Researchers at the University of Oklahoma (OU) have launched a pilot program aimed at reducing cancer care disparities among Indigenous populations in Oklahoma. The initiative, which is part of a broader effort to improve healthcare access for these communities, has successfully decreased missed appointments from 19% to 11%. It also provided financial assistance for transportation and lodging, covering two-thirds of patients’ travel needs.
The program addresses significant barriers faced by Indigenous Oklahomans in accessing cancer care through the Indian Health Service (IHS). This agency, part of the U.S. Department of Health and Human Services, is tasked with delivering health services to American Indians and Alaska Natives. However, the IHS system, which includes federally administered facilities, tribal facilities, and urban Indian facilities, suffers from chronic underfunding. When specialized services, such as cancer treatment, are unavailable, patients often rely on the IHS Purchased/Referred Care program, which operates on limited congressional funds and can involve lengthy authorization processes.
Improving Access Through Patient Navigation
The OU Health Stephenson Cancer Center has been operating the American Indian Navigation Program since 2012, aiding over 4,463 Indigenous patients from 65 different tribes. This program assists patients in navigating the complexities of transitioning between the IHS and cancer care systems. Researchers, including Amanda Janitz, an associate professor of epidemiology at the OU Hudson College of Public Health and a member of the Choctaw Nation, have worked to enhance these navigation services.
The pilot program, funded by the American Cancer Society, took place from July 2023 to February 2025. It provided personalized support to 128 patients, including one-on-one interactions with a nurse navigator. This support involved screenings to assess financial hardships, psychosocial needs, and adherence to cancer treatment. Additionally, the program educated patients about clinical trials and communicated their concerns to oncologists.
Janitz noted the challenges in communication between the cancer center and tribal health facilities, which prompted the program’s development. The pilot’s results demonstrated a significant improvement in patient engagement, with depression screenings conducted increasing from 72% to 100%.
Future Initiatives in Cancer Care Coordination
Researchers plan to expand their efforts through a new initiative called the Care Coordination and Communication Program in Oncology for Tribal Health Systems. Funded by a $17.2 million grant from the National Institutes of Health, this project will further enhance cancer prevention, screening, and care coordination activities.
As part of this initiative, teams from the Stephenson Cancer Center and referring facilities will conduct virtual “huddles” to discuss treatment courses. These meetings will facilitate communication among clinicians and allow navigators and case managers to address psychosocial needs and referral challenges. The huddles will also be integrated into an upcoming clinical trial, where participants will be randomized to receive either the huddles or standard navigation services.
“What I really like about these types of research projects is that we can see improvements for patients very quickly,” Janitz remarked. “We’re working directly with patients who are undergoing cancer treatment, and we are providing them with some resources in terms of this enhanced navigation that we expect to be beneficial.”
Through these efforts, the researchers aim to create a long-term positive impact on the health outcomes of Indigenous Oklahomans. By addressing the logistical and cultural barriers faced by these communities, the initiative represents a significant step toward equitable healthcare access.
