Researchers at the University of Oklahoma Health Campus have initiated a significant program aimed at reducing cancer care disparities faced by Indigenous Oklahomans. This innovative approach seeks to improve access to essential cancer services through enhanced navigation and communication support, addressing challenges in a historically underfunded healthcare system.
The pilot program, which ran from July 2023 to February 2025, successfully reduced missed appointments from 19% to 11%. It also provided financial assistance for travel needs to approximately two-thirds of participating patients. These efforts are crucial for Indigenous individuals who often encounter logistical and cultural barriers when seeking care in Oklahoma’s fragmented health landscape.
The Indian Health Service (IHS), part of the U.S. Department of Health and Human Services, plays a central role in delivering health services to American Indians and Alaska Natives. Indigenous Oklahomans typically receive care through the Indian Health System (IHS), which includes a mix of federally and tribally administered facilities. Unfortunately, the IHS is often constrained by chronic underfunding, leading to significant gaps in specialty services such as cancer care.
Navigating the referral process to obtain specialty care through the IHS Purchased/Referred Care program can be challenging. Patients often face delays due to stringent prior authorization requirements, and uninsured individuals encounter additional hurdles. The newly established patient navigation assistance program is designed to overcome these obstacles, facilitating smoother transitions between various healthcare providers.
The OU Health Stephenson Cancer Center has offered an American Indian Navigation Program since 2012, assisting over 4,463 Indigenous patients from 65 different tribes. This program helps identify eligible patients and ensures authorization for necessary treatments, lab work, and diagnostic imaging. According to Amanda Janitz, an associate professor of epidemiology at the OU Hudson College of Public Health and a member of the Choctaw Nation, the pilot program enhanced these navigation services by addressing specific barriers to cancer care.
Janitz noted, “There were a lot of times frustrations and communication challenges here at the cancer center, also at the tribal health facilities. So we decided to continue moving this work forward.” The pilot program provided personalized support through nurse navigators, who conducted screenings to assess patients’ financial hardships, psychosocial needs, and distress levels. The results showed a marked increase in depression screenings from 72% to 100%.
To further enhance communication, the program implemented regular virtual meetings between nurse navigators and tribal case managers. These meetings allowed for real-time discussions about patient needs and any obstacles they faced in accessing care. Janitz expressed optimism about the effectiveness of these virtual huddles, stating that they would continue to be part of future efforts.
Looking ahead, the researchers plan to expand these initiatives through the Care Coordination and Communication Program in Oncology for Tribal Health Systems, funded by a $17.2 million grant from the National Institutes of Health received last year. This program will focus on cancer prevention, screening, and improved care coordination.
As part of this initiative, teams from the Stephenson Cancer Center and referring facilities will engage in virtual “huddles” to collaboratively discuss patients’ treatment plans and address psychosocial needs. Janitz indicated that while participants will be randomized to receive either huddles or standard navigation services, all will eventually benefit from enhanced support.
Ultimately, the goal of these efforts is to create a lasting positive impact on the health of Indigenous Oklahomans. Janitz remarked, “What I really like about these types of research projects is that we can see improvements for patients very quickly. We’re working directly with patients who are undergoing cancer treatment, and we are providing them with some resources in terms of this enhanced navigation that we expect to be beneficial.”
The innovative approaches being developed at the University of Oklahoma offer hope for addressing long-standing disparities in cancer care among Indigenous populations, paving the way for more equitable health outcomes.
