least 30% African American/Black men. Results: Of the 3,556 articles identified, 8 were included. Two articles covered the same navigation program—one reported the protocol and one reported quasi-experimental trial results. All but one study was conducted prior to 2012. The most common navigation activities reported were care coordination, education/information provision, and comfort/emotional support. Navigation improved screening uptake, PCa management, and access to supportive services. Only 3 articles provided information on navigation training. Both clinical (e.g., nurses) and non-clinical (e.g., peers) navigators were reported. Only 1 article discussed cultural tailoring to African American/Black men. Conclusion: Navigation programs in PCa care are beneficial; however, few studies were identified despite disease burden and disparities among African American/Black men. Contemporary navigation programs tailored for African American/Black men are needed to address persistent disparities.