The Integration of Value Assessment and Social Network Methods for Breast Health Navigation Among African Americans

• Published in: Value in health Vol. 26; no. 10; pp. 1494 - 1502
• Main Authors: Molina, Yamilé, Kao, Szu-Yu, Bergeron, Nyahne Q., Strayhorn-Carter, Shaila M., Strahan, Desmona C., Asche, Carl, Watson, Karriem S., Khanna, Aditya S., Hempstead, Bridgette, Fitzpatrick, Veronica, Calhoun, Elizabeth A., McDougall, Jean
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2023
• Subjects: African American; Black or African American; breast cancer; Breast Neoplasms - diagnosis; Breast Neoplasms - prevention & control; cost-effectiveness; Early Detection of Cancer; Female; Health Promotion; Humans; Mammography; Patient Navigation; Social Networking; patient navigation; cost-effectiveness; breast cancer; African American
• ISSN: 1098-3015; 1524-4733; 1524-4733
• DOI: 10.1016/j.jval.2023.06.001

A major strategy to reduce the impact of breast cancer (BC) among African Americans (AA) is patient navigation, defined here as individualized assistance for reducing barriers to healthcare use. The primary focus of this study was to estimate the added value of incorporating breast health promotion by navigated participants and the subsequent BC screenings that network members may obtain. In this study, we compared the cost-effectiveness of navigation across 2 scenarios. First, we examine the effect of navigation on AA participants (scenario 1). Second, we examine the effect of navigation on AA participants and their networks (scenario 2). We leverage data from multiple studies in South Chicago. Our primary outcome (BC screening) is intermediate, given limited available quantitative data on the long-term benefits of BC screening for AA populations. When considering participant effects alone (scenario 1), the incremental cost-effectiveness ratio was $3845 per additional screening mammogram. When including participant and network effects (scenario 2), the incremental cost-effectiveness ratio was $1098 per additional screening mammogram. Our findings suggest that inclusion of network effects can contribute to a more precise, comprehensive assessment of interventions for underserved communities. •Social network methods are useful tools that have the potential to improve cost estimation about navigation and other interventions.•This article leverages a patient navigation study for improving breast health among African American women in Chicago to assess the utility of applying social network approaches for economic evaluation.•Our work highlights that integration of social network and economic evaluation methods may provide comprehensive, precise assessments for informed healthcare-related decision making.