Researchers at the University of Oklahoma have launched an innovative program aimed at reducing cancer care disparities among Indigenous populations in Oklahoma. The initiative, which focuses on enhancing navigation services, has successfully decreased missed appointments from 19% to 11% among participants.
The initiative is particularly significant as Indigenous Oklahomans face substantial barriers in accessing cancer care due to systemic issues within the Indian Health Service (IHS). The IHS, part of the U.S. Department of Health and Human Services, provides health services to American Indians and Alaska Natives through a network of federally and tribally administered facilities. However, chronic underfunding limits the availability of specialty services, such as cancer treatment, which often leads to patients requiring referrals through the IHS Purchased/Referred Care program.
This program is constrained by limited funding from Congress, making authorization for referrals a challenging process. Patients often encounter delays due to prior authorization requirements, and those who are uninsured face additional hurdles. To address these challenges, the OU Health Stephenson Cancer Center has operated an American Indian Navigation Program since 2012, assisting over 4,463 Indigenous patients from 65 different tribes.
Improving Access and Coordination
The new pilot program, funded by the American Cancer Society, was initiated to enhance navigation services for Indigenous patients. It ran from July 2023 to February 2025, serving 128 patients. Participants received individualized support from a nurse navigator, who assessed their financial hardships, psychosocial needs, and distress levels. The program also provided education on clinical trials and facilitated communication between oncologists and patients regarding their concerns.
Amanda Janitz, an associate professor of epidemiology at the OU Hudson College of Public Health and a member of the Choctaw Nation, highlighted the frustrations and communication barriers that previously existed between the cancer center and tribal health facilities. “We decided to continue moving this work forward,” she said.
The pilot program resulted in notable improvements, including a reduction in missed appointments and an increase in depression screenings from 72% to 100%. Furthermore, two-thirds of the patients received financial assistance for transportation and lodging, alleviating some of the logistical burdens associated with accessing care.
Future Initiatives and Goals
Building on the success of the pilot, Janitz and her team are set to launch the Care Coordination and Communication Program in Oncology for Tribal Health Systems, backed by a $17.2 million grant from the National Institutes of Health. This program will facilitate ongoing collaboration between the Stephenson Cancer Center and referring facilities through regular virtual “huddles.” These meetings will allow clinicians to discuss treatment plans while navigators and case managers address psychosocial needs and referral challenges.
Participants in this upcoming project will either receive the enhanced huddle services or standard navigation without them, although all will eventually gain access to improved services. The goal is to create a long-term, positive impact on the health of Indigenous Oklahomans undergoing cancer treatment.
“What I really like about these types of research projects is that we can see improvements for patients very quickly,” Janitz noted. The commitment to providing resources and support underscores the importance of addressing health disparities in Indigenous communities, ensuring that patients receive the comprehensive care they need during their cancer treatment journey.
