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To facilitate access to care and to ensure adherence to diagnostic follow-up of positive breast cancer screening or prescribed treatment for confirmed cancer, community volunteers were used as patient navigators (PNs) for a population of low-income, medically under-served women, primarily African Americans. Partnerships were established with local healthcare facilities, residents from the targeted areas were hired as county coordinators, and community volunteers were trained to serve as PNs. Patients who had a suspicious mammogram or confirmed diagnosis of breast cancer were recruited from 23 Alabama counties. For these patients, barriers to diagnostic follow-up or treatment were identified by PNs, who assisted in overcoming these barriers by referring patients to appropriate treatment facilities, guiding them through the healthcare system, and providing the necessary logistical, social, or emotional support. With this intervention, patients kept 93% of their appointments. Thus, for medically under-served patients with breast cancer or a suspicious mammogram, intervention by a network of community volunteers serving as PNs improves adherence to follow-up diagnostic procedures and treatment. PNs can help close the gap between development and delivery of cancer treatments to those who are medically underserved. [ABSTRACT FROM AUTHOR]

There is growing evidence that physical activity (PA) can improve quality of life (QOL) and reduce fatigue in cancer survivors. Research staff or healthcare providers have delivered PA interventions to cancer populations. As a first step to dissemination of a previously tested PA intervention, seven American Cancer Society Reach to Recovery volunteers (mean age = 57.4 years) were trained to deliver the telephone-based intervention to 25 breast cancer survivors (mean age = 52.9 years, 56% Stage 2 cancer, mean of 3.3 years since diagnosis). A single group design was used. The theory-based intervention consisted of 12 weekly calls to encourage participants to adopt moderate-intensity PA. Participants' PA, QOL, mood, and fatigue were assessed at baseline, 12, and 24 weeks. Data on intervention feasibility and preliminary effects were collected. The intervention was feasible (mean of 10.7 out of 12 calls were delivered) and acceptable to the volunteers. At 12 weeks, there were significant increases in participants' PA and improvements in fatigue, QOL, and vigor. Effects were maintained at 24 weeks. This pilot study demonstrated that it was feasible for trained volunteers to deliver a telephone-based PA intervention to breast cancer survivors, and there were positive effects on survivors' PA behavior and psychological outcomes. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]