A new study revealed that clinical and nonclinical oncology navigators may perform very different functions and work in very different settings.
Clinical navigators, which included nurse and social worker navigators, were more likely to provide care coordination, treatment and peer support, and basic navigation services, compared with nonclinical navigators like community health workers, peers, or other degreed professions.
Kristen J. Wells, PhD, MPH, of San Diego State University, and colleagues conducted a study using online survey responses from 527 oncology navigators (76.1% were clinical navigators). The survey was designed to assess if clinical and nonclinical navigators differed regarding where in the cancer continuum they worked, differences in work environment, and differences or similarities in self-reported navigation tasks.
Compared with nonclinical navigators, clinical navigators were more likely to have a bachelor’s degree or higher (88.6% vs. 69.6%; P<.001). The researchers noted that under the nonclinical patient navigator staffing model, nonclinical navigators are not required to have a college degree, but this study showed that they are “in practice highly educated”.
Clinical navigators were also more likely to be funded by operational budgets (84.4% vs. 35.7%; P<.001), “which are assumed to be more stable than grant funding”, and less likely to work at a community-based organization or nonprofit (2.0% vs. 36.5%; P<.001).
“Our study indicates that nonclinical navigators may experience job insecurities even with high rates of college education because their funding mainly depends on grants, which may not be a stable source of income to employers,” the researchers wrote. “However, there were no differences in job tenure between clinical and nonclinical navigators across all settings.”
Clinical navigators were more likely to perform basic navigation (P<.001), care coordination (P<.001), treatment support (P<.001), and clinical trial/peer support (P=.005). Additionally, clinical navigators were more likely to engage in treatment (P<.001), end-of-life ( P<.001), and palliative care (P=.001) navigation compared with nonclinical navigators.
“Future research should investigate if there are differences in cancer-related outcomes by patient navigation staffing model,” the researchers wrote. “Finally, given the effectiveness of patient navigation, policy makers should create uniform approaches to reimburse all cancer patient navigators’ services nationwide.”
Comparing Clinical and Nonclinical Cancer Patient Navigators: A National Study in the United States