Developing a practice framework for patient navigation in cancer care: a Global Initiative to Advance Cancer Navigation for Better Outcomes (GINO) project

Abstract

Patient navigation comprises person-centred activities focused on addressing barriers and facilitating timely access to health care. Despite demonstrated effectiveness, the scope of patient navigation remains unclear. To clarify the scope of patient navigation and support global implementation, the Global Initiative to Advance Cancer Navigation for Better Outcomes (GINO) aimed to develop a practice framework for patient navigation in cancer care. Phase 1 involved reviewing patient navigation literature and identifying key areas of practice. Phase 2 involved a modified Delphi process with international experts in navigation (July to December 2024) to establish consensus on practices to include in the framework. Patient navigation experts across regions and disciplines were invited. Two rounds of online surveys were conducted where participants rated the importance of each practice on a scale from 1 ("Not important") to 5 ("Critically important"). Practices rated ≥4 by ≥ 75% of participants in Round 2 met consensus criteria. The remaining items were discussed in a consensus meeting. Eighty-one experts from 29 countries (n = 45, 56% high-income, n = 36, 44% low-middle-income) participated in Round 1. Of these, 60 also participated in Round 2, including healthcare practitioners (n = 30, 50%), navigators (n = 16, 27%), researchers (n = 24, 40%), and advocates (n = 10, 17%). After Round 2, 27/35 (77%) practices reached consensus for inclusion. After the consensus meeting, two items were reworded, and 32 items were included in the final framework. We reached consensus among international experts on the contents of the GINO practice framework for patient navigation in cancer care. By describing the scope of patient navigation, the framework can support the development and implementation of patient navigation programs globally.