A Qualitative Evaluation of Factors Influencing the Lung Cancer Screening Program Navigator Role.

Background: Lung cancer screening program navigators improve adherence and patient experience. However, little is known about how navigators improve program outcomes.

Objective: The aim of this qualitative study was to explore factors influencing the lung cancer screening program navigator role.

Design: From December 2020 to September 2021, we conducted a cross-sectional qualitative study of in-depth interviews in the Veterans Health Administration.

Participants: We interviewed a national sample of healthcare team members involved in lung cancer screening at 10 Veterans Affairs Medical Centers.

Approach: We performed interviews to elicit data on lung cancer screening team and organizational characteristics, barriers to and facilitators of lung cancer screening, and factors influencing the navigator role. We utilized an iterative inductive-deductive approach for qualitative analysis based on the health systems science framework and relational coordination theory.

Participants: We conducted 30 interviews (participation rate = 56%). The 30 participants were predominantly physicians (47%), in primary care (33%), and with 1-10 years of experience in current role (37%).

Key Results: Participants indicated that both structural and relational factors influence the lung cancer screening program navigator role. Specifically, organizational support to strengthen the navigator's ability to function as a boundary spanner emerged as a key factor that can influence program outcomes such as efficient enrollment practices and program growth.

Conclusions: Healthcare team members involved in lung cancer screening indicated that navigators play an important role in impacting lung cancer screening programs. As lung cancer screening programs continue to evolve and expand, developing organizational structure and relational coordination to support navigators can positively impact program outcomes.