Abstract
Introduction: Disparities persist related to supportive care interventions across the cancer continuum for racially and ethnically diverse patients. To meet these unique needs and mitigate the complexities of cancer care, we developed a non-nurse Population Health Navigator (PHN) program to reduce barriers to timely, quality care among traditionally underserved populations. The PHN is a novel approach to address concerns expressed by the community as part of a targeted outreach and engagement strategy by providing culturally and linguistically concordant navigation to reduce barriers to care, increase knowledge and awareness of clinical trials, and address supportive care needs. Methods: We purposively sampled patients presenting for oncology care to enroll a diverse sample with regards to race, ethnicity, insurance coverage, age, and cancer type. Participants completed a single interviewer-administered survey regarding their patient experience, including the 34-item Supportive Care Needs Survey assessing adult cancer patients’ perceived needs (Boyes et al., 2009). Race and ethnicity were self-reported at time of survey completion. ANOVA and chi-square/Fisher’s exact tests compared responses of non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic patients. Results: A majority of survey participants (N=247; participation rate 85%) were female (54.5%) and currently receiving active treatment (60.5%) with a median time since cancer diagnosis of 2.8 years. The racial and ethnic distribution of the sample was 50.6% NHW, 27.3% NHB, and 22.3% Hispanic. Hispanics were more likely to report less than a high school education (47.3% vs 10.4% NHW and 17.9% NHB) and not having enough money to meet the daily needs of their families (45.5% vs 13.6% NHW and 17.9% NHB), p<.001. Common cancer types included hematologic (36.4%), breast (20.7%), gastrointestinal (12.6%), and thoracic (9.3%). Hispanic patients indicated a statistically significant greater need for assistance with patient care and support (p=.0012) and health system and information needs (p=<.0001). There were no significant differences in physical and daily living, psychological, and sexual needs (p>0.10) between racial and ethnic groups. Conclusion: Among patients seeking care at the Wake Forest Baptist Comprehensive Cancer Center, differences in supportive care needs were identified for certain racial/ethnic populations. Implementation of a PHN program with non-nurse navigators may be a cost-effective way to provide culturally and linguistically appropriate support for patients with cancer, allowing for programmatic work to be responsive to the needs of underserved communities and ultimately helping to reduce cancer disparities.
Citation Format: Kelsey Shore, Kathryn E. Weaver, Karen M. Winkfield, Janet A. Tooze, Carla Strom, Jimmy Ruiz. Supportive care needs in diverse cancer patients treated at a Comprehensive Cancer Center [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D046.
