Abstract B008: Implementing electronic health records-based intervention tools in a large NYC healthcare system to facilitate H. pylori eradication strategies for gastric cancer prevention for at-risk Chinese American immigrant patients
Authors: Kwon Simona , Tan Yi-Ling , Pan Janet , Mann Devin , Chokshi Sara , Williams Renee , Zhao QiuQu , Hailu Benyam , Trinh-Shevrin Chau 
Published: September 2020

Background: Gastric cancer is the third most common cause of cancer mortality worldwide. Chinese Americans experience a disproportionate burden of gastric cancer mortality. The bacterium Helicobacter pylori (H. pylori) is the strongest risk factor for gastric cancer; H. pylori eradication through triple antibiotic therapy is the most effective prevention method. Clinician adherence to the American College of Gastroenterology H. pylori treatment guidelines is not high. Medication adherence to the complex treatment regimen is challenging, especially for Chinese New Yorkers for whom 61% have limited English proficiency and low health literacy. Purpose of the Study: Working with an advisory coalition of community and health care safety net provider stakeholders, we developed a health-systems level intervention using electronic health record (EHR)-based tools to facilitate H. pylori treatment strategies for gastric cancer prevention. Methods: We used a mixed methods approach to inform EHR tool development, including: 1) a comprehensive scoping review of the peer reviewed and grey literature on gastric cancer prevention programs for Chinese Americans; 2) 4 site workflow analyses, which consisted of ethnographic observations and key informant interviews with 5 providers for contextual data on organizational workflow, culture and practice; and 3) 15 key informant interviews with community-based stakeholders and former patients. Results: Findings indicated the lack of culturally and linguistically tailored H. pylori and gastric cancer prevention materials. Using an iterative process, we developed 3 EHR-based tools: 1) a H. pylori medication order set for the most common first and second-line therapies; 2) basic health education materials for the patient in English and Chinese; and 3) a follow-up reminder for testing in 2 months to the patient’s primary care physician. Barriers and facilitators to implementation will be shared, including findings from utilization reports on patterns of use. Conclusion: There is a need to integrate system-wide EHR-based tools for underserved, vulnerable communities to enhance and sustain evidence-based practices for treatment adherence and cancer prevention to reduce H. pylori-related gastric cancer disparities for high-risk populations.

Citation Format: Simona Kwon, Yi-Ling Tan, Janet Pan, Devin Mann, Sara Chokshi, Renee Williams, QiuQu Zhao, Benyam Hailu, Chau Trinh-Shevrin. Implementing electronic health records-based intervention tools in a large NYC healthcare system to facilitate H. pylori eradication strategies for gastric cancer prevention for at-risk Chinese American immigrant patients [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 B008.