Abstract PO-082: Relationships between social determinants of health and cancer prevention navigation program outcomes in the Yale Cancer Disparities Firewall Project
Authors: Suttiratana Sakinah C. , Killins Monique , Behringer Hannah , Colon Jonathan , Reyes Eduardo , DeJesus Jose , Alsup Sarah , Herbst Roy , Jones Beth A. 
Published: December 2020

Background Patient navigation is an effective evidenced based strategy for cancer screening, diagnosis and treatment. The Yale Cancer Disparities Firewall (Firewall) launched a “health” navigation program that combines health navigators, technology and screening for social determinants of health (SDOH) to initiate ongoing wellness relationships with people in need of cancer screening and risk reduction support.

This study examines relationships between social factors identified in a routine social determinants of health screening and various endpoints in the health navigation program. Methodology Leveraging activities associated with an ongoing cancer outreach program, we recruit community members into “health” navigation based on management goals (e.g. healthy weight). Screening for SDOH and using a geocoded data platform, we map free/low-cost services within 5 miles of participants’ residential address. Resource lists are augmented with telephonic navigation and 1-year follow-up from navigators. Chi-square and t-tests were used to compare relationships between variables and means for quantitative data including social needs identified and navigation outcome completion rates. Results Between May 2019 and May 2020, 193 people expressed interest in receiving navigation support and 65 completed an intake process. Demographic characteristics of those who completed the intake were: 73.8% female, 20% immigrant, 63.1% Black/African American, 26.6% Latino. Intake responses identified at least one social determinant of health need for 70.8% of participants. Among SDOH needs identified by a validated screening tool, the top 3 SDOH needs were housing instability (41.0%), food insecurity (41.0%), and transportation (32.8%). Housing instability was associated with poorer self-rated health (χ2=9.93, d.f.=4, p=0.042), and fewer requests for help finding food (χ2=4.07, d.f.=41, p=.044); food insecurity was associated with making non-cancer medical appointments (χ2=7.95, d.f.=2, p=0.019); and transportation needs were associated with making cancer screening appointments (χ2=19.05, d.f.=4, p=0.001) and being less likely to report being overweight (χ2=5.98, d.f.=2, p=0.05). Relationships between navigation outcomes (e.g. navigation interactions), cancer risk factors and identified SDOH needs are also presented for this sample. Conclusions In this project, documentation of SDOH was associated with people’s likelihood of scheduling cancer screening appointments; however, utilization and follow through related to navigation resource referrals remain limited. Understanding barriers to resource uptake, goal setting and making appointments will be key to the development of future community-focused programs. Barriers to program participation and navigation goal achievement described by participants include: competing priorities, time constraints, financial constraints and inconsistent use of medical care.

Citation Format: Sakinah C. Suttiratana, Monique Killins, Hannah Behringer, Jonathan Colon, Eduardo Reyes, Jose DeJesus, Sarah Alsup, Roy Herbst, Beth A. Jones. Relationships between social determinants of health and cancer prevention navigation program outcomes in the Yale Cancer Disparities Firewall Project [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-082.